Abstract
BackgroundStudies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence.MethodologyThe spread of disease and social response are simulated under several different intervention strategies. The modeled social response depends upon the perceived risk of the disease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response.ConclusionsThe model-based simulations suggest that the least-cost disease control strategy depends upon the perceived risk of the disease, as well as media intervention. The most cost-effective solution for diseases with low perceived risk was to implement moderate control measures. For diseases with higher perceived severity, such as SARS or Ebola, the most cost-effective strategy shifted toward intervening earlier in the outbreak, with greater resources. When intervention elicited increased media involvement, it remained important to control high severity diseases quickly. For moderate severity diseases, however, it became most cost-effective to implement no intervention and allow the disease to run its course. Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy.
Highlights
Despite progress in the fight against infectious diseases, they remain a persistent threat to global health, resulting in approximately 15 million deaths annually [1]
Our simulation results imply that, when diseases are perceived as severe, the costs of social response have a significant influence on selecting the most cost-effective strategy
These studies attempt to quantify the cost to society imposed by the spread of disease, and by the intervention itself
Summary
Despite progress in the fight against infectious diseases, they remain a persistent threat to global health, resulting in approximately 15 million deaths annually [1]. Modeling studies have investigated the cost-effectiveness of a number of intervention strategies, including vaccination, anti-viral use, and social distancing [2,3,4,5] These studies attempt to quantify the cost to society imposed by the spread of disease (such as death, disability, and lost productivity resulting from illness), and by the intervention itself (such as vaccines, anti-virals, and lost productivity resulting from social distancing). They determine which strategy minimizes the overall cost of the outbreak. These disruptions, which we call social response, can include heightened anxiety, strain on healthcare infrastructure, economic losses, or violence
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