Abstract
This study aimed to assess the cost-effectiveness of various public health measures in dealing with coronavirus disease 2019 (COVID-19) in China. A stochastic agent-based model was used to simulate the progress of the COVID-19 outbreak in scenario I (imported one case) and scenario II (imported four cases) with a series of public health measures. The main outcomes included the avoided infections and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to assess uncertainty. The results indicated that isolation-and-quarantine averted the COVID-19 outbreak at the lowest ICERs. The joint strategy of personal protection and isolation-and-quarantine averted one more case than only isolation-and-quarantine with additional costs. The effectiveness of isolation-and-quarantine decreased with lowering quarantine probability and increasing delay time. The strategy that included community containment would be cost-effective when the number of imported cases was >65, or the delay time of the quarantine was more than 5 days, or the quarantine probability was below 25%, based on current assumptions. In conclusion, isolation-and-quarantine was the most cost-effective intervention. However, personal protection combined with isolation-and-quarantine was the optimal strategy for averting more cases. The community containment could be more cost-effective as the efficiency of isolation-and-quarantine drops and the imported cases increases.
Highlights
The global number of reported cases of coronavirus disease 2019 (COVID-19) has surpassed 256 million in more than 200 countries as of November 23, 2021 [1]
With the introduction of one case, each strategy would avoid the number of cases and be cost-effective compared with no intervention (Table 2)
When the transmission constant was above one, and the quarantine probability was below 25%, program B was cost-effective (ICERs < three times per capita gross domestic product (GDP))
Summary
The global number of reported cases of coronavirus disease 2019 (COVID-19) has surpassed 256 million in more than 200 countries as of November 23, 2021 [1]. The number of COVID-19 cases is significantly higher than cases of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Statistics show that SARS caused more than 8,000 morbidities and MERS more than 2,200 morbidities in over 25 countries [2]. To prevent person-to-person transmission of COVID-19, several measurements have been implemented globally, including non-pharmaceutical interventions (NPIs) and pharmaceutical. Cost-Effectiveness of COVID-19 Controlling Measures interventions (PIs). Given humans’ limited immunity, NPIs are necessary in the fight against COVID-19. The isolation of infected cases and quarantine of humans exposed to these cases were the most common public health measures. Susceptible humans needed to wear masks and maintain good hygiene practices; from a national perspective, authorities introduced restrictions on public gatherings, movement, and public transportation
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