The Clinical Impact and Cost Effectiveness of Intervention Policies Against the SARS-CoV-2 Pandemic: A Mathematical Modelling Analysis

Abstract

Background: To investigate the clinical and economic outcomes, of intervention policies combining nonpharmaceutical interventions and vaccination programs for dealing with the SARS-CoV-2 pandemic. Methods: An agent-based model transmission model was adopted which describes how a SARS-CoV-2 virus will spread in the populations of China. The model inputs were derived from literature and expert opinion. The following intervention policies were simulated: no intervention, strict nonpharmaceutical interventions, nonpharmaceutical intervention for workplace, community, school and home gradually dismissed by combining vaccination programs in pre-specified age groups. The cumulative infection and death in one calendar year, costs and quality adjusted life years (QALYs) were measured. Findings: When the vaccination program had been at least taken up in ≥20 years and all populations, nonpharmaceutical intervention for workplace and community settings could be gradually dismissed because the cumulative number of infections was < 100 per 100,000 persons. Further dismissing nonpharmaceutical intervention for school and home settings could not meet the target even when the vaccination program had been taken up in all populations. When cumulative death was used as the endpoint, nonpharmaceutical intervention in workplace, community and school settings could be gradually dismissed. Vaccine efficacy and coverage have substantial impacts. Dismissing nonpharmaceutical interventions in workplace settings could produce the lowest cost when vaccination programs are at least taken up at age ≥10 years, which also dominates most intervention strategies due to its lower costs and higher QALYs. Interpretation: Continued nonpharmaceutical interventions might be gradually dismissed until herd immunity is achieved. Funding: None to declare. Declaration of Interest: None to declare.