The objective of this paper is to evaluate the potential costs deriving from the adoption of the CoViD-19 epidemic management strategy. For this purpose, we developed a specific methodology that combines an epidemiological model, known in the literature as “SIR” (Susceptible – Infected – Recovered), and a probabilistic state model, also known as “multi-state”. The model thus conceived was then parameterized using the dataset published by the Italian Government through the Civil Protection and the Istituto Superiore di Sanita. We therefore estimated the duration of the disease and the related costs, with reference to the strategy currently under discussion between government institutions and social organizations involved. Given the flexibility of the adopted approach, the tool will also be able to provide useful indications in relation to any alternative strategies that the Government...
Background COVID-19, an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), swept through China in 2019-2020, with over 80,000 confirmed cases reported by end of March 2020. This study estimates the economic burden of COVID-19 in 31 provincial-level administrative regions in China between January and March 2020. Methods The healthcare and societal cost of COVID-19 was estimated using bottom-up approach. The main cost components included identification, diagnosis and treatment of COVID-19, compulsory quarantine and productivity losses for all affected residents in China during the study period. Input data were obtained from government reports, clinical guidelines, and other published literature. The primary outcomes were total health and societal costs. Costs were reported in both RMB and USD (2019 value). Outcomes The total estimated healthcare...
Background: Movement restriction policies (MRPs) are effective in preventing/delaying COVID-19 transition but are associated with high societal cost. This study aims to estimate the health burden of the first wave of COVID-19 in China, and the cost-effectiveness of early versus late implementation of MRPs so to inform preparation for future waves. Methods: The SEIR (susceptible, exposed, infectious and recovered) modelling framework was adapted to simulate the health and cost outcomes of initiating MRPs at different times: rapid implementation (23 rd January, the real-world scenario), delayed by one week, delayed by two weeks and delayed by four weeks. The end point was set as the day when newly confirmed cases reached zero. Two costing perspectives were adopted: healthcare and societal. Input data were obtained from official statistics and published literature. The primary outcomes...
Repurposing’ existing drugs to treat COVID-19 is vital to reducing mortality and controlling the pandemic. Several promising drugs have been identified and are in various stages of clinical trials globally. If efficacy of these drugs is demonstrated, rapid, mass availability at an affordable cost would be essential to ensuring equity and access especially amongst low- and middle-income economies. Minimum costs of production were estimated from the costs of active pharmaceutical ingredients using established methodology, which had good predictive accuracy for medicines for hepatitis C and HIV amongst others. Data were extracted from global export shipment records or analysis of the route of chemical synthesis. The estimated costs were compared with list prices from a range of countries where pricing data were available. Minimum estimated costs of production were US $0.93/day for...
We explore how household consumption responds to epidemics, utilizing transaction-level household financial data to investigate the impact of the COVID-19 virus. As the number of cases grew, households began to radically alter their typical spending across a number of major categories. Initially spending increased sharply, particularly in retail, credit card spending and food items. This was followed by a sharp decrease in overall spending. Households responded most strongly in states with shelter-in-place orders in place by March 29th. We explore heterogeneity across partisan affiliation, demographics and income. Greater levels of social distancing are associated with drops in spending, particularly in restaurants and retail.
The issue of the cost effectiveness of measures taken to tackle COVID-19 are discussed in a BMJ feature article by John Appleby, director of research and chief economist at Nuffield Trust in the UK.Appleby notes that whilst it is hard to discuss the economics of COVID-19 whilst in the midst of an “unprecedented global emergency” during which measures are being taken to minimise mortality and morbidity, the question of cost benefit is one that all health systems routinely face. Although determining cost effectiveness may be viewed as a somewhat “heartless utilitarian” process, it is essentially concerned with fair use of scarce resources. However, this can be hard to apply when rescuing people in emergency situations, which leads Appleby to raise the question “does cost effectiveness even have a role when it comes to covid-19 − undeniably an emergency?”.Although modelling has...
We analyze an approach to managing the COVID-19 pandemic without shutting
down the economy while staying within the capacity of the healthcare system. We
base our analysis on a detailed heterogeneous epidemiological model, which
takes into account different population groups and phases of the disease,
including incubation, infection period, hospitalization, and treatment in the
intensive care unit (ICU). We model the healthcare capacity as the total number
of hospital and ICU beds for the whole country. We calibrate the model
parameters to data reported in several recent research papers. For high- and
low-risk population groups, we calculate the number of total and intensive care
hospitalizations, and deaths as functions of time. The main conclusion is that
countries, which enforce reasonable hygienic measures on time can avoid
lockdowns throughout the pandemic provided...
Background: Countries can decide between one of three COVID-19 control strategies: 1) elimination (e.g., some island countries); 2) suppression, to low infection rates; 3) or mitigation, as per pandemic influenza strategies with ensuing herd immunity. This paper quantifies the health (direct COVID-19 impact, and indirect through unemployment onto self-harm and road traffic crash) and cost (health system and societal) consequences for these strategies across Australia, New Zealand (NZ) and Sweden. Methods: We used proportional multistate lifetable (PMSLT) models for each country, with mortality and morbidity data from the Global Burden of Disease Study and health system expenditure from country-specific sources. Feeding into the PMSLT were monthly SARS-CoV-2 infection rates (0.1%/2.5%/60% for elimination/suppression/mitigation by 18 months), and anticipated changes in unemployment...
Many prominent people have advocated that the IMF undertake an “SDR allocation” to assist countries in dealing with the global financial crisis brought about by the COVID-19 pandemic. To most experts, the idea seems like a no-brainer, but some IMF shareholders have voiced concerns, particularly the United States, which has a controlling vote in the matter. If IMF shareholders show some leadership and bureaucratic flexibility, there are ways to allay the American government’s concerns and quickly get liquidity in the hands of countries who desperately need it.