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ABSTRACT Research in the current pandemic has put a sharp focus on the health burden of Covid-19, thereby largely neglecting the cost to life from the socioeconomic consequences of its containment. The paper develops a model for assessing their proportionality. It compares the years of life lost (YLL) due to Covid-19 and the socioeconomic consequences of its containment. The model reconciles the normative life table approach with de facto socioeconomic realities by correcting YLL estimates for socioeconomic differences in life expectancy. It thereby aims to improve on the attribution of YLL due to immediate and fundamental sources of inequalities in life expectancy. The application of the approach to the pandemic suggests that the socioeconomic consequences of containment measures potentially come with a much higher life tag than the disease itself and therefore need urgent...

Movement restriction policies (MRPs) are effective in preventing/delaying COVID-19 transmission 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 to inform preparation for future waves. The SEIR (susceptible, exposed, infectious, and recovered) modeling framework was adapted to simulate the health and cost outcomes of initiating MRPs at different times: rapid implementation (January 23, the real-world scenario), delayed by 1 week, delayed by 2 weeks, and delayed by 4 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 were disability-adjusted...

ABSTRACT Introduction A recent systematic review and meta-analysis by our group reported on thirteen published cohorts investigating 110,078 patients. Patients administered statins after their COVID-19 diagnosis and hospitalization were found to have a lower risk of mortality. Given this reported superiority, a logical next question would be whether statins are cost-effective treatment options for hospitalized COVID-19 patients. In this paper, we report on a cost-effectiveness analysis of statin-containing treatment regimens for hospitalized COVID-19 patients, from a United States healthcare perspective. Methods A Markov model was used, to compare statin use and no statin use among hospitalized COVID-19 patients. The cycle length was one week, with a time horizon of 4 weeks. A Monte Carlo microsimulation, with 20,000 samples were used. All analyses were conducted using TreeAge...

While highly effective in preventing SARS-CoV-2 spread, national lockdowns come with an enormous economic price. Few countries have adopted an alternative “testing, tracing, and isolation” approach to selectively isolate people at high exposure risk, thereby minimizing the economic impact. To assist policy makers, we performed a cost-effectiveness analysis of these 2 strategies. A modified Susceptible, Exposed, Infectious, Recovered, and Deceased (SEIRD) model was employed to assess the situation in Israel, a small country with ∼9 million people. The incremental cost-effectiveness ratio (ICER) of these strategies as well as the expected number of infected individuals and deaths were calculated. A nationwide lockdown is expected to save, on average, 274 (median 124, interquartile range: 71-221) lives compared to the “testing, tracing, and isolation” approach. However, the ICER...

This paper presents a two-way factor design incorporating both spatial and temporal variation in the prediction of COVID 19 in Africa. In line with this, the impact of COVID-19on the GDP in Africa is well scrutinized. In contrast to the existing works [1–3], this work also extends the two-factor design into the one-way factor design through incorporating covariates into spatial effects. The data rely on the spatial and temporal obtained from WHO datasets [4, 5]. The one-factor design with more covariates is taken into consideration to identify the major potential predictor variables responsible for the deaths and confirmed cases due to COVID 19 in Africa. The MANCOVA considered population density, temperature, humidity; perception, and wind are all considered as co-variates. Simulations show that the two-way analysis of variance has shown that there is a statistically...

Without widespread immunization, the road to recovery from the current COVID-19 lockdowns will optimally follow a path that finds the difficult balance between the social and economic benefits of liberty and the toll from the disease. We provide an approach that combines epidemiology and economic models, taking as given that the maximum capacity of the healthcare system imposes a constraint that must not be exceeded. Treating the transmission rate as a decreasing function of the severity of the lockdown, we first determine the minimal lockdown that satisfies this constraint using an epidemiology model with a homogeneous population to predict future demand for healthcare. Allowing for a heterogeneous population, we then derive the optimal lockdown policy under the assumption of homogeneous mixing and show that it is characterized by a bang-bang solution. Possibilities such as the...

In epidemiology, the effective reproduction number is used to characterize the growth rate of an epidemic outbreak. In this paper, we investigate properties of the reproduction number for a modified SEIR model of COVID-19 in the city of Houston, TX USA, in which the population is divided into low-risk and high-risk subpopulations. The response of reproduction number to two types of control measures (testing and distancing) applied to the two different subpopulations is characterized. A nonlinear cost model is used for control measures, to include the effects of diminishing returns. We propose three types of heuristic strategies for mitigating COVID-19 that are targeted at reducing reproduction number, and we exhibit the tradeoffs between strategy implementation costs and number of deaths. We also consider two variants of each type of strategy: basic strategies, which consider only...

The present study aimed to evaluate the cost-effectiveness of the 5-day remdesivir regimen compared with standard of care among severe COVID-19 patients in China, the evidence on which is essential to inform the necessity of securing access to remdesivir. A dynamic transmission model that extended the susceptible-exposed-infected-recovered framework by incorporating asymptomatic, presymptomatic and waiting-to-be-diagnosed patients was constructed to conduct the cost-effectiveness analysis from the healthcare system perspective. To estimate epidemic parameters, the model was first calibrated to the observed epidemic curve in Wuhan from 23 January to 19 March 2020. Following the calibration, the infected compartment was replaced by 3 severity-defined health states to reflect differential costs and quality of life associated with disease gravity. Costs and quality-adjusted life year...

This paper estimates the benefits and costs of state suppression policies to “bend the curve” during the initial outbreak of COVID-19 in the United States. We employ a value-of-production approach that values benefits and costs in terms of additions or subtractions to total production. Relative to a baseline in which only the infected and at-risk populations mitigate the spread of coronavirus, we estimate that total benefits of suppression policies are between $605.9 billion and $841.1 billion from early March 2020 to August 1, 2020. Relative to private mitigation, the costs of suppression policies are estimated to be between $214.2 billion and $331.5 billion. The cost estimate is based on the duration of nonessential business closures and stay-at-home orders, which were enforced between 42 and 65 days. Our results indicate that the net benefits of suppression policies to slow...