In this cluster-randomised controlled study (CoV-Surv Study), four different “active” SARS-CoV-2 testing strategies for general population surveillance are evaluated for their effectiveness in determining and predicting the prevalence of SARS-CoV-2 infections in a given population. In addition, the costs and cost-effectiveness of the four surveillance strategies will be assessed. Further, this trial is supplemented by a qualitative component to determine the acceptability of each strategy. Findings will inform the choice of the most effective, acceptable and affordable strategy for SARS-CoV-2 surveillance, with the most effective and cost-effective strategy becoming part of the local public health department’s current routine health surveillance activities. Investigating its everyday performance will allow us to examine the strategy’s applicability to real time prevalence prediction...
Introduction: Although patients’ clinical conditions were previously shown to be associated with coronavirus disease 2019 (COVID-19) severity and outcomes, their impact on hospital costs is not known. The economic evaluation of COVID-19 admissions allows the assessment of hospital costs associated with the treatment of these patients, including the main cost components and costs driven by demographic and clinical conditions. The aim of this study was to determine the COVID-19 hospitalization-related costs and their association with clinical conditions. Methods: Prospective observational cohort study of the hospitalization costs of patients with COVID-19 admitted between March 30 and June 30, 2020, who were followed until discharge, death, or external transfer, using micro-costing methodology. The study was carried out in the Central Institute of the Hospital das Clinicas, affiliated...
We compare and contrast the expected duration and number of infections and deaths averted among several designs for clinical trials of COVID-19 vaccine candidates, including traditional and adaptive randomized clinical trials and human challenge trials. Using epidemiological models calibrated to the current pandemic, we simulate the time course of each clinical trial design for 756 unique combinations of parameters, allowing us to determine which trial design is most effective for a given scenario. A human challenge trial provides maximal net benefits-averting an additional 1.1M infections and 8,000 deaths in the U.S. compared to the next best clinical trial design-if its set-up time is short or the pandemic spreads slowly. In most of the other cases, an adaptive trial provides greater net benefits.
Remdesivir is the first antiviral drug fully licensed for the treatment of patients with COVID-19. The use of remdesivir in 2020, can be summarised in five stages. First, between May and July, several regulatory agencies issued the authorisation—under emergency or conditional schemes—to treat selected patients hospitalised with COVID-19.1 Second, the manufacturer, Gilead, set a price of US$2340 for a 5-day treatment course in late June.2 Third, in October, the US Food and Drug Administration (FDA)3 granted full approval for use of remdesivir in adults and adolescent patients (aged 12 years or older; 40 kg) with COVID-19; it should be given intravenously for 5 days (six vials) to patients who do not need invasive mechanical ventilation or extracorporeal membrane oxygenation, or both, and 10 days (11 vials) in those who require this type of support. Fourth, the European Commission4...
The initial response to COVID-19 included quarantine policies. This study aims to determine the infection containment proportions and cost of two variations of quarantine policies based on geographic travel and close contact with infected individuals within deployed US military populations. Special Operations Command Africa (SOCAF) records of individuals quarantined between March 1, 2020 and June 1, 2020 were examined. The infection containment proportion and cost in containment hours were compared between types of quarantine and between geographic areas. Geographic quarantine contained 2 cases out of 63 quarantined individuals in West Africa (3.2%) compared to 0 out of 221 in East Africa (p = 0.0486). Close contact quarantine contained 3 cases out of 31 quarantined individuals in West Africa compared to 4 out of 55 in East Africa (7.3%, p = 0.6989). Total confinement was 42,048 h...
Background: COVID-19 causes more 1.3 million deaths globally in just nine months. Influenza is a virus with respiratory symptoms, fever, and systemic symptoms very similar to COVID 19. Various public health measures have been taken by governments and health authorities to prevent and control the pandemics. This study aimed to review the economic evaluation of public health measures against COVID-19 and influenza pandemics.Methods: We performed a systematic review of the literature to identify full economic evaluation studies on Influenza and COVID-19 pandemic published from 1998-2020. We built an exhaustive database search strategy. The search was done in Pubmed, Web of Science, EMBASE databases, and grey literature. We extracted data from selected studies using a structured data collection form after conducting a risk of bias assessment. Narrative summary tables were used to present...
Social distancing has been the only effective way to contain the spread of an
infectious disease prior to the availability of the pharmaceutical treatment.
It can lower the infection rate of the disease at the economic cost. A pandemic
crisis like COVID-19, however, has posed a dilemma to the policymakers since a
long-term restrictive social distancing or even lockdown will keep economic
cost rising. This paper investigates an efficient social distancing policy to
manage the integrated risk from economic health and public health issues for
COVID-19 using a stochastic epidemic modeling with mobility controls. The
social distancing is to restrict the community mobility, which was recently
accessible with big data analytics. This paper takes advantage of the community
mobility data to model the COVID-19 processes and infer the COVID-19 driven
economic values from major market...
A combination of public health strategies for controlling COVID-19 transmission and preventing deaths appears to be cost effective in South Africa, according to findings of a study published in The Lancet Global Health.The dynamic Clinical and Economic Analysis of COVID Interventions (CEACOV) microsimulation model, populated with data from literature published between January and June 2020, was used to evaluate the cost effectiveness of five public health epidemic control interventions in KwaZulu-Natal province, South Africa, over 360 days: COVID-19 testing alone, in patients presenting to healthcare centres; contact tracing in households with COVID-19 cases; isolation centres for cases not requiring hospital admission; mass symptom screening and molecular testing of symptomatic patients by community healthcare workers; and quarantine centres for household contacts who test negative...
The novel coronavirus disease (COVID-19) caused by a new strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains the current global health challenge. In this paper, an epidemic model based on system of ordinary differential equations is formulated by taking into account the transmission routes from symptomatic, asymptomatic and hospitalized individuals. The model is fitted to the corresponding cumulative number of hospitalized individuals (active cases) reported by the Nigeria Centre for Disease Control (NCDC), and parameterized using the least squares method. The basic reproduction number which measures the potential spread of COVID-19 in the population is computed using the next generation operator method. Further, Lyapunov function is constructed to investigate the stability of the model around a disease-free equilibrium point. It is shown that the model has...
The US Institute for Clinical and Economic Review (ICER) has provided a second update to previous pricing models for remdesivir [Veklury; Gilead Sciences] for the treatment of COVID-19. ICER initially released information on two pricing models for COVID-19 treatments in May 2020,1 and subsequently released updates to the ICER-COVID Cost Recovery Model and the ICER-COVID Cost-Effectiveness Model in June 2020.2In this second update, ICER reports that data from four trials (ACT-1, NCT04292730, RECOVERY and SOLIDARITY) investigating the effects of remdesevir on mortality in patients with COVID-19 do not support a survival benefit with remdesevir. However, data from the US-based ACT-1 trial suggest that remdesevir treatment may result in savings on insurer payments for hospital services.”Given these new data and remdesivir’s expanded label to include less severely ill patients, ICER now...