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The study objective assessed the energy demand and economic cost of two hospital-based COVID-19 infection control interventions: negative pressure (NP) treatment rooms and xenon pulsed ultraviolet (XP-UV) equipment. After projecting COVID-19 hospitalizations, a Hospital Energy Model and Infection De-escalation Models quantified increases in energy demand and reductions in infections. The NP intervention was applied to 11, 22, and 44 rooms for small, medium, and large hospitals, while the XP-UV equipment was used eight, nine, and ten hours a day. For small, medium, and large hospitals, the annum kWh for NP rooms were 116,700 kWh, 332,530 kWh, 795,675 kWh, which correspond to annum energy costs of $11,845 ($1,077/room), $33,752 ($1,534/room), and $80,761 ($1,836/room). For XP-UV, the annum-kilowatt-hours (and costs) were 438 ($45), 493 ($50), and 548 ($56) for small, medium, and...

The rapid, unexpected, and large-scale expansion of the SARS-CoV-19 pandemic has led to a global health and economy crisis. However, although the crisis itself is a worldwide phenomenon, there have been considerable differences between respective countries in terms of SARS-CoV-19 morbidities and fatalities as well as the GDP impact. The object of this paper was to study the influence of the SARS-CoV-19 pandemic on global gross domestic product. We analyzed data relating to 176 countries in the 11-month period from February 2020 to December 2020. We employed SARS-CoV-19 morbidity and fatality rates reported by different countries as proxies for the development of the pandemic. The analysis employed in our study was based on moving median and quartiles, Kendall tau-b coefficients, and multi-segment piecewise-linear approximation with Theil-Sen trend lines. In the study, we...

Treatment with tocilizumab in combination with dexamethasone appears to be cost effective in reducing COVID-19-related deaths, according to findings of a US study published in Clinical Infectious Diseases.A decision-tree model populated with data from the randomised RECOVERY trial, which was conducted in the UK, was used to evaluate the cost effectiveness of tocilizumab plus dexamethasone, compared with dexamethasone alone or best supportive care (BSC) alone, in patients with severe COVID-19 infection. Cost effectiveness was assessed from a US perspective. Assumed drug costs were $5304 for tocilizumab and $12 for dexamethasone, and assumed annual healthcare costs in COVID-19 survivors were $6929 per year.Tocilizumab plus dexamethasone, dexamethasone alone and BSC alone were estimated to achieve a gain 9.36, 8.66 and 8.43 QALYs, respectively, at a total cost of $83 130,...

Focusing only on cases and deaths hides the pandemic’s lasting health burden on people, societies and economies.

The COVID-19 pandemic has brought dramatic worldwide consequences affecting social, economic and healthcare systems. Considering that the number of infected patients requiring admission to intensive care units far exceeded the available resources, healthcare professionals have had to face challenging decisions concerning who should benefit from the limited resources and who should not. In this context, after a careful ethical reflection, we propose some principles to be adopted when dealing with allocation resource decisions, based on core ethical values. Ideally, these strategies should be established and integrated into institutional policies before a crisis scenario, in order to anticipate a potential new public health emergency and prevent possible tragic consequences.

A new susceptible-exposed-infected-asymptomatically infected-removed (SEIAR) model is developed to depict the COVID-19 transmission process, considering the latent period and asymptomatically infected. We verify the suppression effect of typical measures, cultivating human awareness, and reducing social contacts. As for cutting off social connections, the feasible measures encompass social distancing policy, isolating infected communities, and isolating hub nodes. Furthermore, it is found that implementing corresponding anti-epidemic measures at different pandemic stages can achieve significant results at a low cost. In the beginning, global lockdown policy is necessary, but isolating infected wards and hub nodes could be more beneficial as the situation eases. The proposed SEIAR model emphasizes the latent period and asymptomatically infected, thus providing theoretical support...

  COVID-19 has caused an enormous burden on healthcare facilities around the world. Cohorting patients and healthcare professionals (HCPs) into “bubbles” has been proposed as an infection-control mechanism. In this paper, we present a novel and flexible model for clustering patient care in healthcare facilities into bubbles in order to minimize infection spread. Our model aims to control a variety of costs to patients/residents and HCPs so as to avoid hidden, downstream adverse effects of clustering patient care. This model leads to a discrete optimization problem that we call the BubbleClustering problem. This problem takes as input a temporal visit graph, representing HCP mobility, including visits by HCPs to patient/resident rooms. The output of the problem is a rewired visit graph, obtained by partitioning HCPs and patient rooms into bubbles and rewiring HCP visits to patient...

For mitigating the COVID-19 pandemic, much emphasis is made on implementing non-pharmaceutical interventions to keep the reproduction number below one. However, using that objective ignores that some of these interventions, like bans of public events or lockdowns, must be transitory and as short as possible because of their significant economic and societal costs. Here, we derive a simple and mathematically rigorous criterion for designing optimal transitory non-pharmaceutical interventions for mitigating epidemic outbreaks. We find that reducing the reproduction number below one is sufficient but not necessary. Instead, our criterion prescribes the required reduction in the reproduction number according to the desired maximum of disease prevalence and the maximum decrease of disease transmission that the interventions can achieve. We study the implications of our theoretical...