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The COVID-19 global pandemic has caused significant global economic and social disruption. In McKibbin and Fernando (2020), we used data from historical pandemics to explore seven plausible scenarios of the economic consequences if COVID-19 were to become a global pandemic. In this paper, we use currently observed epidemiological outcomes across countries and recent data on sectoral shutdowns and economic shocks to estimate the likely global economic impacts of the pandemic under six new scenarios. The first scenario explores the outcomes if the current course of COVID-19 is successfully controlled, and there is only a mild recurrence in 2021. We then explore scenarios where the opening of economies results in recurrent outbreaks of various magnitudes and countries respond with and without economic shutdowns. We also explore the impact if no vaccine becomes available and the world...

The substantial increase in demand for medical care in intensive care units (ICUs) caused by the recent appearance of coronavirus disease 2019 (COVID-19) has placed severe pressure on hospital beds. Although countries have intensified efforts to contain or delay the spread of COVID-19, they must prepare to cope with the growing demand for critical care inpatient beds or risk being overwhelmed by the pandemic. The subject of this paper is the COVID-19 pandemic and the opportunity cost from the perspective of health economics using the supply and demand model of hospital bed days in ICUs. In this context, it has been seen that there is an excess demand for hospital beds that exceeds the supply of bed days provided by the health system, generating opportunity costs for patients who cannot be admitted to ICUs because beds are not available. Policymakers must take into account the...

  While several non-pharmacological measures have been implemented for a few months in an effort to slow the coronavirus disease (COVID-19) pandemic in the United States, the disease remains a danger in a number of counties as restrictions are lifted to revive the economy. Making a trade-off between economic recovery and infection control is a major challenge confronting many hard-hit counties. Understanding the transmission process and quantifying the costs of local policies are essential to the task of tackling this challenge. Here, we investigate the dynamic contact patterns of the populations from anonymized, geo-localized mobility data and census and demographic data to create data-driven, agent-based contact networks. We then simulate the epidemic spread with a time-varying contagion model in ten large metropolitan counties in the United States and evaluate a combination of...

The emergence of SARS-CoV-2 and attempts to limit its spread have resulted in a contraction of the global economy. Here we document the socioeconomic impacts of the pandemic among households, adults and children in low-income countries. To do so, we rely on longitudinal household survey data from Ethiopia, Malawi, Nigeria and Uganda, originating from pre-COVID-19 face-to-face household surveys plus phone surveys implemented during the pandemic. We estimate that 256 million individuals-77% of the population-live in households that have lost income during the pandemic. Attempts to cope with this loss are exacerbated by food insecurity and an inability to access medicine and staple foods. Finally, we find that student-teacher contact has dropped from a pre-COVID-19 rate of 96% to just 17% among households with school-aged children. These findings can inform decisions by governments...

Waiting for procedures delayed by COVID-19 may cause anxiety and related adverse consequences. To synthesize research on the mental health impact of waiting and patient-centred mitigation strategies that could be applied in the COVID-19 context. Using a scoping review approach, we searched 9 databases for studies on waiting lists and mental health and reported study characteristics, impacts and intervention attributes and outcomes. We included 51 studies that focussed on organ transplant (60.8%), surgery (21.6%) or cancer management (13.7%). Most patients and caregivers reported anxiety, depression and poor quality of life, which deteriorated with increasing wait time. The impact of waiting on mental health was greater among women and new immigrants, and those of younger age, lower socio-economic status, or with less-positive coping ability. Six studies evaluated educational...

The World Health Organization elimination goal for cervical cancer relies on screening 70% of women at ages 35 and 45, preferentially through molecular HPV testing. The SARS-CoV-2 pandemic has led to an unprecedented demand for molecular tests and platforms. Our objective was to gain insight into the impact of SARS-CoV-2 on the actual or anticipated shortage of tests, equipment, consumables, and staff required to deliver molecular HPV laboratory services and to consider the implications for the sustainability and development of cervical screening programs. A 19-item online questionnaire was created and made available online between December 2020 and February 2021. Five companies with clinically validated HPV and SARS-CoV-2 tests in their portfolios were invited to provide a statement on the volumes of molecular COVID-19 tests produced, relevant changes to manufacturing capacity,...

The rapid spread of the Coronavirus (COVID-19) confronts policy makers with the problem of measuring the effectiveness of containment strategies, balancing public health considerations with the economic costs of social distancing measures. We introduce a modified epidemic model that we name the controlled-SIR model, in which the disease reproduction rate evolves dynamically in response to political and societal reactions. An analytic solution is presented. The model reproduces official COVID-19 cases counts of a large number of regions and countries that surpassed the first peak of the outbreak. A single unbiased feedback parameter is extracted from field data and used to formulate an index that measures the efficiency of containment strategies (the CEI index). CEI values for a range of countries are given. For two variants of the controlled-SIR model, detailed estimates of the...

Background: Molecular testing (PCR) is the recommended method for the diagnosis of coronavirus disease 19 (COVID-19). In low-resource settings (LRS), the availability and public health impact of these tests is constrained. Despite lower sensitivity, antigen detection rapid diagnostic tests (Ag-RDTs) could provide improved access at lower costs and quicker turnaround-time (TAT). We evaluated the optimal use of Ag-RDTs to increase testing access within TAT and reduce the cost and the number of cases missed in LRS. Methods: We modeled estimated COVID-19 testing demand coverage based on current PCR capacity in three different epidemic phases across five African countries. We then modelled five additional testing strategies that utilized a combination of PCR and Ag-RDT. For each strategy, epidemic phase and country, we estimated the total number of correct test results expected within...

COVID-19 test sensitivity and specificity have been widely examined and discussed, yet optimal use of these tests will depend on the goals of testing, the population or setting, and the anticipated underlying disease prevalence. We model various combinations of key variables to identify and compare a range of effective and practical surveillance strategies for schools and businesses. We coupled a simulated data set incorporating actual community prevalence and test performance characteristics to a susceptible, infectious, removed (SIR) compartmental model, modeling the impact of base and tunable variables including test sensitivity, testing frequency, results lag, sample pooling, disease prevalence, externally-acquired infections, symptom checking, and test cost on outcomes including case reduction and false positives. Increasing testing frequency was associated with a non-linear...

In response to the COVID-19 pandemic, the UK first adopted physical distancing measures in March, 2020. Vaccines against SARS-CoV-2 became available in December, 2020. We explored the health and economic value of introducing SARS-CoV-2 immunisation alongside physical distancing in the UK to gain insights about possible future scenarios in a post-vaccination era. We used an age-structured dynamic transmission and economic model to explore different scenarios of UK mass immunisation programmes over 10 years. We compared vaccinating 75% of individuals aged 15 years or older (and annually revaccinating 50% of individuals aged 15-64 years and 75% of individuals aged 65 years or older) to no vaccination. We assumed either 50% vaccine efficacy against disease and 45-week protection (worst-case scenario) or 95% vaccine efficacy against infection and 3-year protection (best-case scenario)....