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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...

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,...

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)....

AbstractThe rapid spread of the current COVID-19 pandemic has affected societies worldwide, leading to excess mortality, long-lasting health consequences, strained healthcare systems, and additional strains and spillover effects on other sectors outside health (i.e., intersectoral costs and benefits). In this perspective piece, we demonstrate the broader societal impacts of COVID-19 on other sectors outside the health sector and the growing importance of capturing these in health economic analyses. These broader impacts include, for instance, the effects on the labor market and productivity, education, criminal justice, housing, consumption, and environment. The current pandemic highlights the importance of adopting a societal perspective to consider these broader impacts of public health issues and interventions and only omit these where it can be clearly justified as appropriate to...

SARS-CoV-2 spreads quickly in dense populations, with serious implications for universities, workplaces, and other settings where exposure reduction practices are difficult to implement. Rapid screening has been proposed as a tool to slow the spread of the virus; however, many commonly used diagnostic tests (e.g., RT-qPCR) are expensive, difficult to deploy (e.g., require a nasopharyngeal specimen), and have extended turn-around times. We evaluated testing regimes that combined diagnostic testing using qPCR with high-frequency screening using a novel reverse-transcription loop-mediated isothermal amplification (RT-LAMP, herein LAMP) assay. We used a compartmental susceptible-exposed-infectious-recovered (SEIR) model to simulate screening of a university population. We also developed a Shiny application to allow administrators and public health professionals to develop optimal testing...

Covid-19 is a large shock to the economic system and just a few months of data changed the mean of many time series in significant ways. But while Covid-19 has economic consequences, it is not an economic shock. This creates a problem for the estimation of economic factors from the data. The persistence of its effects also suggests a need for unconventional predictors in factor-augmented regressions. This note uses covid indicators to adjust the post-covid data prior to factor estimation. The adjustment preserves the pre-covid variations in the factors estimates. The real activity factor in FRED-MD is estimated to be down nearly four standard deviations in March/April 2020. Using economic and covid factors to generate $h$ step ahead prediction errors, the JLN measure of uncertainty finds covid-19 to be the third most uncertain episode recorded since 1960.

The Covid-19 pandemic has led to large budget gaps of more than $8 trillion worldwide from higher spending requirements and reduced tax revenue. Sooner or later, policy makers must consider revenue sources to close these budget gaps and avoid debt