Significance of the Study. The Known. Face masks were mandated in Victoria from 23 July 2020 onward, along with a 6-week stage three lockdown which commenced on 9 July 2020. Masks reduce the risk of infection with beta-coronaviruses. The New. Without masks, a 6-week lockdown and the current control measures would likely have resulted in a resurgence in Victoria by September 2020. Masks of modest to good quality with high enough usage (at least 50% of people) can substantially improve epidemic control. Early universal mask use results in a smaller epidemic than late mask use adoption.The ImplicationsThe Victorian government’s decision to mandate mask use is supported by our research. All efforts should be made to ensure the community have the information and means to obtain or make good quality cloth masks, along with instructions on correct mask use. High levels of mask use are...
Given the scarcity of safe and effective COVID-19 vaccines, a chief policy question is how to allocate them among different sociodemographic groups. This paper evaluates COVID-19 vaccine prioritization strategies proposed to date, focusing on their stated goals; the mechanisms through which the selected allocations affect the course and burden of the pandemic; and the main epidemiological, economic, logistical, and political issues that arise when setting the prioritization strategy. The paper uses a simple, age-stratified susceptible-exposed-infectious-recovered model to quantitatively assess the performance of alternative prioritization strategies with respect to avoided deaths, avoided infections, and life-years gained. We demonstrate that prioritizing essential workers is a viable strategy for reducing the number of cases and years of life lost, while the largest reduction in...
We analyze the determination of the optimal intensity and duration of social distancing policy aiming to control the spread of an infectious disease in a simple macroeconomic-epidemiological model. In our setting the social planner wishes to minimize the social costs associated with the levels of disease prevalence and output lost due to social distancing, both during and at the end of epidemic management program. Indeed, by limiting individuals’ ability to freely move or interact with others (since requiring to wear face mask or to maintain physical distance from others, or even forcing some businesses to remain closed), social distancing has on the one hand the effect to reduce the disease incidence and on the other hand to reduce the economy’s productive capacity. We analyze both the early and the advanced epidemic stage intervention strategies highlighting their implications...
We implement a model-based approach to identify the optimal allocation of a COVID-19 vaccine in the province of Alberta, Canada.
We develop an epidemiologic model to evaluate allocation strategies defined by age and risk target groups, coverage, effectiveness, and cost of vaccine. The model simulates hypothetical immunization scenarios within a dynamic context, capturing concurrent public health strategies and population behaviour changes.
In a scenario with 80% vaccine effectiveness, 40% population coverage, and prioritisation of those over the age of 60 at high-risk of poor outcomes, active cases are reduced by 17% and net monetary benefit increased by $263 million dollars, relative to no vaccine. Concurrent implementation of policies such as school closure and senior contact reductions have similar impacts on incremental net monetary benefit...
This paper reviews the management of the COVID-19 crisis and the difficulty of cost estimation model, comparing centralized management or bureaucratic government coaction and the agile market alternative or spontaneous social coordination. This is a study of Political Economy and Health Economics from the perspective of Austrian Economics. We describe and compare the al-ternative models, which are adapted to the current crisis. The analysis is based on the theorem of the impossibility of the economic calculation under coactive systems, and other principles of economy. In this context we pay also attention to collateral problems of the centralized and coac-tive management. Finally we propose a solution based on dynamic efficiency and the constitutions of wellbeing economics
To estimate the overall quality-adjusted life-years (QALYs) gained by averting 1 coronavirus disease 2019 (COVID-19) infection over the duration of the pandemic. A cohort-based probabilistic simulation model, informed by the latest epidemiological estimates on COVID-19 in the United States provided by the Centers for Disease Control and Prevention and literature review. Heterogeneity of parameter values across age group was accounted for. The main outcome studied was QALYs for the infected patient, patient’s family members, and the contagion effect of the infected patient over the duration of the pandemic. Averting a COVID-19 infection in a representative US resident will generate an additional 0.061 (0.016-0.129) QALYs (for the patient: 0.055, 95% confidence interval [CI] 0.014-0.115; for the patient’s family members: 0.006, 95% CI 0.002-0.015). Accounting for the contagion...
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.
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...
The COVID-19 pandemic has hit both the Spanish economy and the population’s health hard. The result is an unprecedented economic and social crisis due to uncertainty about the remedy and the socioeconomic effects on people’s lives. We performed a retrospective analysis of the macroeconomic impact of the COVID-19 pandemic in 2020 using key indicators of the Spanish economy for the 17 Autonomous Communities (ACs) of the country. National statistics were examined in the search for impacts or anomalies occurring since the beginning of the pandemic. To estimate the strength of the impact on each of the indicators analyzed, we used Bayesian structural time series. We also calculated the correlation between the rate of GDP decline during 2020 and the cumulative incidence of COVID-19 cases per 100,000 inhabitants in the ACs. In 2020, the cumulative impact on the gross domestic product was...
While COVID-19 has generated a massive burden of illness worldwide, healthcare workers (HCWs) have been disproportionately exposed to SARS-CoV-2 coronavirus infection. During the so-called ‘first wave’, infection rates among this population group have ranged between 10% and 20%, raising as high as one in every four COVID-19 patients in Spain at the peak of the crisis. Now that many countries are already dealing with new waves of COVID-19 cases, a potential competition between HCW and non-HCW patients for scarce resources can still be a likely clinical scenario. In this paper, we address the question of whether HCW who become ill with COVID-19 should be prioritised in diagnostic, treatment or resource allocation protocols. We will evaluate some of the proposed arguments both in favour and against the prioritisation of HCW and also consider which clinical circumstances might warrant...