Cost-effectiveness of future lockdown policies against the COVID-19 pandemic

Gandjour, Afschin

doi:10.1177/09514848221080687

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…Some cities and countries implemented either complete or partial lockdown. However, individuals affected by restraint measures may experience a loss of personal freedom and autonomy under lockdown, and lower production efficiency from working at home for a long period may result [47,48]. Therefore, lockdown strategies and other extreme restrictions cannot be sustained for an extended period in one outbreak event.…”

Section: Discussionmentioning

confidence: 99%

The rapid and efficient strategy for SARS-CoV-2 Omicron transmission control: analysis of outbreaks at the city level

Zheng

Tian

et al. 2022

Infect Dis Poverty

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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron (B.1.1.529) variant is highly transmissible with potential immune escape. Hence, control measures are continuously being optimized to guard against large-scale coronavirus disease 2019 (COVID-19) outbreaks. This study aimed to explore the relationship between the intensity of control measures in response to different SARS-CoV-2 variants and the degree of outbreak control at city level. Methods A retrospective study was conducted in 49 cities with COVID-19 outbreaks between January 2020 and June 2022. Epidemiological data on COVID-19 were extracted from the National Health Commission, People’s Republic of China, and the population flow data were sourced from the Baidu migration data provided by the Baidu platform. Outbreak control was quantified by calculating the degree of infection growth and the time-varying reproduction number ($${R}_{t}$$ R t ). The intensity of the outbreak response was quantified by calculating the reduction in population mobility during the outbreak period. Correlation and regression analyses of the intensity of the control measures and the degree of outbreak control for the Omicron variant and non-Omicron mutants were conducted, respectively. Results Overall, 65 outbreaks occurred in 49 cities in China from January 2020 to June 2022. Of them, 66.2% were Omicron outbreaks and 33.8% were non-Omicron outbreaks. The intensity of the control measures was positively correlated with the degree of outbreak control (r = 0.351, P = 0.03). The degree of reduction in population mobility was negatively correlated with the Rt value (r = − 0.612, P < 0.01). Therefore, under the same control measure intensity, the number of new daily Omicron infections was 6.04 times higher than those attributed to non-Omicron variants, and the Rt value of Omicron outbreaks was 2.6 times higher than that of non-Omicron variants. In addition, the duration of non-Omicron variant outbreaks was shorter than that of the outbreaks caused by the Omicron variant (23.0 ± 10.7, 32.9 ± 16.3, t = 2.243, P = 0.031). Conclusions Greater intensity of control measures was associated with more effective outbreak control. Thus, in response to the Omicron variant, the management to restrict population movement should be used to control its spread quickly, especially in the case of community transmission occurs widely. Faster than is needed for non-Omicron variants, and decisive control measures should be imposed and dynamically adjusted in accordance with the evolving epidemic situation.

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Section: Discussionmentioning

confidence: 99%

The rapid and efficient strategy for SARS-CoV-2 Omicron transmission control: analysis of outbreaks at the city level

Zheng

Tian

et al. 2022

Infect Dis Poverty

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“…For example, the benefits of lockdowns (in terms of reduced new cases and mortality rate) realized from reduced mobility are uneven across countries [14]. In the situation of waning population immunity and increasing threats from new deadly variants, the lockdowns could have been a cost-effective strategy [15,16]. In other instances, however, the overall cost-benefit impact of imposing a lockdown was not so promising.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding the timing of implementation, researchers argued that the partial, inadequate, and/or delayed implementation of lockdowns was responsible for the continuous surge in COVID-19 cases [21,22]. Furthermore, over longer periods, lockdowns lose marginal benefits over other NPIs [15], they become economically unsustainable [16], and they carry risks of non-adherence [23]. Mobility restriction measures become ineffective as the pandemic progresses, and populations acquire immunity via immunization or acquired infection [24].…”

Section: Introductionmentioning

confidence: 99%

“…Soon after reporting initial travel-related cases, concerned states implemented measures like contact tracing and quarantines. However, cases kept rising in the country, reaching a "local transmission" level by 16 March 2020 [26]. For the first time in its history, India announced a complete threeweek lockdown at 8 PM on 23 March 2020, effective midnight 24 March 2020; it required 1.3 billion people to remain 'home'.…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?

2023

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Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown’s impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 March–31 May 2020), we modeled the epidemic’s trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. Results: The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, −15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, –204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). Conclusion: Maharashtra’s early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India.

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“…As such, it is not meant to be a cumulative analysis of all economic impacts stemming from a regulation. It is also distinct from cost-effectiveness analysis of risk-reducing policies, for which there is an enormous literature, including in the context of COVID-19 policies (e.g., Gandjour 2021Gandjour , 2022. As noted, mortality risk analysis uses cost-effectiveness estimates as inputs, but it is not the same as cost-effectiveness analysis.…”

Section: Introductionmentioning

confidence: 99%

A Mortality Risk Analysis for OSHA’s COVID-19 Emergency Regulations

Broughel

Baxter²

2022

JRFM

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In 2021, the Occupational Safety and Health Administration (OSHA) issued two emergency temporary standard regulations related to COVID-19 hazards in US workplaces. One regulation covered healthcare sector workers, while the second regulation would have covered workers at firms with 100 or more employees. This paper conducts an original mortality risk analysis for these regulations. Mortality risk analysis evaluates the increase or decrease in expected mortality associated with a new policy, such as a rule or regulation, taking into account economic factors like lost income due to regulatory costs. If we accept OSHA’s cost and health benefit estimates at face value, we find that the first regulation related to COVID-19 hazards in the healthcare sector reduces risk initially but increases risk over a longer time horizon. We find that the second regulation would reduce risk according to OSHA’s main estimates but may not reduce risk after including some ancillary costs and adjusting the agency’s prevented hospitalizations estimate based on more reasonable assumptions. Moreover, OSHA’s economic analysis for the two regulations in question does not purport to comprehensively evaluate costs; ergo, our mortality risk estimates probably underestimate countervailing mortality risks stemming from these regulations. We review some of OSHA’s underlying assumptions that could change the outcomes of our mortality analysis. These estimates demonstrate that OSHA would benefit from more comprehensive consideration of costs in its economic analysis.

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Cost-effectiveness of future lockdown policies against the COVID-19 pandemic

Cited by 8 publications

References 31 publications

The rapid and efficient strategy for SARS-CoV-2 Omicron transmission control: analysis of outbreaks at the city level

The rapid and efficient strategy for SARS-CoV-2 Omicron transmission control: analysis of outbreaks at the city level

COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?

A Mortality Risk Analysis for OSHA’s COVID-19 Emergency Regulations

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