Disease burden attributable to the first wave of COVID-19 in China, and the effect of timing on the cost-effectiveness of movement restriction policies

TY - JOUR

T1 - Disease burden attributable to the first wave of COVID-19 in China, and the effect of timing on the cost-effectiveness of movement restriction policies

AU - Zhao, Jidi

AU - Jin, Huajie

AU - Li, Xun

AU - Jia, Jianguo

AU - Zhang, Chao

AU - Zhao, Huijuan

AU - Ma, Wuren

AU - Wang, Zhuozhu

AU - He, Yi

AU - Lee, Jimmy

AU - Yin, Bo

AU - Zheng, Weiwei

AU - Wang, Haiyin

AU - Pennington, Mark

PY - 2021/1/15

Y1 - 2021/1/15

N2 - Objectives Movement restriction policies (MRPs) are effective in preventing/delaying COVID-19 transition but are associated with high societal cost. This study aims to estimate the health burden of the first wave of COVID-19 in China, and the cost-effectiveness of early versus late implementation of MRPs so to inform preparation for future waves. Methods The SEIR (susceptible, exposed, infectious and recovered) modelling framework was adapted to simulate the health and cost outcomes of initiating MRPs at different times: rapid implementation (23rd January, the real-world scenario), delayed by one week, delayed by two weeks and delayed by four weeks. The end point was set as the day when newly confirmed cases reached zero. Two costing perspectives were adopted: healthcare and societal. Input data were obtained from official statistics and published literature. The primary outcomes were disability adjusted life-years (DALY), cost and net monetary benefit. Costs were reported in both Chinese currency Renminbi (RMB) and US Dollar value in 2019 (USD).Results The first wave of COVID-19 in China resulted in 38,348 DALYs lost (95% CI [19,417, 64,130]) and 2,639 billion RMB losses (95% CI [1,347, 4,688]). The rapid implementation strategy dominated all other delayed strategies. This conclusion was robust to all scenarios tested. At a willingness-to-pay threshold of 70,892 RMB (the national annual GDP per capita) per DALY saved, the probability for the rapid implementation to be the optimal strategy was 96.28%.Conclusions Early implementation of MRPs in response to COVID-19 reduced both the health burden and societal cost and thus should be used for future waves of COVID-19.

AB - Objectives Movement restriction policies (MRPs) are effective in preventing/delaying COVID-19 transition but are associated with high societal cost. This study aims to estimate the health burden of the first wave of COVID-19 in China, and the cost-effectiveness of early versus late implementation of MRPs so to inform preparation for future waves. Methods The SEIR (susceptible, exposed, infectious and recovered) modelling framework was adapted to simulate the health and cost outcomes of initiating MRPs at different times: rapid implementation (23rd January, the real-world scenario), delayed by one week, delayed by two weeks and delayed by four weeks. The end point was set as the day when newly confirmed cases reached zero. Two costing perspectives were adopted: healthcare and societal. Input data were obtained from official statistics and published literature. The primary outcomes were disability adjusted life-years (DALY), cost and net monetary benefit. Costs were reported in both Chinese currency Renminbi (RMB) and US Dollar value in 2019 (USD).Results The first wave of COVID-19 in China resulted in 38,348 DALYs lost (95% CI [19,417, 64,130]) and 2,639 billion RMB losses (95% CI [1,347, 4,688]). The rapid implementation strategy dominated all other delayed strategies. This conclusion was robust to all scenarios tested. At a willingness-to-pay threshold of 70,892 RMB (the national annual GDP per capita) per DALY saved, the probability for the rapid implementation to be the optimal strategy was 96.28%.Conclusions Early implementation of MRPs in response to COVID-19 reduced both the health burden and societal cost and thus should be used for future waves of COVID-19.

M3 - Article

SN - 1098-3015

JO - Value in Health

JF - Value in Health

ER -