Association of Simulated COVID-19 Policy Responses for Social Restrictions and Lockdowns With Health-Adjusted Life-Years and Costs in Victoria, Australia

Blakely, Tony; Thompson, Jason; Bablani, Laxman; Andersen, Patrick; Ouakrim, Driss Ait; Carvalho, Natalie; Abraham, P.; Boujaoude, Marie-Anne; Katar, Ameera; Akpan, Edifofon; Wilson, Nick; Stevenson, Mark

doi:10.1001/jamahealthforum.2021.1749

Cited by 20 publications

(20 citation statements)

References 18 publications

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“…Existing acute COVID-19 morbidity estimates were updated to reflect current knowledge of Omicron infection symptom duration and severity across patient sub-groups (Appendix 4). 15,29 Years of life lost (YLLs) due to COVID-19 deaths were estimated using standard burden of disease methods, multiplying deaths due to COVID-19 with the average remaining life expectancy of those who died (with reference life expectancy by sex and age obtained from the 2019 GBD, retrieved from the Institute for Health Metrics and Evaluation [IHME] results tool). 30 This approach assumes no future changes to all-cause mortality rates, no difference in the mortality rates for those who die of COVID-19 and no discounting of YLLs.…”

Section: Methodsmentioning

confidence: 99%

The health impact of long COVID during the 2021-2022 Omicron wave in Australia: a quantitative burden of disease study

Howe

Szanyi

Blakely

2022

Preprint

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Objectives To quantify the morbidity impact of long COVID in Australia during the 2021-2022 Omicron wave in comparison to acute COVID-19 morbidity and mortality, and to other causes of morbidity and mortality in Australia. Design Burden of disease study using inputs from previously published population-based case-control, cross-sectional, or cohort studies. Setting Australia Participants People with symptomatic COVID-19 infection from 10/12/21 to 09/04/22. Main outcomes measured Years lived with disability (YLDs) from acute COVID-19 and long COVID measured as the product of the prevalence, duration and severity of each long COVID symptom determined from existing literature, summed across all long COVID symptoms and applied to the population of COVID-19 surviving cases in Australia during the 2021-2022 Omicron wave. Additionally, acute COVID YLDs and years of life lost from COVID deaths were estimated to generate total COVID-19 disability-adjusted life years (DALYs). Results During the Omicron wave in Australia, 5,300 (95% uncertainty interval [UI] 2,200-8,400) YLDs were attributable to long COVID, accounting for 74% of the overall YLDs from COVID-19 infections in this period. The overall DALYs due to COVID-19 in this four-month period were 51,000 (95% UI 21,000-80,900), comprising 2.4% of total DALYs. This is comparable to the health loss caused by dementia and drug use disorders. Conclusion Long COVID requires consideration in pandemic policy planning given it is responsible for the majority of the total morbidity loss from COVID-19, even during an Omicron wave in a highly vaccinated population. Further research into the symptom profile and duration of long COVID following Omicron infection, and more robust severity measurement, will allow for more accurate estimation of long COVID morbidity.

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Section: Methodsmentioning

confidence: 99%

The health impact of long COVID during the 2021-2022 Omicron wave in Australia: a quantitative burden of disease study

Howe

Szanyi

Blakely

2022

Preprint

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“…Ideally, this unvaccinated subset would only consist of members of the population who are unable to receive the vaccine due to medical or health-related reasons. In practice, idealized herd immunity for SARS-CoV-2 is likely to be difficult to reach, as supported by various models [7][8][9][10][11][12][13][14][15][16][17][18][19]. Thus, it is important to determine whether there is a 'practical' vaccination coverage level at which introduced infections do not lead to outbreaks, or small outbreaks can be effectively suppressed with only mild additional public health interventions such as testing, contact tracing, isolation and quarantine (TTIQ).…”

Section: Introductionmentioning

confidence: 99%

Modelling herd immunity requirements in Queensland: impact of vaccination effectiveness, hesitancy and variants of SARS-CoV-2

Sanz-Leon

Hamilton

Raison

et al. 2022

Phil. Trans. R. Soc. A.

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Long-term control of SARS-CoV-2 outbreaks depends on the widespread coverage of effective vaccines. In Australia, two-dose vaccination coverage of above 90% of the adult population was achieved. However, between August 2020 and August 2021, hesitancy fluctuated dramatically. This raised the question of whether settings with low naturally derived immunity, such as Queensland where less than 0.005 % of the population is known to have been infected in 2020, could have achieved herd immunity against 2021’s variants of concern. To address this question, we used the agent-based model C ovasim . We simulated outbreak scenarios (with the Alpha, Delta and Omicron variants) and assumed ongoing interventions (testing, tracing, isolation and quarantine). We modelled vaccination using two approaches with different levels of realism. Hesitancy was modelled using Australian survey data. We found that with a vaccine effectiveness against infection of 80%, it was possible to control outbreaks of Alpha, but not Delta or Omicron. With 90% effectiveness, Delta outbreaks may have been preventable, but not Omicron outbreaks. We also estimated that a decrease in hesitancy from 20% to 14% reduced the number of infections, hospitalizations and deaths by over 30%. Overall, we demonstrate that while herd immunity may not be attainable, modest reductions in hesitancy and increases in vaccine uptake may greatly improve health outcomes. This article is part of the theme issue ‘Technical challenges of modelling real-life epidemics and examples of overcoming these’.

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“…Such factors include the probability of re‐entry of the virus after initial elimination (and the probability that any such outbreaks can be successfully controlled); the time to produce and availability of a vaccine or highly effective antivirals; and the cost‐benefit ratio of any strategy when taking into account other health, economic and social factors. 51 Here, we present a model that was both robust and flexible enough to assist decision‐makers think through and analyse critical public health policies and their consequences in real‐time. As indicated by the Victorian Government's Chief Health Officer, Professor Brett Sutton, in his public address on Sunday 8 November 2020, the evidence provided through this work was “extraordinarily helpful” in assisting the government to chart Victoria's course to safety in 2020.…”

Section: Discussionmentioning

confidence: 99%

“…There are multiple factors countries must consider in weighing up the benefits of individual infectious disease suppression strategies or preparing themselves to be resilient in the face of second and subsequent waves of infections in the absence of adequate vaccine coverage. Such factors include the probability of re‐entry of the virus after initial elimination (and the probability that any such outbreaks can be successfully controlled); the time to produce and availability of a vaccine or highly effective antivirals; and the cost‐benefit ratio of any strategy when taking into account other health, economic and social factors 51 . Here, we present a model that was both robust and flexible enough to assist decision‐makers think through and analyse critical public health policies and their consequences in real‐time.…”

Section: Discussionmentioning

confidence: 99%

Modelling SARS‐CoV‐2 disease progression in Australia and New Zealand: an account of an agent‐based approach to support public health decision‐making

Thompson

McClure

Blakely

et al. 2022

Australian and New Zealand Journal of Public Health

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Objective : In 2020, we developed a public health decision‐support model for mitigating the spread of SARS‐CoV‐2 infections in Australia and New Zealand. Having demonstrated its capacity to describe disease progression patterns during both countries’ first waves of infections, we describe its utilisation in Victoria in underpinning the State Government's then ‘RoadMap to Reopening’. Methods : Key aspects of population demographics, disease, spatial and behavioural dynamics, as well as the mechanism, timing, and effect of non‐pharmaceutical public health policies responses on the transmission of SARS‐CoV‐2 in both countries were represented in an agent‐based model. We considered scenarios related to the imposition and removal of non‐pharmaceutical interventions on the estimated progression of SARS‐CoV‐2 infections. Results : Wave 1 results suggested elimination of community transmission of SARS‐CoV‐2 was possible in both countries given sustained public adherence to social restrictions beyond 60 days’ duration. However, under scenarios of decaying adherence to restrictions, a second wave of infections (Wave 2) was predicted in Australia. In Victoria's second wave, we estimated in early September 2020 that a rolling 14‐day average of <5 new cases per day was achievable on or around 26 October. Victoria recorded a 14‐day rolling average of 4.6 cases per day on 25 October. Conclusions : Elimination of SARS‐CoV‐2 transmission represented in faithfully constructed agent‐based models can be replicated in the real world. Implications for public health : Agent‐based public health policy models can be helpful to support decision‐making in novel and complex unfolding public health crises.

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Association of Simulated COVID-19 Policy Responses for Social Restrictions and Lockdowns With Health-Adjusted Life-Years and Costs in Victoria, Australia

Abstract: This economic evaluation determines the optimal policy response to the COVID-19 pandemic in Victoria, Australia, using a net monetary benefit approach for policies ranging from aggressive elimination and moderate elimination to tight suppression and loose suppression.

Cited by 20 publications

References 18 publications

The health impact of long COVID during the 2021-2022 Omicron wave in Australia: a quantitative burden of disease study

The health impact of long COVID during the 2021-2022 Omicron wave in Australia: a quantitative burden of disease study

Modelling herd immunity requirements in Queensland: impact of vaccination effectiveness, hesitancy and variants of SARS-CoV-2

Modelling SARS‐CoV‐2 disease progression in Australia and New Zealand: an account of an agent‐based approach to support public health decision‐making

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