Cost-effectiveness of Public Health Strategies on COVID-19 Control: A Systematic Review

Abstract

The COVID-19 pandemic has been one of the greatest public health challenges imposing significant economic and societal costs. A wide range of public health interventions (PHIs) have been implemented to control the virus, with many aggressive measures that led to economic downturn and social calamity. However, evidence concerning their impacts in terms of costs and benefits of the best buy strategy is limited. This systematic review aimed to provide a critical summary of full economic evaluations (EEs) to inform decisions concerning their adoptions. A systemic search in 7 relevant databases and other sources were conducted. Out of 11,584 and 11 records identified from databases and other sources, a total 31 full EEs focusing on PHIs were included. Majority of studies included were in good quality and from the US and upper-middle, and high-income countries whereas only 6 studies were from low and middle-income countries. Suppression/containment was the most deployed strategy (n = 19), followed by screening/detection (n = 8), and protection (n = 4). Aggressive elimination strategy usually results in more lives or QALYs saved compared to mitigation strategies but at a very high cost. The trade-off between aggressive and loose suppressions depends on several factors including timing of implementation, duration, epidemiological characteristics of the virus, and the healthcare capacity. Tight and timely adoption of effective intervention at the early stage of pandemic is key in shrinking the number of cases. Using a combination approach is generally more cost-effective compared to a single intervention. Personal protective measure is highly cost-effective in protecting healthcare workers in a high prevalence scenario and when it is adopted together with social distancing strategy. Future studies to address the flaws of current evidence are warranted. This review provides important insights regarding adoption of PHIs and their cost-effectiveness which would be useful to inform policy decisions in response to COVID-19 and future pandemics.

The Impacts of COVID-19 Restrictions on Quality Adjusted Life Years (QALY): Heterogeneous effects and post-pandemic recovery

“…In addition, we perform our investigation in Latin America, where restrictions were particularly strict and where a context of high inequality highlights the importance of studying the heterogeneous effects. Economic evaluations of the cost-effectiveness of public health measures to deal with the pandemic have concentrated in high and middle income countries and have overlooked distributional concerns [ 20 , 21 ]. This makes our contributions particularly relevant, both from an academic perspective as well as an input for policy-making.…”

COVID-19: Understanding the New Variants of Concern

“…The populations at a higher risk of getting infected are the elderly, individuals with pre-existing medical conditions, and the immunocompromised [63] . In addition, many recovered individuals have also reported post-COVID conditions, which can last for weeks or even months after infection [64,65] . Symptoms of long COVID include fatigue, cough, chest tightness, breathlessness, palpitations, myalgia, difficulty focusing, and brain fog [66,67] .…”

COVID-19 Pandemic in Brunei Darussalam

“…Compared to other ASEAN countries, Brunei seems to have controlled the initial pandemic relatively rapidly, and the outbreak has been controlled for most of 2020 [33,34] . An effective pandemic control could be shown when zero local transmission was reported over 15 months [35,36] . Subsequently, new cases reported were limited to imported infections, bringing the total number of confirmed cases to 338 as of 1st August 2021 [21] .…”