lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

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

47 Pages Posted: 30 Jun 2020

See all articles by Jidi Zhao

Jidi Zhao

East China Normal University - Department of Public Administration

Huajie Jin

King's College London - King's Health Economics

Xun Li

Fudan University - Key Laboratory of Public Health Safety; Fudan University - Key Laboratory of Health Technology Assessment

Jianguo Jia

Tongji University - Development Institute

Chao Zhang

Fudan University - Key Laboratory of Public Health Safety; Fudan University - Key Laboratory of Health Technology Assessment

Huijuan Zhao

Fudan University - Key Laboratory of Public Health Safety; Fudan University - Key Laboratory of Health Technology Assessment

Wuren Ma

Fudan University - Key Laboratory of Public Health Safety; Fudan University - Key Laboratory of Health Technology Assessment

Zhuozhu Wang

Zhejiang University

Yi He

Curtin University of Technology, Australia

Jimmy Lee

University of California, Los Angeles (UCLA)

Donglan Zhang

University of Georgia - Department of Health Policy and Management

Bo Yin

Fudan University - Huashan Hospital

Weiwei Zheng

Fudan University - Key Laboratory of Public Health Safety; Fudan University - Key Laboratory of Health Technology Assessment

Haiyin Wang

Shanghai Health Development Research Centre - Health Technology Assessment Research Department

Mark Pennington

King's College London - King's Health Economics

More...

Abstract

Background: 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 (23 rd 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).

Findings: The first wave of COVID-19 in China resulted in 55,337 DALYs lost and 382 billion USD losses. 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) per DALY saved, the probability for the rapid implementation to be the optimal strategy was 89%.

Interpretation: 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.Funding National Social Science Foundation and Shanghai Municipal Commission of Health and the Family.

Funding Statement: This work is supported by National Social Science Foundation (No. 18BGL235) and Shanghai Municipal Commission of Health and the Family Foundation for Young Talents (2017YQ023).

Declaration of Interests: MP received personal fees from Merck, outside the submitted work. Other than these, the authors declare no competing interests.

Ethics Approval Statement: This study did not access individual patient data. Hence, ethical approval and patient informed consents were not required.

Keywords: COVID-19; Disease Burden; Cost-effectiveness Analysis; Timing; Movement Restriction Policies; DALY

Suggested Citation

Zhao, Jidi and Jin, Huajie and Li, Xun and Jia, Jianguo and Zhang, Chao and Zhao, Huijuan and Ma, Wuren and Wang, Zhuozhu and He, Yi and Lee, Jimmy and Zhang, Donglan and Yin, Bo and Zheng, Weiwei and Wang, Haiyin and Pennington, Mark, 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 (5/17/2020). Available at SSRN: https://ssrn.com/abstract=3605199 or http://dx.doi.org/10.2139/ssrn.3605199

Jidi Zhao

East China Normal University - Department of Public Administration

North Zhongshan Road Campus
3663 N. Zhongshan Rd.
Shanghai, 200062
China

Huajie Jin

King's College London - King's Health Economics ( email )

Strand
London, England WC2R 2LS
United Kingdom

Xun Li

Fudan University - Key Laboratory of Public Health Safety

China

Fudan University - Key Laboratory of Health Technology Assessment

China

Jianguo Jia

Tongji University - Development Institute

Shanghai
China

Chao Zhang

Fudan University - Key Laboratory of Public Health Safety

China

Fudan University - Key Laboratory of Health Technology Assessment

China

Huijuan Zhao

Fudan University - Key Laboratory of Public Health Safety

China

Fudan University - Key Laboratory of Health Technology Assessment

China

Wuren Ma

Fudan University - Key Laboratory of Public Health Safety

China

Fudan University - Key Laboratory of Health Technology Assessment

China

Zhuozhu Wang

Zhejiang University

38 Zheda Road
Hangzhou, Zhejiang 310058
China

Yi He

Curtin University of Technology, Australia

Australia

Jimmy Lee

University of California, Los Angeles (UCLA)

405 Hilgard Avenue
Box 951361
Los Angeles, CA 90095
United States

Donglan Zhang

University of Georgia - Department of Health Policy and Management

105 Spear Rd
Rhodes Hall, Health Sciences Campus
GA 30602
United States

Bo Yin

Fudan University - Huashan Hospital ( email )

Beijing West District Baiyun Load 10th
Shanghai, 100045
China

Weiwei Zheng (Contact Author)

Fudan University - Key Laboratory of Public Health Safety ( email )

China

Fudan University - Key Laboratory of Health Technology Assessment

China

Haiyin Wang

Shanghai Health Development Research Centre - Health Technology Assessment Research Department

NO.181 Xinbei Road
Shanghai 201199
China

Mark Pennington

King's College London - King's Health Economics

Strand
London, England WC2R 2LS
United Kingdom

Click here to go to TheLancet.com

Paper statistics

Abstract Views
1,012
Downloads
64
PlumX Metrics