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Comparative Cost-Effectiveness of SARS-CoV-2 Testing Strategies
20 Pages Posted: 10 Nov 2020More...
Background: To mitigate the coronavirus pandemic that emerged in 2019 (COVID-19), countries worldwide have enacted unprecedented movement restrictions, social distancing measures, and face mask requirements. Until safe and efficacious vaccines or antiviral drugs become widely available, viral testing remains the primary mitigation measure for rapid identification and isolation of infected cases.
Methods: We evaluate the economic tradeoffs of expanding and accelerating SARS-CoV-2 testing using a multi-scale model that incorporates SARS-CoV-2 transmission at the population level and daily viral load dynamics at the individual level.
Findings: Assuming a willingness-to-pay of $100,000 per year of life lost (YLL) and a price of $5 per test, the strategy most likely to be cost-effective under a rapid transmission scenario (Re > 2) is daily testing followed by a one-week rather than two-week isolation period subsequent to test confirmation. Under lower transmission scenarios, weekly testing of the population is expected to be more cost effective. Expanded surveillance testing is expected to be cost effective if the price per test is less than $400 across all transmission rates considered.
Interpretation: Extensive expansion of testing coupled with isolation of confirmed cases is essential for mitigating the COVID-19 pandemic. Further, resources recouped from shortened isolation duration could be cost-effectively allocated to more frequent testing.
Funding Statement: US National Institutes of Health and US Centers for Disease Control and Prevention.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: Not applicable.
Keywords: COVID-19, SARS-CoV-2, Antigen test, Testing frequency, Epidemiological model, Cost effectiveness
Suggested Citation: Suggested Citation