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. 2023 May 9:11:1099116.
doi: 10.3389/fpubh.2023.1099116. eCollection 2023.

Cost-effectiveness analysis of COVID-19 screening strategy under China's dynamic zero-case policy

Haonan Li  1   2 , Hui Zhang  1   2
Affiliations

Cost-effectiveness analysis of COVID-19 screening strategy under China's dynamic zero-case policy

Haonan Li et al. Front Public Health. .

Abstract

This study aims to optimize the COVID-19 screening strategies under China's dynamic zero-case policy through cost-effectiveness analysis. A total of 9 screening strategies with different screening frequencies and combinations of detection methods were designed. A stochastic agent-based model was used to simulate the progress of the COVID-19 outbreak in scenario I (close contacts were promptly quarantined) and scenario II (close contacts were not promptly quarantined). The primary outcomes included the number of infections, number of close contacts, number of deaths, the duration of the epidemic, and duration of movement restriction. Net monetary benefit (NMB) and the incremental cost-benefit ratio were used to compare the cost-effectiveness of different screening strategies. The results indicated that under China's COVID-19 dynamic zero-case policy, high-frequency screening can help contain the spread of the epidemic, reduce the size and burden of the epidemic, and is cost-effective. Mass antigen testing is not cost-effective compared with mass nucleic acid testing in the same screening frequency. It would be more cost-effective to use AT as a supplemental screening tool when NAT capacity is insufficient or when outbreaks are spreading very rapidly.

Keywords: COVID-19; China; agent-based model; cost-effectiveness; dynamic zero-case policy; screening strategy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Schematic of dynamic zero-case policy.
Figure 2
Figure 2
Different states of agents in COVID-19 transmission model. Susceptible S, Latent L, Pre-symptomatic P, Quarantined Q, Asymptomatic Ia, Symptomatic Is, Hospitalized H, Recovered R, Deceased D.
Figure 3
Figure 3
Simulation results of COVID-19 transmission under different strategies in two scenarios.
Figure 4
Figure 4
Total cost and community screening cost under different strategies in two scenarios.
Figure 5
Figure 5
One-way sensitivity analysis results. (A) Impact of parameters on the total cost of S8 in scenario I. (B) Impact of parameters on the total cost of S8 in scenario II.
See this image and copyright information in PMC

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