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Evidence-Based, Cost-Effective Interventions To Suppress The COVID-19 Pandemic: A Systematic Review
dc.contributor.author | Juneau, Carl-Etienne et al. | |
dc.date.accessioned | 2020-07-14T18:32:15Z | |
dc.date.available | 2020-07-14T18:32:15Z | |
dc.date.issued | 2020-06-15 | |
dc.identifier.uri | https://doi.org/10.1101/2020.04.20.20054726 | en_US |
dc.identifier.uri | https://hdl.handle.net/20.500.12663/2045 | |
dc.description.abstract | Background: In an unparalleled global response, during the COVID-19 pandemic, 90 countries asked 3.9 billion people to stay home. Yet some countries avoided lockdowns and focused on other strategies, like contact tracing and case isolation. How effective and cost-effective are these strategies? We aimed to provide a comprehensive summary of the evidence on pandemic control, with a focus on cost-effectiveness. Methods: Following PRISMA systematic review guidelines, MEDLINE (1946 to April week 2, 2020) and Embase (1974 to April 17, 2020) were searched using a range of terms related to pandemic control. Articles reporting on the effectiveness or cost-effectiveness of at least one intervention were included and grouped into higher-quality evidence (randomized trials) and lower-quality evidence (other study designs). Results: We found 1,653 papers; 62 were included. Higher-quality evidence was only available to support the effectiveness of hand washing and face masks. Modelling studies indicated that these measures are highly cost-effective. For other interventions, lower-quality evidence suggested that: (1) the most cost-effective interventions are swift contact tracing and case isolation, surveillance networks, protective equipment for healthcare workers, and early vaccination (when available); (2) home quarantines and stockpiling antivirals are less cost-effective; (3) social distancing measures like workplace and school closures are effective but costly, making them the least cost-effective options; (4) combinations are more cost-effective than single interventions; (5) interventions are more cost-effective when adopted early and for severe viruses like SARS-CoV-2. For H1N1 influenza, contact tracing was estimated to be 4,363 times more cost-effective than school closures ($2,260 vs. $9,860,000 per death prevented). Conclusions: A cautious interpretation of the evidence suggests that for COVID-19: (1) social distancing is effective but costly, especially when adopted late and (2) adopting as early as possible a combination of interventions that includes hand washing, face masks, ample protective equipment for healthcare workers, and swift contact tracing and case isolation is likely to be the most cost-effective strategy. | en_US |
dc.language | English | en_US |
dc.subject | COVID-19 | en_US |
dc.subject | Coronavirus Infections | en_US |
dc.subject | Systematic Review | en_US |
dc.subject | Evidence-Based Practice | en_US |
dc.subject | Pandemics | en_US |
dc.subject | Betacoronavirus | en_US |
dc.title | Evidence-Based, Cost-Effective Interventions To Suppress The COVID-19 Pandemic: A Systematic Review | en_US |
eihealth.country | Global (WHO/OMS) | en_US |
eihealth.category | Public Health Interventions | en_US |
eihealth.type | Published Article | en_US |
eihealth.maincategory | Slow Spread / Reducir la Dispersión | en_US |
dc.relation.ispartofjournal | medRxiv | en_US |
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