A multi-age group cost-effectiveness analysis of lockdown to mitigate the spread of Covid-19

• Autor(a) principal: Lourenço, Diogo Filipe Braz
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10071/26419
• topic: COVID-19; Cost–benefit; Cost–effectiveness; Lockdown; Custo-benefício; Custo-eficácia; Confinamento

There is a growing recognition of the damage the lockdown has caused to economic and social life. A Markov model incorporates population susceptible (S) to infection, population infected (I) and contagious, and population removed (R). The removed group includes people who have died from the disease. The SIR model of disease propagation, informed by the retrospective clinical course of COVID-19 positive cases in Portugal was developed to assess the cost effectiveness of the lockdown. The data are taken from the Business Intelligence of the information technology support platform for the National Epidemiological Surveillance System (BI SINAVE). The confirmed cases of SARS-CoV-2 / COVID-19 infection data are between March 3, 2020 until July 12, 2022. The data on transitional probabilities, costs and utilities were retrieved from both the retrospective data and published literature. This manuscript also explores that the cost of preventing economic activity through lockdowns is heterogeneous within the population. The mortality risk for those over 65 years old from infection is substantially higher than those aged 20-49. The differences in mortality within the population merit examining the cost-benefits of lockdown for different age groups. We simulate the Markov model for three groups, young (20- 49), middle-aged (50-64) and old (65+). Our main result in this paper is that distancing measures can be significantly improved with targeted policies that apply differential lockdowns on the various risk groups. In the Portuguese public healthcare system and under specific hypotheses, from a societal perspective, lockdown provides more QALYs at lower cost for old than for both middle-aged and young population.