Epidemiologic and economic modelling of optimal COVID-19 policy: public health and social measures, masks and vaccines in Victoria, Australia.

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  • Additional Information
    • Source:
      Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101774968 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2666-6065 (Electronic) Linking ISSN: 26666065 NLM ISO Abbreviation: Lancet Reg Health West Pac Subsets: PubMed not MEDLINE
    • Publication Information:
      Original Publication: [London] : Elsevier Ltd., [2020]-
    • Abstract:
      Background: Identifying optimal COVID-19 policies is challenging. For Victoria, Australia (6.6 million people), we evaluated 104 policy packages (two levels of stringency of public health and social measures [PHSMs], by two levels each of mask-wearing and respirator provision during large outbreaks, by 13 vaccination schedules) for nine future SARS-CoV-2 variant scenarios.
      Methods: We used an agent-based model to estimate morbidity, mortality, and costs over 12 months from October 2022 for each scenario. The 104 policies (each averaged over the nine future variant scenarios) were ranked based on four evenly weighted criteria: cost-effectiveness from (a) health system only and (b) health system plus GDP perspectives, (c) deaths and (d) days exceeding hospital occupancy thresholds.
      Findings: More compared to less stringent PHSMs reduced cumulative infections, hospitalisations and deaths but also increased time in stage ≥3 PHSMs. Any further vaccination from October 2022 decreased hospitalisations and deaths by 12% and 27% respectively compared to no further vaccination and was usually a cost-saving intervention from a health expenditure plus GDP perspective. High versus low vaccine coverage decreased deaths by 15% and reduced time in stage ≥3 PHSMs by 20%. The modelled mask policies had modest impacts on morbidity, mortality, and health system pressure. The highest-ranking policy combination was more stringent PHSMs, two further vaccine doses (an Omicron-targeted vaccine followed by a multivalent vaccine) for ≥30-year-olds with high uptake, and promotion of increased mask wearing (but not Government provision of respirators).
      Interpretation: Ongoing vaccination and PHSMs continue to be key components of the COVID-19 pandemic response. Integrated epidemiologic and economic modelling, as exemplified in this paper, can be rapidly updated and used in pandemic decision making.
      Funding: Anonymous donation, University of Melbourne funding.
      Competing Interests: Separate to the current study, the research group will likely soon receive funding from Moderna to conduct vaccine effectiveness studies in Australia. Moderna had no role in the current study.
      (© 2022 The Author(s).)
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    • Contributed Indexing:
      Keywords: COVID-19; Cost effectiveness; Economic; Modelling; Policy
    • Publication Date:
      Date Created: 20230125 Latest Revision: 20230214
    • Publication Date:
      20240105
    • Accession Number:
      PMC9851841
    • Accession Number:
      10.1016/j.lanwpc.2022.100675
    • Accession Number:
      36694478