The cost-effectiveness of common strategies for the prevention of transmission of SARS-CoV-2 in universities [article]

Zafar Zafari, Peter Muennig
2020 medRxiv   pre-print
Background. As universities re-open, it is imperative to understand the added value of measures to prevent the transmission of SARS-CoV-2, the virus that causes COVID-19. Methods. We conducted a cost-effectiveness analysis of common public health interventions used by universities to reduce SARS-CoV-2 transmission. We use a Markov model with Monte Carlo simulations, cycling once per day. The model computes changes in infection among interacting groups of university affiliates both on and off
more » ... pus. Interventions are compared with the Centers for Disease Control and Prevention (CDC) guidelines at three different levels of actively infectious cases of COVID-19 in the community surrounding the university in terms of incremental cost per incremental quality-adjusted life year (QALY) gained. Results. When there are 100 infectious cases per 100,000 people in the community (0.1%), a symptom-checking mobile application is cost-effective relative to CDC guidelines alone. If the community active infectious case rate reaches 1%, providing high quality, 2-ply masks will be cost-saving. As the community prevalence rate of infectious cases reaches 2%, thermal imaging cameras cost $965,070/QALY gained (95% credible interval [CrI] = $198,821 QALY gained, $2.15 million/QALY gained). One-time PCR testing on entry costs $1.08 million/QALY gained (95% CrI = $170,703 QALY gained, $3.33 million/QALY gained). Weekly PCR testing costs $820,119 /QALY gained (95% CrI = $452,673 QALY gained, $1.68 million/QALY gained). Upgrades to ventilation systems or installation of far-UVC light systems will be cost-effective at a willingness-to-pay threshold of $150,000/QALY gained if aerosols account for 86% of all on-campus transmission of SARS-CoV-2. Conclusions. The value of commonly used interventions for the prevention of SARS-CoV-2 varies greatly with the rate of actively infectious cases of COVID-19 in the community surrounding the university.
doi:10.1101/2020.08.13.20166975 fatcat:n7jtcnmb3zagtfoqyhqv2m7rwm