Estimating Societal Costs Associated With Vision Loss And Delayed Cataract Surgery: The Potential Impact Of The COVID-19 Pandemic

IntroductionCataract surgery is the most commonly performed surgical procedure in the UK (approx. 472,000 annually). The suspension of interventions due to the COVID-19 pandemic, has had a devastating impact on patients' access to care. In the UK a complete cessation of elective cataract surgery during the crisis has been an unfortunate reality and encompassed a 14 week hiatus to services in the National Health Service. Patients on prolonged waiting lists may experience negative outcomes during the wait period, including vision loss, increased risk of falls, and ultimately, poorer health-related quality of life (HRQoL). The objective of this research was to estimate the potential societal costs associated with vision-loss related to prolonged waiting times for cataract surgery, as a consequence of COVID-19 in the UK.MethodsIn this analysis, we present estimates relating to two cohorts: a hypothetical cohort of 1,000 cataract surgeries and quarterly estimates of cataract surgeries in the UK. Quarterly estimates (n=122,969) were chosen to reflect a suspension of cataract surgeries for 14 weeks during the COVID-19 crisis. UK cataract surgery numbers were attained from EUROSTAT. Estimates for decreasing visual acuity for those waiting for surgery were attained from the literature, as were the cost estimates associated with cataract-related sight-loss, which were made up of direct, indirect and intangible costs. Five scenarios (at 20% intervals) were simulated for the cost estimates, assuming from 20 percent to 100 percent clearing of waiting lists.ResultsFor cohort 1 (1,000 patients), the societal costs associated patients remaining on waiting list for one year, ranged between GBP 237,765 (EUR 279,533) (20% of patients remain untreated) to GBP 1.18m (EUR 1.39m) (100% remain untreated). For cohort 2 (n=122,969) cost estimates are in the region of GBP 29.23m to GBP 146.18m (EUR 34.36m to EUR 171.73m). Estimates consist of direct (15.6%), indirect (28.7%) and intangible costs (55.6%).ConclusionsCataract surgery is a sight saving procedure and its impact on HRQoL is overwhelmingly positive. Prolonged waiting times for cataract patients due to COVID-19 is likely to be associated with significant societal costs.

Prediction of the Normalized COVID-19 Epidemic Prevention Costs of Construction Projects Based on an Optimized Neural Network

During the COVID-19 epidemic, the Chinese central government adopted a dynamic clearing prevention and control strategy. Meanwhile, most local governments issued policies to incorporate normal epidemic prevention costs into the costs of construction projects. However, there are few provisions on how to determine the calculation standards for these costs. To accurately predict the normalized epidemic prevention costs of construction projects from different aspects, the relevant factors that affect epidemic prevention costs are investigated and an optimized neural network prediction method that can effectively eliminate abnormal data with a too large deviation is proposed. The results show that compared with the traditional backpropagation (BP) neural network and BP neural networks optimized by genetic algorithm, the error of the optimized neural network achieves a smaller error in predicting the normalized epidemic prevention costs of construction projects (the average error of the traditional BP neural networks is 6%). Meanwhile, among the factors that affect epidemic prevention costs, total investment, project category, and construction scale have the greatest impact. Based on the research results, this paper proposes pricing suggestions and corresponding management solutions for the epidemic prevention costs of construction projects, which will be helpful to project managers. [ FROM AUTHOR] Copyright of Mathematical Problems in Engineering is the property of Hindawi Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Does Distance Matter for Trade in Services? The Case of Interprovincial Trade in Canada

We examine the impact of geographic distance, economic size, and jurisdictional borders on Canadian interprovincial trade in services at the industry level. Using a gravity model, we find that the average elasticity of service trade with respect to distance is − 1.1, which coincides with the median estimate of average elasticity of merchandise trade with respect to distance. However, the point estimates of the elasticity of distance are significantly higher in magnitude in Arts and Health, while distance matters much less for Telecommunications and Information Technology. We also find that the elasticity of trade with respect to exporter and importer gross domestic product is highly industry specific. Our findings suggest that distance is still a key determinant of service trade and the income elasticity of demand is heterogeneous within the service sector.

Advancing Urban Water Security in the Indus Basin, Pakistan—Priority Actions for Karachi and Lahore

Despite growing recognition of solutions to water scarcity challenges, decision-makers across the world continue to face barriers to effective implementation of water planning, governance and management. This is evident in the cases of Lahore and Karachi in the Indus Basin in Pakistan and illustrated through the experiences of the provincial government departments and utilities. Water scarcity and associated challenges are continuing to impose significant costs on these cities, which continue to grow as water availability further declines, demand increases, water quality deteriorates, and infrastructure degrades. A team of Australian water experts was commissioned by the Australian Water Partnership to diagnose urban water challenges and identify priority actions for improved water security, in collaboration with Pakistani partners. This paper presents the outcomes of that work. This includes a synthesis of the published literature and data on the geographical, climatic, and water scarcity contexts of both Karachi and Lahore. It then identifies responses to water insecurity that have been considered or implemented in the past and the barriers that have inhibited the effectiveness of these efforts. Finally, it presents actions within five priority action areas that Pakistani stakeholders have identified as being most practical and impactful for improving water security outcomes.