Clinical and Economic Effects of Widespread Rapid Testing to Decrease SARS-CoV-2 Transmission.
Ann Intern Med
; 174(6): 803-810, 2021 06.
Article
in English
| MEDLINE | ID: covidwho-1120310
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See preprint
ABSTRACT
BACKGROUND:
The value of frequent, rapid testing to reduce community transmission of SARS-CoV-2 is poorly understood.OBJECTIVE:
To define performance standards and predict the clinical, epidemiologic, and economic outcomes of nationwide, home-based antigen testing.DESIGN:
A simple compartmental epidemic model that estimated viral transmission, portrayed disease progression, and forecast resource use, with and without testing. DATA SOURCES Parameter values and ranges as informed by Centers for Disease Control and Prevention guidance and published literature. TARGET POPULATION U.S. population. TIME HORIZON 60 days. PERSPECTIVE Societal; costs included testing, inpatient care, and lost workdays. INTERVENTION Home-based SARS-CoV-2 antigen testing. OUTCOMEMEASURES:
Cumulative infections and deaths, number of persons isolated and hospitalized, and total costs. RESULTS OF BASE-CASEANALYSIS:
Without a testing intervention, the model anticipates 11.6 million infections, 119 000 deaths, and $10.1 billion in costs ($6.5 billion in inpatient care and $3.5 billion in lost productivity) over a 60-day horizon. Weekly availability of testing would avert 2.8 million infections and 15 700 deaths, increasing costs by $22.3 billion. Lower inpatient outlays ($5.9 billion) would partially offset additional testing expenditures ($12.5 billion) and workdays lost ($14.0 billion), yielding incremental cost-effectiveness ratios of $7890 per infection averted and $1 430 000 per death averted. RESULTS OF SENSITIVITYANALYSIS:
Outcome estimates vary widely under different behavioral assumptions and testing frequencies. However, key findings persist across all scenarios, with large reductions in infections, mortality, and hospitalizations. Costs per death averted are roughly an order of magnitude lower than commonly accepted willingness-to-pay values per statistical life saved ($5 to $17 million).LIMITATIONS:
Analysis was restricted to at-home testing. There are uncertainties concerning test performance.CONCLUSION:
High-frequency home testing for SARS-CoV-2 with an inexpensive, imperfect test could contribute to pandemic control at justifiable cost and warrants consideration as part of a national containment strategy. PRIMARY FUNDING SOURCE National Institutes of Health.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Mass Screening
/
COVID-19 Testing
/
COVID-19
/
Home Care Services
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
North America
Language:
English
Journal:
Ann Intern Med
Year:
2021
Document Type:
Article
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