College Campuses and COVID-19 Mitigation: Clinical and Economic Value.
Ann Intern Med
; 174(4): 472-483, 2021 04.
Article
in English
| MEDLINE | ID: covidwho-1201212
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:
Colleges in the United States are determining how to operate safely amid the coronavirus disease 2019 (COVID-19) pandemic.OBJECTIVE:
To examine the clinical outcomes, cost, and cost-effectiveness of COVID-19 mitigation strategies on college campuses.DESIGN:
The Clinical and Economic Analysis of COVID-19 interventions (CEACOV) model, a dynamic microsimulation model, was used to examine alternative mitigation strategies. The CEACOV model tracks infections accrued by students and faculty, accounting for community transmissions. DATA SOURCES Data from published literature were used to obtain parameters related to COVID-19 and contact-hours. TARGET POPULATION Undergraduate students and faculty at U.S. colleges. TIME HORIZON One semester (105 days). PERSPECTIVE Modified societal. INTERVENTION COVID-19 mitigation strategies, including social distancing, masks, and routine laboratory screening. OUTCOMEMEASURES:
Infections among students and faculty per 5000 students and per 1000 faculty, isolation days, tests, costs, cost per infection prevented, and cost per quality-adjusted life-year (QALY). RESULTS OF BASE-CASEANALYSIS:
Among students, mitigation strategies reduced COVID-19 cases from 3746 with no mitigation to 493 with extensive social distancing and masks, and further to 151 when laboratory testing was added among asymptomatic persons every 3 days. Among faculty, these values were 164, 28, and 25 cases, respectively. Costs ranged from about $0.4 million for minimal social distancing to about $0.9 million to $2.1 million for strategies involving laboratory testing ($10 per test), depending on testing frequency. Extensive social distancing with masks cost $170 per infection prevented ($49 200 per QALY) compared with masks alone. Adding routine laboratory testing increased cost per infection prevented to between $2010 and $17 210 (cost per QALY gained, $811 400 to $2 804 600). RESULTS OF SENSITIVITYANALYSIS:
Results were most sensitive to test costs.LIMITATION:
Data are from multiple sources.CONCLUSION:
Extensive social distancing with a mandatory mask-wearing policy can prevent most COVID-19 cases on college campuses and is very cost-effective. Routine laboratory testing would prevent 96% of infections and require low-cost tests to be economically attractive. PRIMARY FUNDING SOURCE National Institutes of Health.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Universities
/
Communicable Disease Control
/
COVID-19
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
North America
Language:
English
Journal:
Ann Intern Med
Year:
2021
Document Type:
Article
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