Gandjour Afschin
Frankfurt School of Finance & Management, Adickesallee 32-34, 60322, Frankfurt, Germany.
Q Rev Econ Finance. 2022 May;84:502-509. doi: 10.1016/j.qref.2020.10.007. Epub 2020 Oct 14.
A shutdown of businesses enacted during the SARS-CoV-2 pandemic can serve different goals, e.g., preventing the intensive care unit (ICU) capacity from being overwhelmed ('flattening the curve') or keeping the reproduction number substantially below one ('squashing the curve'). The aim of this study was to determine the clinical and economic value of a shutdown that is successful in 'flattening' or 'squashing the curve' in Germany.
In the base case, the study compared a successful shutdown to a worst-case scenario with no ICU capacity left to treat COVID-19 patients. To this end, a decision model was developed using, e.g., information on age-specific fatality rates, ICU outcomes, and the herd protection threshold. The value of an additional life year was borrowed from new, innovative oncological drugs, as cancer reflects a condition with a similar morbidity and mortality burden in the general population in the short term as COVID-19.
A shutdown that is successful in 'flattening the curve' is projected to yield an average health gain between 0.01 and 0.05 life years (0.1 to 0.6 months) per capita in the German population. The corresponding economic value ranges between €616 and €4797 per capita or, extrapolated to the total population, 1%-12% of the gross domestic product (GDP) in 2019. A shutdown that is successful in 'squashing the curve' is expected to yield a minimum health gain of 0.08 life years (1 month) per capita, corresponding to 19 % of the GDP in 2019. Results are particularly sensitive to mortality data and the prevalence of undetected cases.
A successful shutdown is forecasted to yield a considerable gain in life years in the German population. Nevertheless, questions around the affordability and underfunding of other parts of the healthcare system emerge.
在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行期间实施的企业停业措施可服务于不同目标，例如防止重症监护病房（ICU）不堪重负（“拉平曲线”）或使繁殖数大幅低于1（“压平曲线”）。本研究的目的是确定在德国成功“拉平”或“压平曲线”的停业措施的临床和经济价值。
在基础案例中，该研究将成功的停业措施与没有ICU能力治疗新型冠状病毒肺炎（COVID-19）患者的最坏情况进行了比较。为此，开发了一个决策模型，例如使用特定年龄死亡率、ICU结果和群体保护阈值等信息。额外生命年的价值借鉴了新型创新肿瘤药物，因为癌症在短期内反映出一种在一般人群中与COVID-19具有相似发病率和死亡率负担的疾病。
预计成功“拉平曲线”的停业措施将使德国人口人均健康收益在0.01至0.05生命年之间（0.1至0.6个月）。相应的经济价值为人均616欧元至4797欧元，或者推算至总人口，相当于2019年国内生产总值（GDP）的1%至12%。预计成功“压平曲线”的停业措施将使人均健康收益至少达到0.08生命年（1个月），相当于2019年GDP的19%。结果对死亡率数据和未检测到病例的患病率特别敏感。
预计成功的停业措施将使德国人口的生命年有可观的增加。然而，围绕医疗保健系统其他部分的可负担性和资金不足的问题也随之出现。
