Department of Medicine D and The Liver Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Value Health. 2021 May;24(5):607-614. doi: 10.1016/j.jval.2020.09.013. Epub 2020 Dec 9.
While highly effective in preventing SARS-CoV-2 spread, national lockdowns come with an enormous economic price. Few countries have adopted an alternative "testing, tracing, and isolation" approach to selectively isolate people at high exposure risk, thereby minimizing the economic impact. To assist policy makers, we performed a cost-effectiveness analysis of these 2 strategies.
A modified Susceptible, Exposed, Infectious, Recovered, and Deceased (SEIRD) model was employed to assess the situation in Israel, a small country with ∼9 million people. The incremental cost-effectiveness ratio (ICER) of these strategies as well as the expected number of infected individuals and deaths were calculated.
A nationwide lockdown is expected to save, on average, 274 (median 124, interquartile range: 71-221) lives compared to the "testing, tracing, and isolation" approach. However, the ICER will be, on average, $45 104 156 (median $49.6 million, interquartile range: 22.7-220.1) to prevent 1 case of death.
A national lockdown has a moderate advantage in saving lives with tremendous costs and possible overwhelming economic effects. These findings should assist decision makers dealing with additional waves of this pandemic.
尽管在预防 SARS-CoV-2 传播方面非常有效，但全国性封锁会带来巨大的经济代价。很少有国家采用替代的“检测、追踪和隔离”方法，选择性地隔离高暴露风险人群，从而将经济影响降到最低。为了协助决策者，我们对这两种策略进行了成本效益分析。
采用改良的易感者-暴露者-感染者-恢复者-死亡者（SEIRD）模型评估以色列的情况，该国是一个拥有约 900 万人口的小国。计算了这两种策略的增量成本效益比（ICER）以及预期感染人数和死亡人数。
与“检测、追踪和隔离”方法相比，全国性封锁预计平均可挽救 274 人（中位数为 124 人，四分位距：71-221）的生命。然而，为预防 1 例死亡，ICER 平均将达到 45104156 美元（中位数为 4960 万美元，四分位距：22.7-220.1）。
全国性封锁在挽救生命方面具有适度优势，但代价巨大，可能产生压倒性的经济影响。这些发现应有助于决策者应对这一流行病的后续浪潮。
