Mol Ben W, Karnon Jonathan
Department of Obstetrics and Gynaecology, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
Arch Clin Biomed Res. 2023;7(1):58-63. doi: 10.26502/acbr.50170319. Epub 2023 Feb 1.
To balance the costs and effects comparing a strict lockdown versus a flexible social distancing strategy for societies affected by Coronavirus-19 Disease (COVID-19).
Cost-effectiveness analysis.
We used societal data and COVID-19 mortality rates from the public domain.
The intervention was a strict lockdown strategy that has been followed by Denmark. Reference strategy was flexible social distancing policy as was applied by Sweden. We derived mortality rates from COVID-19 national statistics, assumed the expected life years lost from each COVID-19 death to be 11 years and calculated lost life years until 31 August 2020. Expected economic costs were derived from gross domestic productivity (GDP) statistics from each country's official statistics bureau and forecasted GDP. The incremental financial costs of the strict lockdown were calculated by comparing Sweden with Denmark using externally available market information. Calculations were projected per one million inhabitants. In sensitivity analyses we varied the total cost of the lockdown (range -50% to +100%).
Financial costs per life years saved.
In Sweden, the number of people who died with COVID-19 was 577 per million inhabitants, resulting in an estimated 6,350 life years lost per million inhabitants. In Denmark, where a strict lockdown strategy was installed for months, the number of people dying with COVID-19 was on average 111 per million, resulting in an estimated 1,216 life years per million inhabitants lost. The incremental costs of strict lockdown to save one life year was US$ 137,285, and higher in most of the sensitivity analyses.
Comparisons of public health interventions for COVID-19 should take into account life years saved and not only lost lives. Strict lockdown costs more than US$ 130,000 per life year saved. As our all our assumptions were in favour of strict lockdown, a flexible social distancing policy in response to COVID19 is defendable.
对于受冠状病毒病（COVID-19）影响的社会，比较严格封锁与灵活社交距离策略的成本和效果，以实现两者的平衡。
成本效益分析。
我们使用了来自公共领域的社会数据和COVID-19死亡率。
干预措施是丹麦所采用的严格封锁策略。参考策略是瑞典实施的灵活社交距离政策。我们从COVID-19国家统计数据中得出死亡率，假设每例COVID-19死亡导致的预期寿命损失为11年，并计算截至2020年8月31日的寿命损失年数。预期经济成本来自各国官方统计局的国内生产总值（GDP）统计数据和预测的GDP。通过利用外部可得的市场信息，将瑞典与丹麦进行比较，计算出严格封锁的增量财务成本。计算按每百万居民进行。在敏感性分析中，我们改变了封锁的总成本（范围为-50%至+100%）。
每挽救一个生命年的财务成本。
在瑞典，每百万居民中死于COVID-19的人数为577人，导致每百万居民估计损失6350个生命年。在丹麦，实施了数月严格封锁策略，每百万居民中死于COVID-19的人数平均为111人，导致每百万居民估计损失1216个生命年。严格封锁挽救一个生命年的增量成本为137285美元，在大多数敏感性分析中更高。
对COVID-19公共卫生干预措施的比较应考虑挽救的生命年数，而不仅仅是死亡人数。严格封锁每挽救一个生命年的成本超过13万美元。由于我们所有的假设都有利于严格封锁，因此应对COVID-19采取灵活的社交距离政策是合理的。
