School of Medical Business, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.
Guangdong Health Economics and Health Promotion Research Center, Guangzhou, Guangdong, China.
Front Public Health. 2023 May 9;11:1099116. doi: 10.3389/fpubh.2023.1099116. eCollection 2023.
This study aims to optimize the COVID-19 screening strategies under China's dynamic zero-case policy through cost-effectiveness analysis. A total of 9 screening strategies with different screening frequencies and combinations of detection methods were designed. A stochastic agent-based model was used to simulate the progress of the COVID-19 outbreak in scenario I (close contacts were promptly quarantined) and scenario II (close contacts were not promptly quarantined). The primary outcomes included the number of infections, number of close contacts, number of deaths, the duration of the epidemic, and duration of movement restriction. Net monetary benefit (NMB) and the incremental cost-benefit ratio were used to compare the cost-effectiveness of different screening strategies. The results indicated that under China's COVID-19 dynamic zero-case policy, high-frequency screening can help contain the spread of the epidemic, reduce the size and burden of the epidemic, and is cost-effective. Mass antigen testing is not cost-effective compared with mass nucleic acid testing in the same screening frequency. It would be more cost-effective to use AT as a supplemental screening tool when NAT capacity is insufficient or when outbreaks are spreading very rapidly.
本研究旨在通过成本效益分析优化中国动态清零政策下的 COVID-19 筛查策略。设计了总共 9 种具有不同筛查频率和检测方法组合的筛查策略。采用随机基于代理的模型模拟了情景 I（密切接触者立即被隔离）和情景 II（密切接触者未立即被隔离）中 COVID-19 疫情的进展。主要结果包括感染人数、密切接触人数、死亡人数、疫情持续时间和限制流动时间。净货币收益（NMB）和增量成本效益比用于比较不同筛查策略的成本效益。结果表明，在中国 COVID-19 动态清零政策下，高频筛查有助于控制疫情传播，减少疫情规模和负担，具有成本效益。与相同筛查频率的大规模核酸检测相比，大规模抗原检测不具有成本效益。当 NAT 能力不足或疫情传播非常迅速时，使用 AT 作为补充筛查工具将更具成本效益。
