Emerg Infect Dis. 2023 Aug;29(8):1608-1617. doi: 10.3201/eid2908.221775.
The COVID-19 pandemic has imposed substantial burdens on the global society. To find an optimal combination of wastewater surveillance and clinical testing for tracking COVID-19, we evaluated the economic efficiency of hypothetical screening options at a single facility in Japan. To conduct cost-benefit analyses, we developed standard decision models in which we assumed model parameters from literature and primary data, such as screening policies used at the Tokyo Olympic and Paralympic Village in 2021. We compared hypothetical 2-step screening options that used clinical PCR to diagnose COVID-19 after a positive result from primary screening using antigen tests (option 1) or wastewater surveillance (option 2). Our simulation results indicated that option 2 likely would be economically more justifiable than option 1, particularly at lower incidence levels. Our findings could help justify and promote the use of wastewater surveillance as a primary screening at a facility level for COVID-19 and other infectious diseases.
COVID-19 大流行给全球社会带来了巨大负担。为了找到一种优化的废水监测和临床检测组合，以追踪 COVID-19，我们评估了日本一个单一设施的假设筛选方案的经济效率。为了进行成本效益分析，我们开发了标准决策模型，其中我们假设了来自文献和原始数据的模型参数，例如 2021 年东京奥运会和残奥会村使用的筛选政策。我们比较了使用临床 PCR 对原发性检测呈阳性后进行 COVID-19 诊断的两步筛选方案，使用抗原检测（方案 1）或废水监测（方案 2）。我们的模拟结果表明，方案 2 在经济上可能比方案 1 更合理，特别是在发病率较低的情况下。我们的研究结果可能有助于证明和促进将废水监测作为 COVID-19 和其他传染病的主要筛查手段在设施层面上的使用。
