Peng Amy, Simmons Alison, Amoako Afia, Tuite Ashleigh, Fisman David
Dalla Lana School of Public Health, University of Toronto, Toronto, ON.
Public Health Agency of Canada, Ottawa, ON.
Can Commun Dis Rep. 2023 May 1;49(5):197-205. doi: 10.14745/ccdr.v49i05a05.
National responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have been highly variable. We sought to explore the effectiveness of the Canadian pandemic response up to May 2022 relative to responses in four peer countries with similar political, economic and health systems, and with close historical and cultural ties to Canada.
We used reported age-specific mortality data to generate estimates of pandemic mortality standardized to the Canadian population. Age-specific case fatality, hospitalization, and intensive care admission probabilities for the Canadian province of Ontario were applied to estimated deaths, to calculate hospitalizations and intensive care admissions averted by the Canadian response. Health impacts were valued in both monetary terms, and in terms of lost quality-adjusted life years.
We estimated that the Canadian pandemic response averted 94,492, 64,306 and 13,641 deaths relative to the responses of the United States, United Kingdom and France, respectively, and more than 480,000 hospitalizations relative to the United States. The United States pandemic response, if applied to Canada, would have resulted in more than $40 billion in economic losses due to healthcare expenditures and lost quality-adjusted life years. In contrast, an Australian pandemic response applied to Canada would have averted over 28,000 additional deaths and averted nearly $9 billion in costs.
Canada outperformed several peer countries that aimed for mitigation rather than elimination of SARS-CoV-2 in the first two years of the pandemic, with substantial numbers of lives saved and economic costs averted. However, a comparison with Australia demonstrated that an elimination focus would have saved Canada tens of thousands of lives as well as substantial economic costs.
各国对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行的应对措施差异很大。我们试图探讨截至2022年5月加拿大应对大流行措施的有效性，并与四个在政治、经济和卫生系统方面相似，且与加拿大有着密切历史和文化联系的同侪国家的应对措施进行比较。
我们使用报告的特定年龄死亡率数据来生成按加拿大人口标准化的大流行死亡率估计值。将加拿大安大略省的特定年龄病死率、住院率和重症监护入院概率应用于估计死亡人数，以计算加拿大应对措施避免的住院和重症监护入院人数。健康影响既以货币形式评估，也以质量调整生命年损失来评估。
我们估计，与美国、英国和法国的应对措施相比，加拿大的大流行应对措施分别避免了94492例、64306例和13641例死亡，与美国相比避免了超过48万例住院。如果将美国的大流行应对措施应用于加拿大，由于医疗保健支出和质量调整生命年损失，将导致超过400亿美元的经济损失。相比之下，将澳大利亚的大流行应对措施应用于加拿大，将避免额外的28000多例死亡，并避免近90亿美元的成本。
在大流行的头两年，加拿大的表现优于几个旨在缓解而非消除SARS-CoV-2的同侪国家，挽救了大量生命并避免了经济成本。然而，与澳大利亚的比较表明，以消除为重点本可以为加拿大挽救数万人的生命以及大量经济成本。
