Comparative cost-effectiveness of SARS-CoV-2 testing strategies in the USA: a modelling study
Zhanwei Du, Abhishek Pandey, Yuan Bai, Meagan C. Fitzpatrick, Matteo Chinazzi, Ana Pastore y Piontti, Michael Lachmann, Alessandro Vespignani, Benjamin J. Cowling, Alison P. Galvani, Lauren Ancel Meyers
Abstract
BACKGROUND: To mitigate the COVID-19 pandemic, countries worldwide have enacted unprecedented movement restrictions, physical distancing measures, and face mask requirements. Until safe and efficacious vaccines or antiviral drugs become widely available, viral testing remains the primary mitigation measure for rapid identification and isolation of infected individuals. We aimed to assess the economic trade-offs of expanding and accelerating testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across the USA in different transmission scenarios. METHODS: from 1·1 to 3), we estimated a threshold test price at which the status-quo strategy outperforms all testing strategies considered. FINDINGS: of 1·2), monthly testing of the population followed by 1-week isolation rather than 2-week isolation is likely to be most cost-effective. Expanded surveillance testing is more likely to be cost-effective than the status-quo testing strategy if the price per test is less than $75 across all transmission rates considered. INTERPRETATION: Extensive expansion of SARS-CoV-2 testing programmes with more frequent and rapid tests across communities coupled with isolation of individuals with confirmed infection is essential for mitigating the COVID-19 pandemic. Furthermore, resources recouped from shortened isolation duration could be cost-effectively allocated to more frequent testing. FUNDING: US National Institutes of Health, US Centers for Disease Control and Prevention, and Love, Tito's.