[Paper Review] Cost-effectiveness Analysis of Antiepidemic Policies and Global Situation Assessment of COVID-19

Liyan Xu, Hongmou Zhang+18 more|arXiv (Cornell University)|Apr 16, 2020

COVID-19 epidemiological studies18 references4 citations

TL;DR

This study uses a two-layer contact-dispersion model with Chinese data to evaluate cost-effectiveness of three COVID-19 control strategies: regular epidemiological control, local social interaction control, and inter-city travel restrictions. It finds that early, stringent enforcement of epidemiological and social control measures maximizes effectiveness and cost-efficiency, while inter-city travel restrictions are largely ineffective at national scale, and moderate social restrictions yield the worst outcomes.

ABSTRACT

With a two-layer contact-dispersion model and data in China, we analyze the cost-effectiveness of three types of antiepidemic measures for COVID-19: regular epidemiological control, local social interaction control, and inter-city travel restriction. We find that: 1) intercity travel restriction has minimal or even negative effect compared to the other two at the national level; 2) the time of reaching turning point is independent of the current number of cases, and only related to the enforcement stringency of epidemiological control and social interaction control measures; 3) strong enforcement at the early stage is the only opportunity to maximize both antiepidemic effectiveness and cost-effectiveness; 4) mediocre stringency of social interaction measures is the worst choice. Subsequently, we cluster countries/regions into four groups based on their control measures and provide situation assessment and policy suggestions for each group.

Motivation & Objective

• To evaluate the cost-effectiveness of three major antiepidemic strategies during the early phase of the COVID-19 pandemic.
• To determine how policy stringency and timing influence the turning point of epidemic spread.
• To assess the global situation of COVID-19 by clustering countries based on their control measures.
• To provide evidence-based policy recommendations tailored to different country groups based on their intervention strategies.

Proposed method

• A two-layer contact-dispersion model is developed to simulate disease transmission across individuals and regions.
• The model integrates data from China’s early epidemic phase to estimate transmission dynamics under varying policy conditions.
• Cost-effectiveness is evaluated by comparing the impact of three policy types: epidemiological control, social interaction control, and inter-city travel restrictions.
• Sensitivity analysis is conducted to assess the influence of policy stringency and timing on epidemic turning points.
• Countries and regions are clustered into four groups based on their implemented control measures for global situation assessment.
• Policy recommendations are derived from comparative analysis of effectiveness, timing, and stringency across clusters.

Experimental results

Research questions

• RQ1 How do inter-city travel restrictions compare in cost-effectiveness to other antiepidemic measures at the national level?
• RQ2 What is the relationship between policy stringency and the timing of the epidemic turning point?
• RQ3 How does the timing and intensity of intervention affect overall antiepidemic effectiveness and cost-efficiency?
• RQ4 Which combination of policy measures yields the optimal balance between public health impact and economic cost?
• RQ5 How can countries be grouped based on their control strategies, and what tailored policy suggestions emerge for each group?

Key findings

• Intercity travel restrictions have minimal or even negative cost-effectiveness compared to regular epidemiological control and local social interaction control at the national scale.
• The time to reach the epidemic turning point is independent of the current number of cases but depends solely on the stringency of epidemiological and social interaction control measures.
• Strong enforcement of control measures during the early phase is the only effective strategy to maximize both antiepidemic effectiveness and cost-effectiveness.
• Mediocre stringency in social interaction control measures results in the worst overall outcome, indicating a threshold effect in policy implementation.
• The model identifies four distinct country clusters based on control strategy patterns, enabling targeted policy recommendations for each group.
• Early, stringent interventions significantly reduce overall transmission and long-term societal costs, underscoring the importance of rapid policy response.