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Optimal health and economic impact of non-pharmaceutical intervention measures prior and post vaccination in England : a mathematical modelling study

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Tildesley, Michael J., Vassall, Anna, Riley, Steven, Jit, Mark, Sandmann, Frank, Hill, Edward M., Thompson, Robin N., Atkins, Benjamin D., Edmunds, John, Dyson, Louise and Keeling, Matt J. (2022) Optimal health and economic impact of non-pharmaceutical intervention measures prior and post vaccination in England : a mathematical modelling study. Royal Society Open Science, 9 (8). 211746. doi:10.1098/rsos.211746 ISSN 2054-5703.

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Official URL: https://doi.org/10.1098/rsos.211746

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Abstract

Background. Even with good progress on vaccination, SARS-CoV-2 infections in the UK may continue to impose a high burden of disease and therefore pose substantial challenges for health policy decision makers. Stringent government-mandated physical distancing measures (lockdown) have been demonstrated to be epidemiologically effective, but can have both positive and negative economic consequences. The duration and frequency of any intervention policy could, in theory, be optimized to maximize economic benefits while achieving substantial reductions in disease. Methods. Here, we use a pre-existing SARS-CoV-2 transmission model to assess the health and economic implications of different strengths of control through time in order to identify optimal approaches to non-pharmaceutical intervention stringency in the UK, considering the role of vaccination in reducing the need for future physical distancing measures. The model is calibrated to the COVID-19 epidemic in England and we carry out retrospective analysis of the optimal timing of precautionary breaks in 2020 and the optimal relaxation policy from the January 2021 lockdown, considering the willingness to pay (WTP) for health improvement. Results. We find that the precise timing and intensity of interventions is highly dependent upon the objective of control. As intervention measures are relaxed, we predict a resurgence in cases, but the optimal intervention policy can be established dependent upon the WTP per quality adjusted life year loss avoided. Our results show that establishing an optimal level of control can result in a reduction in net monetary loss of billions of pounds, dependent upon the precise WTP value. Conclusion. It is vital, as the UK emerges from lockdown, but continues to face an on-going pandemic, to accurately establish the overall health and economic costs when making policy decisions. We demonstrate how some of these can be quantified, employing mechanistic infectious disease transmission models to establish optimal levels of control for the ongoing COVID-19 pandemic.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
Faculty of Science, Engineering and Medicine > Science > Mathematics
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Communicable diseases -- Epidemiology -- Mathematical models
Journal or Publication Title: Royal Society Open Science
Publisher: The Royal Society Publishing
ISSN: 2054-5703
Official Date: August 2022
Dates:
DateEvent
August 2022Published
10 August 2022Available
1 June 2022Accepted
Volume: 9
Number: 8
Article Number: 211746
DOI: 10.1098/rsos.211746
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 10 August 2022
Date of first compliant Open Access: 15 August 2022
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
EP/S022244/1[EPSRC] Engineering and Physical Sciences Research Councilhttp://dx.doi.org/10.13039/501100000266
MR/V009761/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MR/V038613/1 (JUNIPER)Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
NIHR200929National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
NIHR200908National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
101003688 (Epipose)European Commissionhttp://dx.doi.org/10.13039/501100000780

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