TY - JOUR
T1 - Cost-effectiveness and return on investment of protecting health workers in low- And middle-income countries during the COVID-19 pandemic
AU - Risko, Nicholas
AU - Werner, Kalin
AU - Offorjebe, O. Agatha
AU - Vecino-Ortiz, Andres I.
AU - Wallis, Lee A.
AU - Razzak, Junaid
N1 - Publisher Copyright:
© 2020 Risko et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/10
Y1 - 2020/10
N2 - Background In this paper, we predict the health and economic consequences of immediate investment in personal protective equipment (PPE) for health care workers (HCWs) in low- and middleincome countries (LMICs). Methods To account for health consequences, we estimated mortality for HCWs and present a costeffectiveness and return on investment (ROI) analysis using a decision-analytic model with Bayesian multivariate sensitivity analysis and Monte Carlo simulation. Data sources included inputs from the World Health Organization Essential Supplies Forecasting Tool and the Imperial College of London epidemiologic model. Results An investment of $9.6 billion USD would adequately protect HCWs in all LMICs. This intervention would save 2,299,543 lives across LMICs, costing $59 USD per HCW case averted and $4,309 USD per HCW life saved. The societal ROI would be $755.3 billion USD, the equivalent of a 7,932% return. Regional and national estimates are also presented. Discussion In scenarios where PPE remains scarce, 70-100% of HCWs will get infected, irrespective of nationwide social distancing policies. Maintaining HCW infection rates below 10% and mortality below 1% requires inclusion of a PPE scale-up strategy as part of the pandemic response. In conclusion, wide-scale procurement and distribution of PPE for LMICs is an essential strategy to prevent widespread HCW morbidity and mortality. It is cost-effective and yields a large downstream return on investment.
AB - Background In this paper, we predict the health and economic consequences of immediate investment in personal protective equipment (PPE) for health care workers (HCWs) in low- and middleincome countries (LMICs). Methods To account for health consequences, we estimated mortality for HCWs and present a costeffectiveness and return on investment (ROI) analysis using a decision-analytic model with Bayesian multivariate sensitivity analysis and Monte Carlo simulation. Data sources included inputs from the World Health Organization Essential Supplies Forecasting Tool and the Imperial College of London epidemiologic model. Results An investment of $9.6 billion USD would adequately protect HCWs in all LMICs. This intervention would save 2,299,543 lives across LMICs, costing $59 USD per HCW case averted and $4,309 USD per HCW life saved. The societal ROI would be $755.3 billion USD, the equivalent of a 7,932% return. Regional and national estimates are also presented. Discussion In scenarios where PPE remains scarce, 70-100% of HCWs will get infected, irrespective of nationwide social distancing policies. Maintaining HCW infection rates below 10% and mortality below 1% requires inclusion of a PPE scale-up strategy as part of the pandemic response. In conclusion, wide-scale procurement and distribution of PPE for LMICs is an essential strategy to prevent widespread HCW morbidity and mortality. It is cost-effective and yields a large downstream return on investment.
UR - http://www.scopus.com/inward/record.url?scp=85092754660&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0240503
DO - 10.1371/journal.pone.0240503
M3 - Article
C2 - 33035244
AN - SCOPUS:85092754660
SN - 1932-6203
VL - 15
JO - PLoS ONE
JF - PLoS ONE
IS - 10 October
M1 - e0240503
ER -