背景:COVID-19大流行对全球卫生系统和经济结构产生了深远的影响。尽管实施封锁措施在遏制大流行蔓延方面取得了显著成功,它同时产生了巨大的社会经济成本。
目的:这项研究的目的是在封锁措施的经济损失和健康利益之间建立平衡,目的是确定在各个大流行阶段实施这些措施的最佳边界条件。
方法:本研究使用模型估算了观察到的不同菌株的病死率的半衰期。它基于世界卫生组织收集的全球感染和死亡数据以及Nextstrain提供的菌株序列时间序列数据。通过计算残疾调整寿命年,建立了健康福利与封锁措施带来的经济损失之间的联系。以中国的城市封锁为例,这项研究确定了COVID-19演变过程中各种封锁措施的成本效益界限。
结果:该研究揭示了由于封锁造成的经济损失与观察到的病毒株病死率之间的直接比例关系。无论人口规模或人均经济产出如何,这种关系都成立。随着SARS-CoV-2菌株的进化和人群免疫力的变化,随着时间的推移,观察到的病例死亡率显着下降,半衰期约为8个月。死亡率的下降可能会抵消维持封锁措施不变的健康益处,鉴于由此产生的经济损失可能超过健康益处。
结论:武汉最初实施封锁带来了显著的健康益处。然而,随着观察到的病毒株病死率的下降,经济损失越来越超过健康益处。因此,必须根据不同病毒株不断变化的死亡率和感染率,不断完善和加强封锁策略,从而优化预测未来大流行的结果。
BACKGROUND: The COVID-19 pandemic had a profound impact on the global health system and economic structure. Although the implementation of lockdown measures achieved notable success in curbing the spread of the pandemic, it concurrently incurred substantial socioeconomic costs.
OBJECTIVE: The objective of this study was to delineate an equilibrium between the economic losses and health benefits of lockdown measures, with the aim of identifying the optimal boundary conditions for implementing these measures at various pandemic phases.
METHODS: This study used a model to estimate the half-lives of the observed case fatality rates of different strains. It was based on global infection and death data collected by the World Health Organization and strain sequence time series data provided by Nextstrain. The connection between the health benefits and economic losses brought by lockdown measures was established through the calculation of disability-adjusted life years. Taking
China\'s city lockdowns as an example, this study determined the cost-benefit boundary of various lockdown measures during the evolution of COVID-19.
RESULTS: The study reveals a direct proportionality between economic losses due to lockdowns and the observed case fatality rates of virus strains, a relationship that holds true irrespective of population size or per capita economic output. As SARS-CoV-2 strains evolve and population immunity shifts, there has been a notable decrease in the observed case fatality rate over time, exhibiting a half-life of roughly 8 months. This decline in fatality rates may offset the health benefits of maintaining unchanged lockdown measures, given that the resultant economic losses might exceed the health benefits.
CONCLUSIONS: The initial enforcement of lockdown in Wuhan led to significant health benefits. However, with the decline in the observed case fatality rate of the virus strains, the economic losses increasingly outweighed the health benefits. Consequently, it is essential to consistently refine and enhance lockdown strategies in accordance with the evolving fatality and infection rates of different virus strains, thereby optimizing outcomes in anticipation of future pandemics.