Indirect COVID-19 health effects and potential mitigating interventions: Cost-effectiveness framework.

Area of Science:

• Public Health
• Health Economics
• Epidemiology

Background:

• The COVID-19 pandemic resulted in substantial indirect health and social harms beyond direct SARS-CoV-2 infection impacts.
• These indirect effects, including increased depression and substance abuse, can have lasting life-course consequences.
• Estimating the health and economic outcomes of these conditions and their mitigation is crucial for public health policy.

Purpose of the Study:

• To develop a cost-effectiveness framework for evaluating societal costs and quality-adjusted life years (QALYs) lost due to indirect COVID-19 health effects in California.
• To assess short- and long-term outcomes for the adult population.
• To identify evidence-based mitigation strategies and estimate their impact on QALYs gained, intervention costs, and averted harms.

Main Methods:

• A cost-effectiveness framework was developed to analyze six indirect health effects of COVID-19.
• Societal costs and QALYs lost were evaluated for the adult population in California.
• Data were sourced from literature reviews, public data, and expert opinions to estimate outcomes and mitigation impacts.

Main Results:

• Indirect COVID-19 effects were estimated to cause over 192,000 QALYs lost and nearly $7 billion in societal costs per million adults over the life course.
• Adult depression represented the largest contributor to costs and QALYs lost.
• All assessed mitigation strategies demonstrated cost and QALY savings, with five achieving savings within one year. Addressing depression and excessive alcohol use offered the greatest 10-year net savings.

Conclusions:

• The COVID-19 pandemic imposes significant human suffering and societal costs through its indirect health effects.
• Policymakers can mitigate these societal costs and health harms by implementing targeted public health interventions.
• Investing in strategies to address conditions like depression and substance abuse is economically beneficial and improves population health outcomes.