Five Ways that COVID-19 Diagnostics Can Save Lives: Prioritizing Uses of Tests to Maximize Cost-Effectiveness

Produced by: 
The World Bank
Available from: 
March 2021
Paper author(s): 
Tristan Reed
William Waites
David Manheim
Damien de Walque
Chiara Vallini
Roberta Gatti
Timothy B. Hallett
Topic: 
Education - Health
Year: 
2021

Supplies of tests to diagnose the virus that causes COVID-19 (SARS-CoV-2) are still limited in many countries, and there is uncertainty about how to allocate the scarce supply across alternative types of testing to support diagnosis and disease control in the most cost-effective way. This Research & Policy Brief quantifies the cost-effectiveness of five types of interventions in terms of tests required per death averted. Across the five types, a single death can be averted by administering 940 to 8,838 tests, implying a large and positive return on investment in all five types—even assuming a very low value for loss of life. That is, all five types pay for themselves many times over. When prevalence of SARS-CoV-2 is high, the most cost-effective uses of SARS-CoV-2 diagnostics seem to be clinical triage of patients, at-risk worker screening, and population surveillance. Test-trace-isolate programs and border screening are also worthwhile, although they are more resource intensive per death averted if done comprehensively. These latter two interventions become relatively more cost effective when prevalence is low, and can stop the virus from entering a community completely. While governments should seek widespread deployment of tests in all five types of interventions, prioritizing them in this way is likely to maximize the cost-effectiveness of their use. As more contagious strains emerge, each type will become more valuable than ever.

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Research section: 
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