Michaels, J.A. and Stevenson, M.D. orcid.org/0000-0002-3099-9877 (2020) Explaining national differences in the mortality of Covid-19 : individual patient simulation model to investigate the effects of testing policy and other factors on apparent mortality. Report. ScHARR HEDS Discussion Papers . School of Health and Related Research, University of Sheffield
Abstract
There has been extensive speculation on the apparent differences in mortality between countries reporting on the confirmed cases and deaths due to Covid-19. A number of explanations have been suggested, but there is no clear evidence about how apparent fatality rates may be expected to vary with the different testing regimes, admission policies and other variables. An individual patient simulation model was developed to address this question. Parameters and sensitivity analysis based upon recent international data sources for Covid-19 and results were averaged over 100 iterations for a simulated cohort of over 500,000 patients.
Different testing regimes for Covid-19 were considered; testing admitted patients only, various rates of community testing of symptomatic cases and active contact-tracing and screening.
In the base case analysis, apparent mortality ranged from 10.5% under a policy of testing only admitted patients to 0.4% with intensive contact tracing and community testing. These findings were sensitive to assumptions regarding admission rates and the rate of spread, with more selective admission policies and suppression of spread increasing the apparent mortality and the potential for apparent mortality rates to exceed 18% under some circumstances. Under all scenarios the proportion of patients tested in the community had the greatest impact on apparent mortality.
Whilst differences in mortality due to health service and demographic factors cannot be excluded, the current international differences in reported mortality are all consistent with differences in practice regarding screening, community testing and admission policies.
Metadata
Item Type: | Monograph |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The Author(s). Article available under the terms of the CC-BY-NC-ND 4.0 licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > Health Economics and Decision Science > HEDS Discussion Paper Series |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 07 Apr 2020 06:47 |
Last Modified: | 07 Apr 2020 06:47 |
Published Version: | https://www.sheffield.ac.uk/scharr/sections/heds/d... |
Status: | Published |
Publisher: | School of Health and Related Research, University of Sheffield |
Series Name: | ScHARR HEDS Discussion Papers |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:159228 |
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