Researchers at the Johns Hopkins Bloomberg School of Public Health, along with partners at the University of Washington and the Colombian Ministry of Health, found that implementing a Test-Trace-Isolate (TTI) Program in Colombia could reduce COVID-19 mortality and is more cost-effective than doing no interventions at all. Researchers conducted a modeling study and found that compared to conducting no intervention, the TTI program could reduce COVID-19 mortality by 67% and save an average of $1,895 per case in total costs.
The study was led by Yenny Guzmán Ruiz, in the Department of Health Services at the University of Washington. Antonio Trujillo, PhD, MPP, associate professor in the Department of International Health at the Bloomberg School was the senior author of the study.
Test-Trace-Isolate programs include the testing of individuals to identify cases of COVID-19 in the community, tracing their known contacts to identify additional cases, and quarantining those with confirmed COVID-19 for a certain period during when they are infectious. In this modeling study, researchers estimated the cost-effectiveness of a comprehensive TTI strategy in Colombia compared with conducting no intervention at all over a one-year time span, looking at savings in both societal and health-related costs. Health costs include direct health service utilization; societal costs include the productivity years of life lost for premature death. The average savings per case was equal to approximately $1,045 in health costs and $850 in societal costs.
Key findings from the modeling study include:
- The program could prevent 84,730 deaths, potentially saving US $2.123 billion dollars for potential productive years of life lost.
- The monitoring component of the TTI program increased the hospitalization costs due to the required treatment times, but overall expenses were still lower due to savings on ICU expenses.
- Early detection and monitoring of COVID-19 infections is associated with better survival rates.
- Even with vaccines, other public health interventions are necessary to help end the pandemic; therefore, TTI programs should be maintained and strengthened even with high vaccination coverage.
Budgets for health expenditures are often limited in low- and middle-income countries. Economic evaluations, such as this one, can help provide decision-makers with data in order to inform spending priorities. This study shows that a TTI program in Colombia could save lives and improve health outcomes while being cost-effective. Findings from this study can help provide guidance for the prioritization of TTI programs as a health intervention against the COVID-19 pandemic and any future potential outbreaks in Colombia, as well as in other resource-constrained settings.
The study was funded by the Colombian Ministry of Health. Cost-effectiveness of the COVID-19 Test, Trace and Isolate Program in Colombia was published in The Lancet Regional Health – Americas on November 1, 2021.
