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Article ; Online: Corrigendum to: The Clinical and Economic Burden of Norovirus Gastroenteritis in the United States.

Bartsch, Sarah M / O'Shea, Kelly J / Lee, Bruce Y

2021 Volume 224, Issue 4, Page(s) 741

Language	English
Publishing date	2021-07-12
Publishing country	United States
Document type	Published Erratum
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiab197
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Article ; Online: Cost-effectiveness of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) testing and isolation strategies in nursing homes.

Bartsch, Sarah M / Weatherwax, Colleen / Martinez, Marie F / Chin, Kevin L / Wasserman, Michael R / Singh, Raveena D / Heneghan, Jessie L / Gussin, Gabrielle M / Scannell, Sheryl A / White, Cameron / Leff, Bruce / Huang, Susan S / Lee, Bruce Y

Infection control and hospital epidemiology

2024 , Page(s) 1–8

Abstract: Objective: Nursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 and how this may change as severe acute respiratory ... ...

Abstract	Objective: Nursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 and how this may change as severe acute respiratory coronavirus virus 2 (SARS-CoV-2) evolves. Design: We developed an agent-based model representing a typical nursing home, COVID-19 spread, and its health and economic outcomes to determine the clinical and economic value of various screening and isolation strategies and how it may change under various circumstances. Results: Under winter 2023-2024 SARS-CoV-2 omicron variant conditions, symptom-based antigen testing averted 4.5 COVID-19 cases compared to no testing, saving $191 in direct medical costs. Testing implementation costs far outweighed these savings, resulting in net costs of $990 from the Centers for Medicare & Medicaid Services perspective, $1,545 from the third-party payer perspective, and $57,155 from the societal perspective. Testing did not return sufficient positive health effects to make it cost-effective [$50,000 per quality-adjusted life-year (QALY) threshold], but it exceeded this threshold in ≥59% of simulation trials. Testing remained cost-ineffective when routinely testing staff and varying face mask compliance, vaccine efficacy, and booster coverage. However, all antigen testing strategies became cost-effective (≤$31,906 per QALY) or cost saving (saving ≤$18,372) when the severe outcome risk was ≥3 times higher than that of current omicron variants. Conclusions: SARS-CoV-2 testing costs outweighed benefits under winter 2023-2024 conditions; however, testing became cost-effective with increasingly severe clinical outcomes. Cost-effectiveness can change as the epidemic evolves because it depends on clinical severity and other intervention use. Thus, nursing home administrators and policy makers should monitor and evaluate viral virulence and other interventions over time.
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2024.9
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Article ; Online: How to determine if a model is right for neglected tropical disease decision making.

Lee, Bruce Y / Bartsch, Sarah M

PLoS neglected tropical diseases

2017 Volume 11, Issue 4, Page(s) e0005457

Abstract: Mathematical and computational modeling can transform decision making for neglected tropical diseases (NTDs) if the right model is used for the right question. Modeling can help better understand and address the complex systems involved in making ... ...

Abstract	Mathematical and computational modeling can transform decision making for neglected tropical diseases (NTDs) if the right model is used for the right question. Modeling can help better understand and address the complex systems involved in making decisions for NTD prevention and control. However, all models, modelers, and modeling are not the same. Thus, decision makers need to better understand if a particular model actually fits their needs. Here are a series of questions that a decision maker can ask when determining whether a model is right for him or her.
MeSH term(s)	Computer Simulation ; Decision Making ; Humans ; Models, Theoretical ; Neglected Diseases/prevention & control ; Neglected Diseases/therapy ; Tropical Medicine/trends
Language	English
Publishing date	2017-04-20
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2727
ISSN (online)	1935-2735
ISSN	1935-2727
DOI	10.1371/journal.pntd.0005457
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Article ; Online: Cancer systems epidemiology: Overcoming misconceptions and integrating systems approaches into cancer research.

Mabry, Patricia L / Pronk, Nicolaas P / Amos, Christopher I / Witte, John S / Wedlock, Patrick T / Bartsch, Sarah M / Lee, Bruce Y

PLoS medicine

2022 Volume 19, Issue 6, Page(s) e1004027

Abstract: Patricia Mabry and coauthors discuss application of systems approaches in cancer research. ...

Abstract	Patricia Mabry and coauthors discuss application of systems approaches in cancer research.
MeSH term(s)	Humans ; Neoplasms/epidemiology ; Neoplasms/genetics ; Neoplasms/therapy ; Research
Language	English
Publishing date	2022-06-17
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2185925-5
ISSN	1549-1676 ; 1549-1277
ISSN (online)	1549-1676
ISSN	1549-1277
DOI	10.1371/journal.pmed.1004027
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Article ; Online: The Clinical and Economic Burden of Norovirus Gastroenteritis in the United States.

Bartsch, Sarah M / O'Shea, Kelly J / Lee, Bruce Y

The Journal of infectious diseases

2020 Volume 222, Issue 11, Page(s) 1910–1919

Abstract: Background: Although norovirus outbreaks periodically make headlines, it is unclear how much attention norovirus may receive otherwise. A better understanding of the burden could help determine how to prioritize norovirus prevention and control.: ... ...

Abstract	Background: Although norovirus outbreaks periodically make headlines, it is unclear how much attention norovirus may receive otherwise. A better understanding of the burden could help determine how to prioritize norovirus prevention and control. Methods: We developed a computational simulation model to quantify the clinical and economic burden of norovirus in the United States. Results: A symptomatic case generated $48 in direct medical costs, $416 in productivity losses ($464 total). The median yearly cost of outbreaks was $7.6 million (range across years, $7.5-$8.2 million) in direct medical costs, and $165.3 million ($161.1-$176.4 million) in productivity losses ($173.5 million total). Sporadic illnesses in the community (incidence, 10-150/1000 population) resulted in 14 118-211 705 hospitalizations, 8.2-122.9 million missed school/work days, $0.2-$2.3 billion in direct medical costs, and $1.4-$20.7 billion in productivity losses ($1.5-$23.1 billion total). The total cost was $10.6 billion based on the current incidence estimate (68.9/1000). Conclusion: Our study quantified norovirus' burden. Of the total burden, sporadic cases constituted >90% (thus, annual burden may vary depending on incidence) and productivity losses represented 89%. More than half the economic burden is in adults ≥45, more than half occurs in winter months, and >90% of outbreak costs are due to person-to-person transmission, offering insights into where and when prevention/control efforts may yield returns.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cost of Illness ; Disease Outbreaks/economics ; Gastroenteritis/economics ; Gastroenteritis/epidemiology ; Gastroenteritis/virology ; Health Care Costs ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Norovirus ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2020-07-15
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiaa292
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Article ; Online: What is the economic benefit of annual COVID-19 vaccination from the adult individual perspective?

Bartsch, Sarah M / O'Shea, Kelly J / Weatherwax, Colleen / Strych, Ulrich / Velmurugan, Kavya / John, Danielle C / Bottazzi, Maria Elena / Hussein, Mustafa / Martinez, Marie F / Chin, Kevin L / Ciciriello, Allan / Heneghan, Jessie / Dibbs, Alexis / Scannell, Sheryl A / Hotez, Peter J / Lee, Bruce Y

The Journal of infectious diseases

2024

Abstract: Background: With COVID-19 vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward.: Methods: We developed a Markov model representing the ... ...

Abstract	Background: With COVID-19 vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward. Methods: We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine. Results: For an 18-49-year-old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is ≥50% and the weekly risk of getting infected is ≥0.2%, corresponding to an individual interacting with 9 other people in a day under Winter 2023-2024 Omicron SARS-CoV-2 variant conditions with an average infection prevalence of 10%. For a 50-64-year-old, these cost-savings increase to $111-$1,278 and $119-$1,706, for someone without and with insurance, respectively. The risk threshold increases to ≥0.4% (interacting with 19 people/day), when the individual has 13.4% pre-existing protection against infection (e.g., vaccinated 9 months earlier). Conclusion: There is both clinical and economic incentive for the individual to continue to get vaccinated against COVID-19 each year.
Language	English
Publishing date	2024-04-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiae179
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Article ; Online: Benefits of Meeting the Healthy People 2030 Youth Sports Participation Target.

Martinez, Marie F / Weatherwax, Colleen / Piercy, Katrina / Whitley, Meredith A / Bartsch, Sarah M / Heneghan, Jessie / Fox, Martin / Bowers, Matthew T / Chin, Kevin L / Velmurugan, Kavya / Dibbs, Alexis / Smith, Alan L / Pfeiffer, Karin A / Farrey, Tom / Tsintsifas, Alexandra / Scannell, Sheryl A / Lee, Bruce Y

American journal of preventive medicine

2024 Volume 66, Issue 5, Page(s) 760–769

Abstract: Introduction: Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target.: Methods!# ...

Abstract	Introduction: Healthy People 2030, a U.S. government health initiative, has indicated that increasing youth sports participation to 63.3% is a priority in the U.S. This study quantified the health and economic value of achieving this target. Methods: An agent-based model developed in 2023 represents each person aged 6-17 years in the U.S. On each simulated day, agents can participate in sports that affect their metabolic and mental health in the model. Each agent can develop different physical and mental health outcomes, associated with direct and indirect costs. Results: Increasing the proportion of youth participating in sports from the most recent participation levels (50.7%) to the Healthy People 2030 target (63.3%) could reduce overweight/obesity prevalence by 3.37% (95% CI=3.35%, 3.39%), resulting in 1.71 million fewer cases of overweight/obesity (95% CI=1.64, 1.77 million). This could avert 352,000 (95% CI=336,200, 367,500) cases of weight-related diseases and gain 1.86 million (95% CI=1.86, 1.87 million) quality-adjusted life years, saving $22.55 billion (95% CI=$22.46, $22.63 billion) in direct medical costs and $25.43 billion (95% CI= $25.25, $25.61 billion) in productivity losses. This would also reduce depression/anxiety symptoms, saving $3.61 billion (95% CI=$3.58, $3.63 billion) in direct medical costs and $28.38 billion (95% CI=$28.20, $28.56 billion) in productivity losses. Conclusions: This study shows that achieving the Healthy People 2030 objective could save third-party payers, businesses, and society billions of dollars for each cohort of persons aged 6-17 years, savings that would continue to repeat with each new cohort. This suggests that even if a substantial amount is invested toward this objective, such investments could pay for themselves.
MeSH term(s)	Humans ; Adolescent ; Child ; United States ; Male ; Youth Sports ; Female ; Healthy People Programs ; Mental Health ; Overweight/epidemiology ; Overweight/prevention & control
Language	English
Publishing date	2024-02-27
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632646-8
ISSN	1873-2607 ; 0749-3797
ISSN (online)	1873-2607
ISSN	0749-3797
DOI	10.1016/j.amepre.2023.12.018
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Article ; Online: The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study.

Bartsch, Sarah M / O'Shea, Kelly J / John, Danielle C / Strych, Ulrich / Bottazzi, Maria Elena / Martinez, Marie F / Ciciriello, Allan / Chin, Kevin L / Weatherwax, Colleen / Velmurugan, Kavya / Heneghan, Jessie / Scannell, Sheryl A / Hotez, Peter J / Lee, Bruce Y

EClinicalMedicine

2024 Volume 68, Page(s) 102369

Abstract: Background: With efforts underway to develop a universal coronavirus vaccine, otherwise known as a pan-coronavirus vaccine, this is the time to offer potential funders, researchers, and manufacturers guidance on the potential value of such a vaccine and ...

Abstract	Background: With efforts underway to develop a universal coronavirus vaccine, otherwise known as a pan-coronavirus vaccine, this is the time to offer potential funders, researchers, and manufacturers guidance on the potential value of such a vaccine and how this value may change with differing vaccine and vaccination characteristics. Methods: Using a computational model representing the United States (U.S.) population, the spread of SARS-CoV-2 and the various clinical and economic outcomes of COVID-19 such as hospitalisations, deaths, quality-adjusted life years (QALYs) lost, productivity losses, direct medical costs, and total societal costs, we explored the impact of a universal vaccine under different circumstances. We developed and populated this model using data reported by the CDC as well as observational studies conducted during the COVID-19 pandemic. Findings: A pan-coronavirus vaccine would be cost saving in the U.S. as a standalone intervention as long as its vaccine efficacy is ≥10% and vaccination coverage is ≥10%. Every 1% increase in efficacy between 10% and 50% could avert an additional 395,000 infections and save $1.0 billion in total societal costs ($45.3 million in productivity losses, $1.1 billion in direct medical costs). It would remain cost saving even when a strain-specific coronavirus vaccine would be subsequently available, as long as it takes at least 2-3 months to develop, test, and bring that more specific vaccine to the market. Interpretation: Our results provide support for the development and stockpiling of a pan-coronavirus vaccine and help delineate the vaccine characteristics to aim for in development of such a vaccine. Funding: The National Science Foundation, the Agency for Healthcare Research and Quality, the National Institute of General Medical Sciences, the National Center for Advancing Translational Sciences, and the City University of New York.
Language	English
Publishing date	2024-01-11
Publishing country	England
Document type	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2023.102369
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Article ; Online: The Need for Systems Approaches for Precision Communications in Public Health.

Lee, Bruce Y / Greene, Danielle / Scannell, Sheryl A / McLaughlin, Christopher / Martinez, Marie F / Heneghan, Jessie L / Chin, Kevin L / Zheng, Xia / Li, Ruobing / Lindenfeld, Laura / Bartsch, Sarah M

Journal of health communication

2023 Volume 28, Issue sup1, Page(s) 13–24

Abstract: A major challenge in communicating health-related information is the involvement of multiple complex systems from the creation of the information to the sources and channels of dispersion to the information users themselves. To date, public health ... ...

Abstract	A major challenge in communicating health-related information is the involvement of multiple complex systems from the creation of the information to the sources and channels of dispersion to the information users themselves. To date, public health communications approaches have often not adequately accounted for the complexities of these systems to the degree necessary to have maximum impact. The virality of COVID-19 misinformation and disinformation has brought to light the need to consider these system complexities more extensively. Unaided, it is difficult for humans to see and fully understand complex systems. Luckily, there are a range of systems approaches and methods, such as systems mapping and systems modeling, that can help better elucidate complex systems. Using these methods to better characterize the various systems involved in communicating public health-related information can lead to the development of more tailored, precise, and proactive communications. Proceeding in an iterative manner to help design, implement, and adjust such communications strategies can increase impact and leave less opportunity for misinformation and disinformation to spread.
MeSH term(s)	Humans ; Public Health ; COVID-19/epidemiology ; Health Communication
Language	English
Publishing date	2023-06-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1427988-5
ISSN	1087-0415 ; 1081-0730
ISSN (online)	1087-0415
ISSN	1081-0730
DOI	10.1080/10810730.2023.2220668
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Article ; Online: Estimated number of N95 respirators needed for healthcare workers in acute-care hospitals during the coronavirus disease 2019 (COVID-19) pandemic.

Wedlock, Patrick T / O'Shea, Kelly J / Conte, Madellena / Bartsch, Sarah M / Randall, Samuel L / Ferguson, Marie C / Cox, Sarah N / Siegmund, Sheryl S / Kulkarni, Sarah / Nash, Denis / Lin, Michael Y / Lee, Bruce Y

Infection control and hospital epidemiology

2021 Volume 42, Issue 11, Page(s) 1318–1326

Abstract: Objective: Due to shortages of N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to estimate the number of N95s required for healthcare workers (HCWs) to inform manufacturing targets and resource allocation.: ... ...

Abstract	Objective: Due to shortages of N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to estimate the number of N95s required for healthcare workers (HCWs) to inform manufacturing targets and resource allocation. Methods: We developed a model to determine the number of N95 respirators needed for HCWs both in a single acute-care hospital and the United States. Results: For an acute-care hospital with 400 all-cause monthly admissions, the number of N95 respirators needed to manage COVID-19 patients admitted during a month ranges from 113 (95% interpercentile range [IPR], 50-229) if 0.5% of admissions are COVID-19 patients to 22,101 (95% IPR, 5,904-25,881) if 100% of admissions are COVID-19 patients (assuming single use per respirator, and 10 encounters between HCWs and each COVID-19 patient per day). The number of N95s needed decreases to a range of 22 (95% IPR, 10-43) to 4,445 (95% IPR, 1,975-8,684) if each N95 is used for 5 patient encounters. Varying monthly all-cause admissions to 2,000 requires 6,645-13,404 respirators with a 60% COVID-19 admission prevalence, 10 HCW-patient encounters, and reusing N95s 5-10 times. Nationally, the number of N95 respirators needed over the course of the pandemic ranges from 86 million (95% IPR, 37.1-200.6 million) to 1.6 billion (95% IPR, 0.7-3.6 billion) as 5%-90% of the population is exposed (single-use). This number ranges from 17.4 million (95% IPR, 7.3-41 million) to 312.3 million (95% IPR, 131.5-737.3 million) using each respirator for 5 encounters. Conclusions: We quantified the number of N95 respirators needed for a given acute-care hospital and nationally during the COVID-19 pandemic under varying conditions.
MeSH term(s)	COVID-19 ; Health Personnel ; Hospitals ; Humans ; Masks ; N95 Respirators ; Pandemics/prevention & control ; SARS-CoV-2 ; United States/epidemiology
Language	English
Publishing date	2021-01-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2020.1418
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