MOSAIC: A model to assess the cost-effectiveness of ICU strategies for the South African Covid-19 response

As the COVID-19 pandemic progresses, the demands on the health care system will intensify and will result in critical shortages of resources (hospital beds, intensive care unit (ICU) beds, ventilators, medical workforce), particularly in the public sector. Given the expected downturn in an already weak economy coupled with the increased demand for government resources for economic relief and other measures, the ability of government to commit additional funding to an already under-funded public health sector is limited. Within this context, it is imperative that available public resources are used fairly, optimally and efficiently - we simply cannot afford to waste any resources.

This rapid economic evaluation intends to inform Covid-19 health system decision-making. In this report, we respond to the question: What is the cost-effectiveness of ICU care versus treatment in general ward in supporting severe Covid-19 cases? Given the emergent nature of Covid-19 and the huge uncertainty in key parameters, a simple excel-based model is provided. This simplicity is designed to facilitate understanding. In addition, the framework allows for parameters to be varied and ultimately updated as sufficient local data become available.