Cancer systems epidemiology: Overcoming misconceptions and integrating systems approaches into cancer research.

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

The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Finding medications or vaccines that may decrease the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could potentially reduce transmission in the broader population. We developed a computational model of the U.S. simulating the spread of SARS-CoV-2 and the potential clinical and economic impact of reducing the infectious period duration. Simulation experiments found that reducing the average infectious period duration could avert a median of 442,852 [treating 25% of symptomatic cases, reducing by 0.5 days, reproductive number (R0) 3.5, and starting treatment when 15% of the population has been exposed] to 44.4 million SARS-CoV-2 cases (treating 75% of all infected cases, reducing by 3.5 days, R0 2.0). With R0 2.5, reducing the average infectious period duration by 0.5 days for 25% of symptomatic cases averted 1.4 million cases and 99,398 hospitalizations; increasing to 75% of symptomatic cases averted 2.8 million cases. At $500/person, treating 25$209.5 billion (societal perspective). Further reducing the average infectious period duration by 3.5 days averted 7.4 million cases (treating 25% of symptomatic cases). Expanding treatment to 75% of all infected cases, including asymptomatic infections (R0 2.5), averted 35.9 million cases and 4 million hospitalizations, saving $48.8 billion (societal perspective and starting treatment after 5% of the population has been exposed). Our study quantifies the potential effects of reducing the SARS-CoV-2 infectious period duration

Key model inputs.

<p>Key model inputs.</p

Total costs for all states combined.

<p>Medicaid costs, direct medical costs, productivity losses, and total costs for all six states combined. Illustrated here is the base case scenario (solid line) as well as the range from the more conservative to the less conservative scenario (shaded region).</p

Productivity losses per state.

<p>Total productivity losses by state and attack rate. Illustrated here is the base case scenario (solid line) as well as the range from the more conservative to the less conservative scenario (shaded region).</p

Direct medical costs by at risk group for all states combined.

<p>Direct medical costs by at risk group for all states combined.</p

Model structure.

<p>The flow diagram above illustrates each of the paths an individual in the model can take in the event of a Zika virus outbreak, given different probabilities at each node. The model includes all individuals in the six selected states considered at risk for Zika virus infection in the US.</p

Potential number of cases and costs for specific attack rates.

<p>Potential number of cases and costs for specific attack rates.</p

Direct medical costs per state.

<p>Direct medical costs by state and attack rate. Illustrated here is the base case scenario (solid line) as well as the range from the more conservative to the less conservative scenario (shaded region).</p

Total costs per state.

<p>Total costs (direct medical and productivity losses) by state and attack rate. Illustrated here is the base case scenario (solid line) as well as the range from the more conservative to the less conservative scenario (shaded region).</p