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    The cost-effectiveness of standalone HEPA filtration units for the prevention of airborne SARS CoV-2 transmission.

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    Author
    Zafari, Zafar
    de Oliveira, Pedro M
    Gkantonas, Savvas
    Ezeh, Chinenye
    Muennig, Peter Alexander
    Date
    2022-05-12
    Journal
    Cost Effectiveness and Resource Allocation : C/E
    Publisher
    Springer Nature
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1186/s12962-022-00356-1
    Abstract
    Objective: Airborne infection from aerosolized SARS-CoV-2 poses an economic challenge for businesses without existing heating, ventilation, and air conditioning (HVAC) systems. The Environmental Protection Agency notes that standalone units may be used in areas without existing HVAC systems, but the cost and effectiveness of standalone units has not been evaluated. Study design: Cost-effectiveness analysis with Monte Carlo simulation and aerosol transmission modeling. Methods: We built a probabilistic decision-analytic model in a Monte Carlo simulation that examines aerosol transmission of SARS-CoV-2 in an indoor space. As a base case study, we built a model that simulated a poorly ventilated indoor 1000 square foot restaurant and the range of Covid-19 prevalence of actively infectious cases (best-case: 0.1%, base-case: 2%, and worst-case: 3%) and vaccination rates (best-case: 90%, base-case: 70%, and worst-case: 0%) in New York City. We evaluated the cost-effectiveness of improving ventilation rate to 12 air changes per hour (ACH), the equivalent of hospital-grade filtration systems used in emergency departments. We also provide a customizable online tool that allows the user to change model parameters. Results: All 3 scenarios resulted in a net cost-savings and infections averted. For the base-case scenario, improving ventilation to 12 ACH was associated with 54 [95% Credible Interval (CrI): 29-86] aerosol infections averted over 1 year, producing an estimated cost savings of $152,701 (95% CrI: $80,663, $249,501) and 1.35 (95% CrI: 0.72, 2.24) quality-adjusted life years (QALYs) gained. Conclusions: It is cost-effective to improve indoor ventilation in small businesses in older buildings that lack HVAC systems during the pandemic.
    Data Availibility
    We build an accompanying online dashboard for the model. Other data will be available upon request from the authors.
    Rights/Terms
    © 2022. The Author(s).
    Keyword
    Commercial spaces
    Covid-19
    Economic evaluation
    Improving ventilation
    Prevention strategies
    Restaurants and bars
    SARS-CoV-2
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18876
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12962-022-00356-1
    Scopus Count
    Collections
    UMB Coronavirus Publications
    UMB Open Access Articles

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