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. In such a context, it becomes imperative that resources are used in the most humane ways possible; and that decisions about resource allocation are made carefully and with compassion.

While there are a number of key resource allocation decisions that need to be made in the response to COVID-19, this rapid economic evaluation responds 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.