Social Restrictions Versus Testing Campaigns in the COVID-19 Crisis: A Predictive Model Based on the Spanish Case

Background: The global COVID-19 spread has forced countries to implement different nonpharmacological interventions (NPI) to preserve their health systems. Spain was one of the first and most severely impacted countries, both clinically and economically. In an effort to support policy decision-making, we aimed to assess the impacts of different NPI on COVID-19 epidemiology, healthcare costs and Gross Domestic Product (GDP). Methods: A modified Susceptible-Exposed-Infectious-Removed epidemiological model was created to simulate the pandemic evolution. Its output was then used to populate an economic model to predict healthcare costs and Q4 2020 GDP decline, estimated through a multiple linear regression model based on NPIs and GDP decline from 42 countries during Q2 2020. Thirteen scenarios combining different NPI were consecutively simulated in the epidemiological and economic models. Findings: With no changes in testing rate or stringency (lockdown), 2·38 million new exposed cases in the subsequent 90 days were estimated in Spain. Both increased testing and stringency could reduce cases, hospitalizations and deaths. While policies based on increased testing rates led to higher healthcare costs, increased stringency led to greater GDP declines with differences of up to 4·4% points. Increased test sensitivity may lead to a reduction of cases, hospitalizations and deaths and to the implementation of pooling techniques that can increase throughput testing capacity. Interpretation: Alternative strategies for controlling the COVID-19 spread lead to differing economic outcomes. Decision-makers may utilize this tool to identify the most suitable strategy considering epidemiological and economic outcomes. Funding: This study is funded by Grifols S.A.Declaration of Interests: EV is employee from Grifols S.A. FJC, JS-R-M, RR, PB and MMC received honoraria from Grifols S.A. for their participation in the study as subject experts, within the Fair Market Value range. DC and AK are employees from IQVIA, which was the Clinical Research Organization hired by Grifols S.A. for the implementation of this study and medical writing support. MCR is employee from Grifols S.S.N.A.