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Background We projected the clinical and economic impact of alternative testing strategies on coronavirus disease 2019 (COVID-19) incidence and mortality in Massachusetts using a microsimulation model. Methods We compared 4 testing strategies: (1) hospitalized: polymerase chain reaction (PCR) testing only for patients with severe/critical symptoms warranting hospitalization; (2) symptomatic: PCR for any COVID-19–consistent symptoms, with self-isolation if positive; (3) symptomatic + asymptomatic once: symptomatic and 1-time PCR for the entire population; and (4) symptomatic + asymptomatic monthly: symptomatic with monthly retesting for the entire population. We examined effective reproduction numbers (Re = 0.9–2.0) at which policy conclusions would change. We assumed homogeneous mixing among the Massachusetts population (excluding those residing in long-term care facilities). We used published data on disease progression and mortality, transmission, PCR sensitivity/specificity (70%/100%), and costs. Model-projected outcomes included infections, deaths, tests performed, hospital-days, and costs over 180 days, as well as incremental cost-effectiveness ratios (ICERs, $/quality-adjusted life-year [QALY]). Results At Re = 0.9, symptomatic + asymptomatic monthly vs hospitalized resulted in a 64% reduction in infections and a 46% reduction in deaths, but required >66-fold more tests/day with 5-fold higher costs. Symptomatic + asymptomatic monthly had an ICER Conclusions Testing people with any COVID-19–consistent symptoms would be cost-saving compared to testing only those whose symptoms warrant hospital care. Expanding PCR testing to asymptomatic people would decrease infections, deaths, and hospitalizations. Despite modest sensitivity, low-cost, repeat screening of the entire population could be cost-effective in all epidemic settings.

Clements, A. J., Strong, J. A., Flanagan, C., and Service, M. 2010. Objective stratification and sampling-effort allocation of ground-truthing in benthic-mapping surveys. – ICES Journal of Marine Science, 67: 628–637. The application of statistical procedures for objective stratification of sampling effort during map ground-truthing is presented. Marine benthic mapping is usually undertaken in two stages: a remotely sensed acoustic survey followed by ground-truthing to confirm ground-type and habitat classification. The objective of this study was to assess the application of optimum allocation analysis (OAA) through the use of remotely sensed data to direct expensive ground-truthing sampling effort. At an offshore site in the Irish Sea, classification of remotely sensed data, namely bathymetry and slope angle, generated six predicted ground-types. Calculated data variances within each ground-type were assumed to be a predictor of substratum heterogeneity, and these were used in an OAA to apportion ground-truthing effort objectively within each ground-type in order to achieve a set level of sampling precision. The sampling effort recommended by the OAA was realistic and practical with regard to video footage, but the collection of grabs was limited by resource constraints. The coefficient of variation (CV) of the video ground-truthing data matched that estimated by OAA, but the inability to collect all the recommended grabs resulted in CVs greater than expected for sediment grain-size parameters. The efficient identification of substratum classes using OAA represents a first stage whereby this method could direct ground-truthing that could ultimately be used for habitat mapping.