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The Effect of Early Response During COVID-2019 Outbreak: A Quasi Experiment
20 Pages Posted: 5 Mar 2020
More...Abstract
Background: Since the initial outbreak of the new coronavirus (COVID-2019) in Hubei, other provinces in mainland China initiated level-1 responses to the public health emergency from January 23 to 25, 2020. The 3-day time window for policy implementation provides a quasi-experiment opportunity to evaluate the effects of the response timing and types in surrounding areas. As the COVID-2019 spreads to more countries nowadays, the answers to these questions are of great value to global public-health research and policy-making.
Methods: We collected data on the daily confirmed cases reported by the National Health Commission of China between January 20 and February 9, 2020, as well as provincial demographic, socioeconomic and policy information. We used a quasi-experimental estimation strategy by comparing outbreak situations in provinces that initiated emergency responses by January 24 with provinces that responded 1 day later.
Results: The early response significantly decreased the newly-confirmed rate and the newly-confirmed number after 11 days of initiation. The conditional treatment effect estimation showed that provinces responded 1 day earlier could averagely reduce 2.2% newly-confirmed rate and 497.4 newly confirmed cases per 10,000 population per square kilometer.
Interpretation: The study quantified the positive effect of early prevention efforts surrounding the epidemic area, and assessed how many infection cases would be avoided if the response was initiated 1 day earlier in the surrounding provinces. Meanwhile, the study also determined the importance of nonpharmaceutical interventions and validated the marginal mitigating effects for provinces with late responses.
Funding Statement: This research was supported by National Natural Science Fund of China (#91846302, 71871065, 81501294) for data collection and analysis.
Declaration of Interests: The authors declare no competing interests.
Keywords: COVID-2019; Outbreak; quasi experiment, policy evaluation
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