lancet-header
Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed. For more information see the Comment published in The Lancet, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com

An Ecological Study Assessing the Relationship between Public Health Policies and Severity of the COVID-19 Pandemic

29 Pages Posted: 23 Sep 2020

See all articles by Zahra Pasdar

Zahra Pasdar

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Tiberiu A Pana

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Kai D Ewers

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Weronika A Szlachetka

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Jesus A Perdomo-Lampignano

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

David T Gamble

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Sohinee Bhattacharya

University of Aberdeen - Instutute of Applied Health Sciences

Ben Carter

Department of Biostatistics, and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London

Phyo Kyaw Myint

University of Aberdeen - ​Institute​ ​of​ ​Medical​ ​Sciences

More...

Abstract

Background: The COVID-19 pandemic has claimed almost half a million deaths worldwide. Reliance on government-led policies have been heightened during the pandemic to mitigate the spread of disease. Which of these policies are associated with important outcomes other than mortality rates remains unknown. Hence, we aimed to determine the associations between government public health policies on the severity of the COVID-19 pandemic.

Methods: This ecological study utilised publicly accessible data on seventeen policy indicators of Containment, Economic and Health systems and their respective Stringency Index described by the Blavatnik school of Government. Countries reporting >25 daily COVID-related deaths until end May 2020 were included. We assessed the association of individual SI with the profile of severity of COVID-19 by using several outcomes; mean mortality rate, time to peak, peak deaths per 100,000 population, cumulative deaths after peak per 100,000 population and ratio of the mean slope of the descending curve to the mean slope of the ascending curve. Analyses were stratified according to age, income and region. Spearman rank-order tests were employed to measure associations. Results were presented descriptively and direct comparisons were made.

Findings: Twenty-two countries were included. Containment policies appeared more effective in younger populations and debt/contract relief in older populations. In European countries, containment policies were generally associated with good outcomes. In non-European countries, school closures alone had the strongest association with most of the outcomes examined. In high-income countries, health system policies such as public information campaigns and testing were generally effective, in contrast to low-income countries.

Interpretation: Containment policies may be effective when targeted towards younger populations and occur in high-income or European countries. Health system policies have not been as effective in low-income and non-European countries.

Funding Statement: None.

Declaration of Interests: None.

Ethics Approval Statement: Due to the ecological study design and the use of publicly accessible data, ethical approval was not required.

Keywords: Ecological study; COVID-19; Public health policies

Suggested Citation

Pasdar, Zahra and Pana, Tiberiu A and Ewers, Kai D and Szlachetka, Weronika A and Perdomo-Lampignano, Jesus A and Gamble, David T and Bhattacharya, Sohinee and Carter, Ben and Myint, Phyo Kyaw, An Ecological Study Assessing the Relationship between Public Health Policies and Severity of the COVID-19 Pandemic (6/23/2020). Available at SSRN: https://ssrn.com/abstract=3634847 or http://dx.doi.org/10.2139/ssrn.3634847

Zahra Pasdar

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen ( email )

Tiberiu A Pana

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Kai D Ewers

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Weronika A Szlachetka

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Jesus A Perdomo-Lampignano

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

David T Gamble

Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen

Sohinee Bhattacharya

University of Aberdeen - Instutute of Applied Health Sciences

Aberdeen, Scotland AB25 2ZD
United Kingdom

Ben Carter

Department of Biostatistics, and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London

Phyo Kyaw Myint (Contact Author)

University of Aberdeen - ​Institute​ ​of​ ​Medical​ ​Sciences ( email )

​IMS​ ​Building,​ ​Foresterhill
Aberdeen, Scotland AB25​ ​2ZD
United Kingdom

Click here to go to TheLancet.com

Paper statistics

Abstract Views
355
Downloads
28
PlumX Metrics