Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jun 15, 2021)
Date Submitted: Dec 23, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Appropriate levels of government intervention to incidence of coronavirus disease 2019: a modeling study in OECD countries
ABSTRACT
Background:
Government intervention is one of the most important methods for controlling the coronavirus disease 2019 (COVID-19) pandemic.
Objective:
Using the stringency index (SI) from the Oxford COVID-19 Government Response Tracker, we aimed to identify appropriate levels of government intervention by country and to analyze quantitatively and qualitatively the effectiveness of government interventions for mitigating COVID-19 incidence in OECD countries.
Methods:
We obtained the controllable stringency index (CSI) from each country’s data through the decision tree method and used two models to determine the significance and effectiveness of the CSI by estimating changes in the number of confirmed cases of COVID-19. In the first model, all COVID-19 data from each country was merged into a dataset.
Results:
Daily changes (gradient) in the number of confirmed cases decreased by 2.9% (95% confidence interval (CI), 2.9% to 2.9%; p < .001) for every 1.0 increase in SI based on the CSI. In logistic regression analysis, an SI higher than the CSI was related to lower numbers of daily confirmed cases (odds ratio (OR), 6.757; 95% CI, 5.618 to 8.130; p < .001) in the country model, and the average difference between daily SI and CSI was negatively correlated with the average gradient of the number of confirmed cases (β = -.017; 95% CI, -.026 to -.008; p < .001) across different countries. The CSI was associated with regions determined by the World Health Organization (WHO) (West-Pacific to Europe, β = 17.267; 95% CI, 8.120 to 26.414; p = .001 and West-Pacific to America, β = 28.318; 95% CI, 13.849 to 42.787; p < .001) together with average annual temperature (β = 1.493; 95% CI, .674 to 2.312; p = .001).
Conclusions:
This study suggests that the appropriate level of government intervention for each country expressed as the CSI and the difference between the appropriate level and the actual level of SI might show a quantitative increase or decrease in the number of COVID-19 patients. Maintaining a SI above the CSI has the potential to decrease COVID-19 incidence in OECD countries. Considering the impact of government intervention on society and the economy, it may be more efficient to maintain levels of government intervention above appropriate levels per specific parameters than to implement higher levels of intervention. The findings may support political decisions and research methods in current or future waves of the pandemic.
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