Effectiveness assessment of non-pharmaceutical interventions: lessons learned from the COVID-19 pandemic

Lison, Adrian; Banholzer, Nicolas; Sharma, Mrinank; Mindermann, Sören; Unwin, H. Juliette T.; Mishra, Swapnil; Stadler, Tanja; Bhatt, Samir; Ferguson, Neil; Brauner, Jan Markus; Vach, Werner

doi:10.1016/s2468-2667(23)00046-4

Cited by 25 publications

(15 citation statements)

References 51 publications

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“…Globally, evidence relating to travel restrictions’ effectiveness in reducing COVID-19 burden is mixed. Several reviews on the topic highlight a lack of consensus in methodologies for empirically evaluating COVID-19 interventions’ effectiveness, including different definitions or criteria for effectiveness ( 11 , 12 , 23 ). In United Arab Emirates, a decline of transmissions from international sources followed implementation of international travel restrictions in 2020 ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Travel restrictions are a class of NPI applied to mitigate pandemic burden; they include restricted entry of foreign nationals, flight bans, border entry requirements such as testing or vaccination, and quarantine requirements. Globally, evidence for their effectiveness has been mixed (11)(12)(13)(14)(15). Some evidence suggests countries where VOCs were first detected had diminishing contributions towards international dispersal over time, particularly those with high global connectivity, calling into question targeted travel restriction effectiveness on domestic case burden (16).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Canadian travel restrictions in reducing burden of SARS-CoV-2 variants of concern

McLaughlin,

Montoya,

Miller

et al. 2023

Preprint

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Evaluating travel restriction effectiveness in mitigating infectious disease burden is critical for informing public health policy. Here, we quantify where and when variants of SARS-CoV-2 were introduced into Canada to evaluate the extent to which travel restrictions averted viral introductions and COVID-19 case burden. Our results suggest that, across SARS-CoV-2 variants of concern subject to travel restrictions, at least 281 introductions were prevented, accounting for an averted burden of approximately 44,064 cases. This corresponds to approximately 441 averted hospitalizations, 24 averted deaths, and cost savings to Canadian health care systems of approximately $11.2 million Canadian dollars. Travel restrictions were found to be most effective when implemented rapidly during exponential case growth in the focal source and when global circulation was limited. Our analyses reveal that COVID-19 travel restrictions mitigated case burdens and highlight their value in future pandemic response.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of Canadian travel restrictions in reducing burden of SARS-CoV-2 variants of concern

McLaughlin,

Montoya,

Miller

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…1 2 19 20 22-24 Others use semi-mechanistic or mechanistic models to infer transmission rates or reproduction numbers, such as Bayesian hierarchical models. [25][26][27] For a study using a time-varying government response index from the same data source of our study, although measures were adopted to mitigate estimation bias due to endogeneity, it remains a concern when assessing the long-term policy effectiveness. 28 We overcome some of the limitations by constructing the country-level NPIs as time invariant indices based on government responses before the outbreak of the pandemic, which contributes to the existing literature by offering a different perspective on the measurements of NPIs.…”

Section: Methodsmentioning

confidence: 99%

How much does government’s short-term response matter for explaining cross-country variation in COVID-19 infection outcomes? A regression-based relative importance analysis of 84 countries

Liu,

Peng,

Yang

et al. 2024

bmjph

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ObjectiveWe study the predetermined characteristics of countries in addition to their government non-pharmaceutical interventions (NPIs) to shed light on the correlates of the variation in COVID-19 infection outcomes across countries.Methods and analysisWe conduct a systematic investigation of the validity of government responses in 84 countries by gradually adding the predetermined cultural, natural and socioeconomic factors of each country using a fixed-effect model and daily panel data. A relative importance analysis is conducted to isolate the contribution of each variable to the R2of the model.ResultsGovernment NPIs are effective in containing the virus spread and explain approximately 9% of the variations in the pandemic outcomes. COVID-19 is more prevalent in countries that are more individual-oriented or with a higher gross domestic product (GDP) per capita, while a country’s government expenditure on health as a proportion of GDP and median age are negatively associated with the infection outcome. The SARS-CoV-2 lifecycle and the impacts of other unobserved factors together explain more than half of the variation in the prevalence of COVID-19 across countries. The degree of individualism explains 9.30% of the variation, and the explanatory power of the other socioeconomic factors is less than 4% each.ConclusionThe COVID-19 infection outcomes are correlated with multivariate factors, ranging from state NPIs, culture-influenced human behaviours, geographical conditions and socioeconomic conditions. As expected, the stronger or faster are the government responses, the lower is the level of infections. In the meantime, many other factors underpin a major part of the variation in the control of COVID-19. As such, from a scientific perspective, it is important that country-specific conditions are taken into account when evaluating the impact of NPIs in order to conduct more cost-effective policy interventions.

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“…In the literature, such ensemble methods often use the mean (e.g., [11]) or median (e.g., [10]) of the base model outputs. However, pandemics like COVID-19 are dynamic, there are times when the number of cases barely changes, there is exponential growth and decay, and there are turning points of waves, which can all depend on external factors like interventions [13,14], people's behavior [15], seasonality [16,17], or variants of concern [18,19].…”

Section: Introductionmentioning

confidence: 99%

A dynamic ensemble model for short-term forecasting in pandemic situations

Botz,

Valderrama,

Guski

et al. 2024

Preprint

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During the COVID-19 pandemic, many hospitals reached their capacity limits and could no longer guarantee treatment of all patients. At the same time, governments endeavored to take sensible measures to stop the spread of the virus while at the same time trying to keep the economy afloat. Many models extrapolating confirmed cases and hospitalization rate over short periods of time have been proposed, including several ones coming from the field of machine learning. However, the highly dynamic nature of the pandemic with rapidly introduced interventions and new circulating variants imposed non-trivial challenges for the generalizability of such models. In the context of this paper, we propose the use of ensemble models, which are allowed to change in their composition or weighting of base models over time and can thus adapt to highly dynamic pandemic or epidemic situations. In that regard, we also explored the use of secondary metadata - Google searches - to inform the ensemble model. We tested our approach using surveillance data from COVID-19, Influenza, and hospital syndromic surveillance of severe acute respiratory infections (SARI). In general, we found ensembles to be more robust than the individual models. Altogether we see our work as a contribution to enhance the preparedness for future pandemic situations.

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Effectiveness assessment of non-pharmaceutical interventions: lessons learned from the COVID-19 pandemic

Cited by 25 publications

References 51 publications

Effectiveness of Canadian travel restrictions in reducing burden of SARS-CoV-2 variants of concern

Effectiveness of Canadian travel restrictions in reducing burden of SARS-CoV-2 variants of concern

How much does government’s short-term response matter for explaining cross-country variation in COVID-19 infection outcomes? A regression-based relative importance analysis of 84 countries

A dynamic ensemble model for short-term forecasting in pandemic situations

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