Government responses and COVID-19 deaths: Global evidence across multiple pandemic waves

Abstract

We provide an assessment of the impact of government closure and containment measures on deaths from COVID-19 across sequential waves of the COVID-19 pandemic globally. Daily data was collected on a range of containment and closure policies for 186 countries from January 1, 2020 until March 11th, 2021. These data were combined into an aggregate stringency index (SI) score for each country on each day (range: 0–100). Countries were divided into successive waves via a mathematical algorithm to identify peaks and troughs of disease. Within our period of analysis, 63 countries experienced at least one wave, 40 countries experienced two waves, and 10 countries saw three waves, as defined by our approach. Within each wave, regression was used to assess the relationship between the strength of government stringency and subsequent deaths related to COVID-19 with a number of controls for time and country-specific demographic, health system, and economic characteristics. Across the full period of our analysis and 113 countries, an increase of 10 points on the SI was linked to 6 percentage points (P < 0.001, 95% CI = [5%, 7%]) lower average daily deaths. In the first wave, in countries that ultimately experiences 3 waves of the pandemic to date, ten additional points on the SI resulted in lower average daily deaths by 21 percentage points (P < .001, 95% CI = [8%, 16%]). This effect was sustained in the third wave with reductions in deaths of 28 percentage points (P < .001, 95% CI = [13%, 21%]). Moreover, interaction effects show that government policies were effective in reducing deaths in all waves in all groups of countries. These findings highlight the enduring importance of non-pharmaceutical responses to COVID-19 over time.

Risk factors for increased COVID-19 case-fatality in the United States: A county-level analysis during the first wave

“…Finally, our study period ended in mid-June. Recent work has divided the COVID-19 pandemic in the USA into three waves, with the first wave running from late March 2020 until mid-June 2020 [ 71 ]. The exact day of June 12, 2020 was chosen because [ 1 ] enough cases had occurred in the US to obtain reliable estimates of laCFR by county and [ 2 ] it preceded CDC reopening guidance and a shift in reporting to the HHS Protect system, which is less readily available to the public than the prior CDC reporting system [ 72 ].…”

Identification of COVID-19 Waves: Considerations for Research and Policy

“…The analysis highlights the importance of considering time as a key factor, both to understand the causes and effects of the pandemic, and to design policies to address it; for example, it is relevant to assess governments’ interventions throughout the pandemic [ 24 ]. It also emphasizes the need to acknowledge the researchers’ methodological choices and their consequences in the results [ 25 ].…”

A year of living distantly: global trends in the use of stay-at-home orders over the first 12 months of the COVID-19 pandemic

“…Retrospective studies of this period have generally found that both the overall stringency of NPIs and the speed of implementation contribute to reducing cases and deaths [ 1 , 12 , 22 – 23 ]. At the very least, the initial global response managed to steady what was, at that time, a rapidly accelerating pandemic.…”

“…Global transmission of the SARS-CoV-2 virus was first detected in January 2020, when cases outside of China were reported in France, Japan, Thailand, the USA and several other countries. Since then, over the course of the pandemic, almost every country in the world has experienced one or more waves of epidemic community transmission [1][2][3]. High levels of COVID-19 cases have threatened to overwhelm healthcare systems in many countries, and in some cases have collapsed them, compounding the infection fatality rate of the virus and causing high excessive mortality [4,5].…”