Statistical Analyses of the Public Health and Economic Performance of Nordic Countries in Response to the COVID-19 Pandemic

  1. Daniel V. Gordon
  2. R. Quentin Grafton
  3. Stein Ivar Steinshamn

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Abstract

Aim

To compare trends and undertake statistical analyses of differences in public health performance (confirmed cases and fatalities) of Nordic countries; Denmark, Finland, Norway and Sweden, and New Zealand, in response to the COVID-19 pandemic.

Methods

Per capita trends in total cases and per capita fatalities were analysed and difference-in-difference statistical tests undertaken to assess whether differences in stringency of mandated social distancing (SD) measures, testing rates and border closures explain cross-country differences.

Results

Sweden is a statistical outlier, relative to its Nordic neighbours, for both per capita cases and per capita fatalities associated with COVID-19 but not in terms of the reduction in economic growth. Sweden’s public health differences, compared to its Nordic neigbours, are partially explained by differences in terms of international border closures and the level of stringency of SD measures (including testing) implemented from early March to June 2020.

Conclusions

We find that: one, early imposition of full international travel restrictions combined with high levels of government-mandated stringency of SD reduced the per capita cases and per capita fatalities associated with COVID-19 in 2020 in the selected countries and, two, in Nordic countries, less stringent government-mandated SD is not associated with higher quarterly economic growth.

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  1. ScreenIT

    SciScore for 10.1101/2020.11.23.20236711: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: The principal limitation of our study is that the pandemic will continue for many more months, possibly even years, even with the widespread use of vaccines [17]. Thus, our findings of a worse public health performance, and no better economic performance, in Sweden relative to its Nordic neighbours only applies to the end of October 2020. A second limitation is that because we have adopted a ‘like-with-like comparison’ to control for cross-country differences we have only five observations at a country level. In turn, this limits our ability to undertake statistical tests for differences in means among the selected countries. A third limitation is that the data on confirmed cases of COVID-19 are likely to be less than actual cases [18] and this is likely to more pronounced in countries that have had a low testing rate, such as Sweden. A downward bias may also apply, at least in some countries, in relation to COVID-19 fatalities [12]. Another data limitation is that our stringency measure of SD only accounts for government-related measures and does not account for the voluntary behaviours of individuals themselves to avoid becoming infected, or infecting others, with the SARS-CoV-2 virus. Implications: Notwithstanding the limitations of our study, an important public health implication of our findings is that early imposition of full international travel restrictions combined, with high levels of government-mandated stringency levels of SD, appear to have reduced ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.11.23.20236711v1 on medRxiv