Comparing the impact on COVID ‐19 mortality of self‐imposed behavior change and of government regulations across 13 countries
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
Objective
Countries have adopted different approaches, at different times, to reduce the transmission of coronavirus disease 2019 (COVID‐19). Cross‐country comparison could indicate the relative efficacy of these approaches. We assess various nonpharmaceutical interventions (NPIs), comparing the effects of voluntary behavior change and of changes enforced via official regulations, by examining their impacts on subsequent death rates.
Data Sources
Secondary data on COVID‐19 deaths from 13 European countries, over March–May 2020.
Study Design
We examine two types of NPI: the introduction of government‐enforced closure policies and self‐imposed alteration of individual behaviors in the period prior to regulations. Our proxy for the latter is Google mobility data, which captures voluntary behavior change when disease salience is sufficiently high. The primary outcome variable is the rate of change in COVID‐19 fatalities per day, 16–20 days after interventions take place. Linear multivariate regression analysis is used to evaluate impacts.
Data collection/extraction methods: publicly available.
Principal Findings
Voluntarily reduced mobility, occurring prior to government policies, decreases the percent change in deaths per day by 9.2 percentage points (pp) (95% confidence interval [CI] 4.5–14.0 pp). Government closure policies decrease the percent change in deaths per day by 14.0 pp (95% CI 10.8–17.2 pp). Disaggregating government policies, the most beneficial for reducing fatality, are intercity travel restrictions, canceling public events, requiring face masks in some situations, and closing nonessential workplaces. Other sub‐components, such as closing schools and imposing stay‐at‐home rules, show smaller and statistically insignificant impacts.
Conclusions
NPIs have substantially reduced fatalities arising from COVID‐19. Importantly, the effect of voluntary behavior change is of the same order of magnitude as government‐mandated regulations. These findings, including the substantial variation across dimensions of closure, have implications for the optimal targeted mix of government policies as the pandemic waxes and wanes, especially given the economic and human welfare consequences of strict regulations.
Article activity feed
-
-
SciScore for 10.1101/2020.08.02.20166793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.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:As one of the first studies to explore these issues empirically using substantial data, this analysis inevitably involves a number of limitations. Without randomization or other exogenous variation in the treatments, evidently, we cannot fully ascertain a causal link between the NPIs and the resulting changes in death rates. We do not …
SciScore for 10.1101/2020.08.02.20166793: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.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:As one of the first studies to explore these issues empirically using substantial data, this analysis inevitably involves a number of limitations. Without randomization or other exogenous variation in the treatments, evidently, we cannot fully ascertain a causal link between the NPIs and the resulting changes in death rates. We do not expect any reverse causality, since future deaths will not change current behaviors. However, it is conceivable that some third variable, for instance heightened media attention and scrutiny, could directly influence both government policies and individual behaviors. Future studies, using data on this and similar potential confounders, may be able to fully disentangle the various mechanisms at play. Finally, the quality of the fatality data is subject to variation in reporting standards across countries, although this will be partially mitigated by focusing on rates of change rather than levels. Similarly, the quality of the government closure data is, although compiled independently and not biased in any way, somewhat subjective in nature as to the precise degree of severity in each category at each point in time. The main messages here are that NPIs can have significant impacts in reducing COVID-19 mortality, and that the empirical evidence suggests that the simpler, more flexible and more easily reversed interventions that result in self-motivated voluntary behavioral change, working remotely to the extent possible, and reducing large-scale d...
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.
-
