On the effectiveness of COVID-19 restrictions and lockdowns: Pan metron ariston

  1. Leonidas Spiliopoulos

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Abstract

Background

Early evaluations of the effectiveness of non-pharmaceutical intervention (NPI) mandates were constrained by the lack of empirical data, thereby also limiting model sophistication (e.g., models did not take into account the endogeneity of key variables).

Methods

Observational analysis using a behavioral four-equation structural model that accounts for the endogeneity of many variables and correlated unobservable country characteristics. The dataset includes information from 132 countries from February 15, 2020, to April 14, 2021, with data on confirmed cases and deaths, mobility, vaccination and testing rates, and NPI stringency. The main outcomes of interest are the growth rates of confirmed cases and deaths.

Results

There were strongly decreasing returns to more stringent NPI mandates. No additional impact was found for NPI mandates beyond a Stringency Index range of 51–60 for cases and 41–50 for deaths. A nonrestrictive policy of extensive and open testing constituted 51% [27% to 76%] of the impact on pandemic dynamics of the optimal NPIs. Reductions in mobility were found to increase, not decrease, both case $$\left( -0.0417,\left[ -0.0578,-0.0256\right] ,p<0.001\right)$$ - 0.0417 , - 0.0578 , - 0.0256 , p < 0.001 and death growth rates $$\left( -0.0162,\left[ -0.03,-0.002\right] ,p=0.025\right)$$ - 0.0162 , - 0.03 , - 0.002 , p = 0.025 . More stringent restrictions on gatherings and international movement were found to be effective. Governments conditioned policy choices on recent pandemic dynamics, and were found to be more hesitant in de-escalating NPIs than they were in imposing them.

Conclusion

At least 90% of the maximum effectiveness of NPI mandates is attainable with interventions associated with a Stringency Index in the range of 31–40, which impose minimal negative social externalities. This was significantly less than the average stringency level of implemented policies around the world during the same time period.

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  1. Version published to 10.1186/s12889-022-14177-7
  2. ScreenIT

    SciScore for 10.1101/2021.07.06.21260077: (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:
    Strengths and limitations of this study: The simultaneous modeling of pandemic dynamics with behavioral models of citizens’ behavioral adaptation to the pandemic, along with a model of governments’ decision-making processes regarding policy implementation is the primary strength of this study with respect to earlier work. Identification of this more sophisticated model with behavioral components was made possible by the larger amount of accumulated data including testing and vaccination rates. Nonetheless, certain simplifications were still necessary to ensure identification and to rein in the computational complexity of the estimation processes. These simplifications included examining the effects of nations’ stringency index compiled from individual NPIs, rather than examining each NPI separately. Similarly, an average measure of the change in mobility was used instead of disaggregated sub-measures of the type of mobility. Furthermore, while random-effects allowed for variation across countries in unobservable variables, estimates of the variables of interest (NPIs and other interventions) were pooled across countries. Unanswered questions and further research: As more data becomes available over time, future research should be directed towards relaxing some of the acknowledged limitations of the current modeling. For example, allowing for heterogeneity in the variable estimates across countries would be desirable rather than pooling estimates across countries, as would the...

    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.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.07.06.21260077v1 on medRxiv