Rabail Chaudhry, George Dranitsaris, Talha Mubashir, Justyna Bartoszko, Sheila Riazi: A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes, in: EClinicalMedicine 25 (2020) 100464, DOI: https://doi.org/10.1016/j.eclinm.2020.100464.
The authors conducted a country-level exploratoy analysis to assess the impact of timing and nature of national health policies or actions taken on COVID-19 mortality and related health outcomes.
They used information on COVID-19 policies and health outcomes from websites and country specific sources. Data collection included government policies, national preparedness levels, and country-specific socioeconomic factors. Data were collected from the top 50 countries ranked by number of cases. Multivariable negative binomial regression was used to identify factors associated with COVID-19 mortality and related health outcomes.
The authors concluded that increasing COVID-19 case rates occurred in countries that had higher obesity (adjusted rate ratio [RR]=1.06; 95%CI: 1.01-1.11), mean population age (RR=1.10; 95%CI: 1.05-1.15), and longer time to border closure from the first reported case (RR=1.04; 95%CI: 1.01-1.08). Increased mortality per million was significantly associated with higher obesity prevalence (RR=1.12; 95%CI: 1.06-1.19) and higher per capita gross domestic product (GDP) (RR=1.03; 95%CI: 1.00-1.06). Lower income dispersion reduced mortality (RR=0.88; 95%CI: 0.83-0.93) and the number of critical cases (RR=0.92; 95% CI: 0.87-0.97). Rapid border closures, full lockdowns, and broad-based testing were not associated with COVID-19 mortality per million people. However, complete closures (RR=2.47; 95%CI: 1.08-5.64) and lower country vulnerability to biological threats (i.e., high scores on the Global Health Security Scale for risk environment) (RR=1.55; 95%CI: 1.13-2.12) were significantly associated with higher patient recovery rates.
In this exploratory analysis, low scores for national preparedness, scale of testing, and population characteristics were associated with increased national case load and overall mortality.
Link to article on EClinicalMedicine home page.