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

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 usi...

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Bibliographic Details
Published in:BMC public health 2022-10, Vol.22 (1), p.1-1842, Article 1842
Main Author: Spiliopoulos, Leonidas
Format: Article
Language:English
Subjects:
Behavior
Case growth rate
Contact tracing
Control
Coronaviruses
COVID-19
Death growth rates
Disease transmission
Econometrics
Effectiveness
Empirical analysis
Enforcement
Epidemics
Fatalities
Germany
Growth models
Growth rate
Medical research
Methods
Mobility
Non-pharmaceutical interventions
Pandemics
SARS-CoV-2
School closures
Simultaneous structural equations
Structural models
Vaccination
Variables
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Summary: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 [formula omitted] and death growth rates [formula omitted]. 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. Keywords: SARS-CoV-2, Non-pharmaceutical interventions, Case growth rate, Death growth rates, Simultaneous structural equations, Contact tracing, Vaccination
ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-022-14177-7