Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug:25:100464.
doi: 10.1016/j.eclinm.2020.100464. Epub 2020 Jul 21.

A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes

Rabail Chaudhry  1 , George Dranitsaris  2 , Talha Mubashir  3 , Justyna Bartoszko  1 , Sheila Riazi  1
Affiliations

A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes

Rabail Chaudhry et al. EClinicalMedicine. 2020 Aug.

Abstract

Background: A country level exploratory analysis was conducted to assess the impact of timing and type of national health policy/actions undertaken towards COVID-19 mortality and related health outcomes.

Methods: Information on COVID-19 policies and health outcomes were extracted from websites and country specific sources. Data collection included the government's action, level of national preparedness, and country specific socioeconomic factors. Data was 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.

Findings: Increasing COVID-19 caseloads were associated with countries with higher obesity (adjusted rate ratio [RR]=1.06; 95%CI: 1.01-1.11), median population age (RR=1.10; 95%CI: 1.05-1.15) and longer time to border closures 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 per capita gross domestic product (GDP) (RR=1.03; 95%CI: 1.00-1.06). Reduced 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 wide-spread testing were not associated with COVID-19 mortality per million people. However, full lockdowns (RR=2.47: 95%CI: 1.08-5.64) and reduced 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 increased patient recovery rates.

Interpretation: In this exploratory analysis, low levels of national preparedness, scale of testing and population characteristics were associated with increased national case load and overall mortality.

Funding: This study is non-funded.

Keywords: COVID-19; Country-level analysis; Public health policies.

PubMed Disclaimer

Conflict of interest statement

Rabail Chaudhry MD, MSc: This author declares no financial interests. George Dranitsaris PhD: This author declares no financial interests. Talha Mubashir MD: This author declares no financial interests. Justyna Bartoszko MD, MSc: This author declares no financial interests. Sheila Riazi MD: This author declares no financial interests.

Figures

Fig. 1
Fig. 1
Mean deaths per million by number of nurses per million population, as of May 1, 2020 (p = 0.10 via one-way ANOVA, but p < 0.001 by multivariable analysis).
Fig. 2
Fig. 2
Mean deaths per million by median age of country population, as of May 1, 2020 (p = 0.017 via one way ANOVA).
See this image and copyright information in PMC

References

    1. World Health Organization. 2020. Coronavirus disease 2019 (COVID-19) situation report – 51 [Online]. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2... (Accessed: 1 April 2020).
    1. World Health Organization. 2020. Coronavirus disease 2019 (COVID-19) situation report – 72 [Online]. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2.... (Accessed: 28 May 2020).
    1. Xu S., Li Y. Beware of the second wave of COVID-19. Lancet. 2020;395::1321–1322. - PMC - PubMed
    1. Hartley D., Perencevich E. Public health interventions for COVID-19: emerging evidence and implications for an evolving public health crisis. JAMA. 2020 doi: 10.1001/jama.2020.5910. Published online April 10, 2020. - DOI - PubMed
    1. Remuzzi A., Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;395:1225–1228. - PMC - PubMed