First 100 Days of the COVID-19 Pandemic: An Evaluation of Preventive Measures Taken By Countries

Year 2020, Issue: Special Issue on COVID 19, 228 - 237, 20.03.2020

Omer Atac Sabanur Çavdar Ayşe Zülal Tokaç

https://doi.org/10.21673/anadoluklin.733245

Cited By: 2

Abstract

Aim: The aim of the study is, evaluation of the pandemic data of and measures taken by 20 countries with the highest reported number of cases in the first 100 days of the pandemic, in terms of demographic data and healthcare resources.

Materials and Methods: The data used in the study were obtained from ECDC, OECD and Oxford COVID-19 Government Response Tracker. The countries were categorized into two groups, early-onset and late-onset countries, in terms of their date of first confirmed cases and Stringency Index (SI) were calculated.

Results: United States has the highest number of cases (432,132). France was the first country to report death, outside of China. Top three countries with the highest Case Fatality Rate (CFR) are France (13.25), Italy (12.67) and United Kingdom (11.69). There was a strong negative correlation between “total death/total population proportion” and the intensive care unit bed per million population (r= -0.720; p= 0.008). The ‘’proportion of ≥65 age’’ was found to have a moderately positive correlation with “total case / total population proportion” as well as “total death / total population proportion” (r= 0.687; p= 0.001; r= 0.635; p= 0.003, respectively). In the late-onset countries, the logarithmic growth of both case and death numbers is faster than the early-onset countries. The SI is higher in late-onset counties both on the dates of logarithmic growth in the number of cases and on the 100th day of the pandemic. Restrictions on international travel is the earliest measure taken by countries. Turkey is the only country to implement 3 of 9 measures before its first case.

Discussion and Conclusion: The first encounter dates of countries with the pandemic are important in terms of preparedness. Despite, late-onset countries benefited from the experiences of early-onset countries and implemented measures, the emergence of cases and deaths could not be prevented. Moreover, the increase in cases and deaths was faster. Countries which have more elderly population are affected more adversely. Because the transmission patterns of the pandemic are related with country-specific characteristics, all variables that have an impact on the pandemic should be considered.

Keywords

COVID19, SARS-CoV-2, Stringency Index, preventive measures

Thanks

We would like to thank Fatma Zişan Tokaç and Enes Ataç for their help.

COVID-19 Pandemisinin İlk 100 Günü: Ülkeler Tarafından Alınan Önlemlerin Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, pandeminin ilk 100 gününde en çok vaka görülen 20 ülkenin salgın verileri ve önleyici müdahalelerinin, demografik ve sağlık hizmeti kapasitesi verileriyle birlikte incelenmesidir.

Gereç ve Yöntemler: Araştırmada ECDC’nin salgın verileri, OECD’nin sosyodemografik ve sağlık hizmeti kapasitesi verileri, Oxford COVID-19 Government Response Tracker veritabanının ise önlemlere dair verileri ve ‘Stringency Index’ puanı kullanılmıştır. Salgının başlangıcından itibaren ilk 1 ay içerisinde vaka görülen ülkeler erken, diğerleri geç olarak tanımlanmıştır.

Bulgular: İlk 100 gün itibariyle toplam vaka sayısının en yüksek olduğu ülke ABD’dir (432.132). Çin’den sonra ilk ölüm bildiren ülke Fransa’dır. Vaka ölüm oranının en yüksek olduğu ülkeler Fransa (13,25), İtalya (12,67) ve Birleşik Krallık’tır (11,69). Ülkelerin, “toplam ölüm/toplam nüfus oranı” ile nüfus başına düşen yoğun bakım yatağı arasında negatif yönde güçlü bir ilişki saptanmıştır (r= -0,720; p= 0,008). 65 yaş ve üzeri nüfus oranı ile “toplam vaka/toplam nüfus oranı” ve “toplam ölüm/toplam nüfus oranı” arasında pozitif yönde orta derecede bir ilişki bulunmuştur (r= 0,687; p= 0,001; r= 0,635; p= 0,003). Geç gruptaki ülkelerde hem vaka hem de ölüm sayılarının logaritmik artışı erken grup ülkelere göre istatistiksel olarak anlamlı düzeyde daha hızlıdır. Stringency Index, geç grup ülkelerde hem vaka sayısının logaritmik artış tarihlerinde hem de pandeminin 100. gününde daha yüksektir. Ülkelerin en erken aldıkları önlem, uluslararası seyahatlerin kısıtlanmasıdır. Türkiye, ilk vakasından önce en çok önlem alan ülke olup, dokuz önlemin üçünü uygulamıştır.

Sonuç: Ülkelerin salgına yakalandıkları tarih, salgına karşı hazırlıklı olunması açısından önemlidir. Salgının geç başladığı ülkeler, erken başlayan ülkelerin yaşadığı tecrübeleri dikkate alarak önlemleri daha sıkı tutmalarına rağmen bu ülkelerde de vaka ve ölümlerin önüne geçilememiştir. Üstelik vaka ve ölümlerde artış erken grup ülkelere göre daha hızlı olmuştur. Bununla birlikte yaşlı nüfusun daha şiddetli etkilendiği bir sağlık sorununda, yaşlı nüfus yüzdesi yüksek ülkeler daha olumsuz etkilenmektedir. Pandeminin yayılımı ve seyrinde ülkelere özgü dinamikler olması nedeniyle, tüm sürecin anlaşılabilmesi salgını etkileyen tüm faktörlerin göz önünde bulundurulmasını gerekmektedir.

Keywords

COVID19, SARS-CoV-2, Stringency İndex, önleyici tedbirler

References

• World Health Organization. Novel Coronavirus (2019-nCoV) Situation Report - 1 [Internet]. [cited 2020 May 5]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4
• WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020 [Internet]. [cited 2020 May 5]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
• World Health Organization. Novel Coronavirus (2019-nCoV) Situation Report-12 [Internet]. [cited 2020 May 5]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200201-sitrep-12-ncov.pdf?sfvrsn=273c5d35_2
• WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. [cited 2020 May 5]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
• World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Repoert - 80 [Internet]. 2020 [cited 2020 May 5]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200409-sitrep-80-covid-19.pdf?sfvrsn=1b685d64_6
• European Centre for Disease Prevention and Control. Considerations relating to social distancing measures in response to the COVID-19 epidemic. Stockholm: ECDC; 2020.
• Organisation for Economic Co-operation and Development. Flattening the COVID-19 peak : Containment and mitigation policies. OECD; 2020. Available from: https://read.oecd-ilibrary.org/view/?ref=124_124999-yt5ggxirhc&title=Flattening_the_COVID-19_peak-Containment_and_mitigation_policies
• Nussbaumer‐Streit B, Mayr V, Dobrescu AI, Chapman A, Persad E, Klerings I, Wagner G, Siebert U, Christof C, Zachariah C, Gartlehner G. Quarantine alone or in combination with other public health measures to control COVID‐19: a rapid review. Cochrane Database of Systematic Reviews; 2020(4). Art. No.: CD013574. doi:10.1002/14651858.CD013574.
• Flaxman S, Mishra S, Gandy A, Unwin JT, Coupland H, Mellan TA, et al. Report 13: Estimating the number of infections and the impact of non-pharmaceutical interventions on COVID-19 in 11 European countries. Imperial College London; 2020 doi:10.25561/77731.
• World Health Organization. COVID‑19 Strategy Update 14 April 2020 [Internet]. 2020 [cited 2020 May 5]. Available from: https://www.who.int/publications-detail/covid-19-strategy-update---14-april-2020
• World Health Organization. Considerations in adjusting public health and social measures in the context of COVID-19: interim guidance, 16 April 2020. [Internet]. 2020 [cited 2020 May 5]. Available from: https://apps.who.int/iris/handle/10665/331773.
• European Centre for Disease Prevention and Control. Download today’s data on the geographic distribution of COVID-19 cases worldwide [Internet]. [cited 2020 May 5]. Available from: https://www.ecdc.europa.eu/en/publications-data/download-todays-data-geographic-distribution-covid-19-cases-worldwide
• Organisation for Economic Co-operation and Development. OECD.Stat [Internet]. [cited 2020 Apr 22]. Available from: https://stats.oecd.org/
• United Nations. World Population Prospects 2019 [Internet]. [cited 2020 Apr 23]. Available from: https://population.un.org/wpp/DataQuery/
• Hale T, Webster S, Petherick A, Phillips T, Kira B. Oxford COVID-19 Government Response Tracker [Internet]. 2020 [cited 2020 Apr 26]. Available from: https://covidtracker.bsg.ox.ac.uk/
• Hale T, Petherick A, Phillips T, Webster S. Variation in government responses to COVID-19. Work Pap [Internet]. 2020; Available from: www.bsg.ox.ac.uk/covidtracker
• Tartari F, Guglielmo A, Fuligni F, Pileri A. Changes in emergency service access after spread of COVID19 across Italy. J Eur Acad Dermatology Venereol JEADV. 2020;0–2. doi:10.1111/jdv.16553.
• T.C. Sağlık Bakanlığı. COVID-19 (SARS-CoV-2 enfeksiyonu) rehberi, bilim kurulu çalışması [Internet]. [cited 2020 May 5]. Ankara; 2020. Available from: https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf
• Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA - J Am Med Assoc. 2020;323(13):3–6. doi:10.1001/jama.2020.2648
• Bialek S, Boundy E, Bowen V, Chow N, Cohn A, Dowling N, et al. Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12-march 16, 2020. Morb Mortal Wkly Rep. 2020;69(12):343–6. doi:10.15585/mmwr.mm6912e2
• T.C. Sağlık Bakanlığı. Türkiye’deki güncel durum [Internet]. [cited 2020 Apr 30]. Available from: https://covid19.saglik.gov.tr/
• T.C. Sağlık Bakanlığı. Bakan Koca, TBMM’de koronavirüs ile mücadeleye ilişkin sunum yaptı [Internet]. [cited 2020 May 3]. Available from: https://www.saglik.gov.tr/TR,64544/bakan-koca-tbmmde-koronavirus-ile-mucadeleye-iliskin-sunum-yapti.html
• Her M. How is COVID-19 affecting South Korea? What is our current strategy? Disaster Med Public Health Prep. 2020;(May):233–5. doi: 10.1017/dmp.2020.69.
• Oh J, Lee J-K, Schwarz D, Ratcliffe HL, Markuns JF, Hirschhorn LR. National Response to COVID-19 in the Republic of Korea and Lessons Learned for Other Countries. Heal Syst Reform [Internet]. 2020 Jan 1 [cited 2020 May 4];6(1):e-1753464. Available from: https://www.tandfonline.com/doi/full/10.1080/23288604.2020.1753464 doi:10.1080/23288604.2020.1753464.