Abstract
The coronavirus disease (COVID-19) outbreak has killed over a million people since its emergence in late 2019. However, there has been substantial variability in the policies and intensity of diagnostic efforts between countries. In this paper, we quantitatively evaluate the association between national contact tracing policies and case fatality rates of COVID-19 in 138 countries. Our regression analyses indicate that countries that implement comprehensive contact tracing have significantly lower case fatality rates. This association of contact tracing policy and case fatality rates is robust in our longitudinal regression models, even after controlling for the number of tests conducted and non-pharmaceutical control measures adopted by governments. Our results suggest that comprehensive contact tracing is instrumental not only to curtailing transmission but also to reducing case fatality rates. Contact tracing achieves the early detection and isolation of secondary cases which are particularly important given that the peak in infectiousness occurs during the presymptomatic phase. The early detection achieved by contact tracing accelerates the rate at which infected individuals receive medical care they need to maximize their chance of recovery. In addition, the combination of reduced transmission and more rapid recovery diminishes the burden on the healthcare system which in turn ensures that the resources remain available for individuals who do become infected.
Highlights
The coronavirus disease (COVID-19) outbreak has killed over a million people since its emergence in late 2019
Our regression analyses indicate that countries that implement comprehensive contact tracing have significantly lower case fatality rates. This association of contact tracing policy and case fatality rates is robust in our longitudinal regression models, even after controlling for the number of tests conducted and nonpharmaceutical control measures adopted by governments
In our longitudinal data analysis, we regressed case fatality rates on four sets of predictors: testing policy variables, healthcare system capabilities, country characteristics, economic measures against COVID-19 and stringency score
Summary
The coronavirus disease (COVID-19) outbreak has killed over a million people since its emergence in late 2019. Our regression analyses indicate that countries that implement comprehensive contact tracing have significantly lower case fatality rates This association of contact tracing policy and case fatality rates is robust in our longitudinal regression models, even after controlling for the number of tests conducted and nonpharmaceutical control measures adopted by governments. Anecdotal evidence suggests that countries that have controlled the epidemic and that have relatively lower death rates have conducted ample testing and comprehensive contact tracing (e.g., South Korea, Germany)[7,8,9]. Contact tracing involves identifying, testing and quarantining the contacts of an index case It had been used as an effective policy in the control of infectious diseases, including severe acute respiratory s yndrome[13]. Variables Age over 70 Diabetes (% of population aged 20 to 79) # of hospital beds (per 1000) Percentage of smokers # of physicians (per1000) Fiscal stimulus GDP per capita Case fatality rate Case mortality rate Total tests (per million) Contact tracing Stringency Score Log-population during the following six weeks (from March up to the third week of April), and adopted contact tracing for all cases since the third week of April
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