Effective COVID-19 Control: A Systematic and Comparative Analysis of the Stringency and Timeliness of Government Responses of Selected Countries and Subregions in Asia

Abstract

Background: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Systematically synthesizing these responses is vital for disease control evidence-based policy making.Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from January 1 to May 30, 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT).Findings: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74·2), followed by Singapore (67·4), Vietnam (66·8), Hong Kong (66·2), South Korea (62·3), Taiwan (52·1), and Japan (50·3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI>50·0), while Japan (42·4) and Mainland China (4·2) followed.Interpretation: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.Funding: Saudi Ministry of Finance; Duke Global Health Institute.Declaration of Interests: The authors declare no conflict of interests.