Local public health officials and COVID-19: evidence from China

Abstract

PurposeDid Chinese cities whose public health departments are headed by medical professionals fare better in fighting coronavirus disease 2019 (COVID-19)?Design/methodology/approachThe authors collected the professional background of the directors of the public health departments of 350 Chinese cities, which include 87% of the Chinese population. Excluding Wuhan, the epicenter of COVID-19, the authors analyzed the infection rates and death rates from COVID-19 between 131 Chinese cities whose public health departments are led by medical professionals and 218 cities whose public health departments are led by nonprofessionals. The authors employed a multivariate regression controlling for the number of people that traveled from Wuhan to each city, the local economic development and the number of hospital beds.FindingsChinese cities whose public health departments are led by medical professionals had 21 fewer confirmed cases per 10 million as of January 31, 2020 [95% CI, −40 to −3], 58 fewer cases per 10 million in the next 10 days [95% CI, −116 to 0], similar new cases between February 11 and February 20, 2020, and 3 fewer deaths per 10 million as of February 20, 2020 [95% CI, −7 to 0].Research limitations/implicationsAssociation could not make a strong causal claim.Practical implicationsLocal public health authorities are critical for combating a pandemic. The authors found that Chinese cities whose public health departments are headed by medical professionals were associated with lower infection rates and fewer death rates from COVID-19. The results were significant only at the start of the outbreak. This study’s results suggest that to better combat a pandemic, local public health authorities should be led by competent people who have a medical background.Originality/valueThe authors provide the first empirical evidence about the association between a local public health head's competence and the infection rate and death rate of COVID-19. The authors’ manually collected data also show that only 38% of the heads of the public health departments of Chinese cities have a medical background.