Abstract
This study employs a spatial autoregressive probit-log linear (SAP-Log) hurdle model to investigate the influencing factors on the probability of death and case fatality rate (CFR) of coronavirus disease 2019 (COVID-19) at the city level in China. The results demonstrate that the probability of death from COVID-19 and the CFR level are 2 different processes with different determinants. The number of confirmed cases and the number of doctors are closely associated with the death probability and CFR, and there exist differences in the CFR and its determinants between cities within Hubei Province and outside Hubei Province. The spatial probit model also presents positive spatial autocorrelation in death probabilities. It is worth noting that the medical resource sharing among cities and enjoyment of free medical treatment services of citizens makes China different from other countries. This study contributes to the growing literature on determinants of CFR with COVID-19 and has significant practical implications.
Highlights
The ongoing coronavirus disease 2019 (COVID-19), as a rapidly spreading global pandemic, comes as a big blow to the economic and social development of the world and has become a global health concern
Given the enormous damages to human society caused by the spread of COVID-19, robust scientific evidence will significantly contribute to the epidemic responses, especially the successful disease prevention and control experiences in China
A spatial autoregressive probit-log linear (SAP-Log) hurdle model is employed to deal with the zero-inflation problem since nearly three quarters of cities have zero-value case fatality rate (CFR), which dramatically reduces the estimation bias and improves the explanatory power and goodness of fit of the model
Summary
The ongoing coronavirus disease 2019 (COVID-19), as a rapidly spreading global pandemic, comes as a big blow to the economic and social development of the world and has become a global health concern. Case fatality rate (CFR), known as the proportion of deaths from a kind of disease to the number of confirmed cases of this disease (the proportion of infected people who die), is an important indicator to measure the severity degree of the epidemic [1], as well as a reflection of the government capacity to prevent and control the epidemic [2]. Outbreaking in Wuhan, China, in January 2020, the virus rapidly spreads through Hubei Province and the rest of China. It became under control within 2 months through stringent prevention and control measures taken by Chinese governments such as lockdown, wearing face masks, self-quarantine, the detection and isolation of infected individuals, contacttracing, social distancing, traffic restrictions, and community containment [3]. The experience of China in controlling the spread of the virus and reducing mortality
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