Oxford COVID-19 Government Response Tracker Research Articles

State COVID-19 Policies and Drug Overdose Mortality Among Working-Age Adults in the United States, 2020.

Objectives. To identify relationships between US states' COVID-19 in-person activity limitation and economic support policies and drug overdose deaths among working-age adults in 2020. Methods. We used county-level data on 140 435 drug overdoses among adults aged 25 to 64 years during January 2019 to December 2020 from the National Vital Statistics System and data on states' COVID-19 policies from the Oxford COVID-19 Government Response Tracker to assess US trends in overdose deaths by sex in 3138 counties. Results. Policies limiting in-person activities significantly increased, whereas economic support policies significantly decreased, overdose rates. A 1-unit increase in policies restricting activities predicted a 15% average monthly increase in overdose rates for men (incident rate ratio [IRR] = 1.15; 95% confidence interval [CI] = 1.09, 1.20) and a 14% increase for women (IRR = 1.14; 95% CI = 1.09, 1.20). A 1-unit increase in economic support policies predicted a 3% average monthly decrease for men (IRR = 0.97; 95% CI = 0.95, 1.00) and a 4% decrease for women (IRR = 0.96; 95% CI = 0.93, 0.99). All states' policy combinations are predicted to have increased drug-poisoning mortality. Conclusions. The economic supports that states enacted were insufficient to fully mitigate the adverse relationship between activity limitations and drug overdoses. (Am J Public Health. Published online ahead of print May 2, 2024:e1-e9. https://doi.org/10.2105/AJPH.2024.307621).

The long-term effect of COVID-19 policy stringency on consumer food demand quantities in Switzerland

This is the first study investigating the effect of COVID-19 policy stringency on consumer food demand for the years 2020 and 2021. In particular, we compared food demand in periods with strict COVID-19 policies to food demand in periods with less strict COVID-19 policies. For this purpose, we used Switzerland, which imposed two COVID-19 lockdowns, as a case study. To test this link, we applied fixed effects dummy variable regressions (as baseline estimates) and dose–response functions. To capture the stringency of Swiss COVID-19 policies, we relied on daily data from the Oxford COVID-19 Government Response Tracker. Food demand data at the product level came from the combined retail and consumer panel of the market research company Nielsen and covered meat, milk products, vegetables, and fruits. Empirical findings revealed that consumer demand for all food products was on average 2.5 times higher during the two lockdowns compared to periods without lockdowns. While we found no statistically significant differences in consumer food demand between the two lockdowns for milk products, vegetables, and fruits, the total food demand and the demand for meat was higher during the first lockdown. Increases in Swiss food demand were likely caused by the closing of restaurants (both lockdowns) and the closing of borders to neighboring countries (only the first lockdown), preventing shopping tourism. Against the background of potential future pandemics, our research provides important information for policymakers on the quantification of food demand changes in times of crisis.

Crisis Leadership in the Time of Covid: Effects of Personality Traits on Response Speed

Abstract Why were some countries faster than others at introducing COVID-19 mitigation policies? Existing research shows that leaders are central to defining and making sense of crises, which then shapes their governments’ crisis response. I argue that crisis-sense-making depends on leaders’ personality traits pertaining to how they perceive their power status, collect and process information, and interact with their environment, subsequently influencing their governments’ crisis response speed. I test this argument in the context of the European experience with COVID-19, combining an original Leadership Traits Analysis dataset of thirty-two leaders with the Oxford COVID-19 Government Response Tracker data. I show that leaders who were highly self-confident or exhibited a tendency to challenge constraints were significantly slower at introducing pandemic mitigation policies. Leaders who were open to information were significantly faster to do so. I also show that policy emulation between countries over time dissipated the slowing effects of the leaders’ need for power and conceptual complexity on response speed. The results present new and systematic evidence on how leader personality shaped pandemic policy-making, contributing to the literature on crisis policy-making and political leadership. They also offer science advisors food for thought on how to communicate with leaders.

Effects of Face Mask Mandates on COVID-19 Transmission in 51 Countries: Retrospective Event Study.

The question of the utility of face masks in preventing acute respiratory infections has received renewed attention during the COVID-19 pandemic. However, given the inconclusive evidence from existing randomized controlled trials, evidence based on real-world data with high external validity is missing. To add real-world evidence, this study aims to examine whether mask mandates in 51 countries and mask recommendations in 10 countries increased self-reported face mask use and reduced SARS-CoV-2 reproduction numbers and COVID-19 case growth rates. We applied an event study approach to data pooled from four sources: (1) country-level information on self-reported mask use was obtained from the COVID-19 Trends and Impact Survey, (2) data from the Oxford COVID-19 Government Response Tracker provided information on face mask mandates and recommendations and any other nonpharmacological interventions implemented, (3) mobility indicators from Google's Community Mobility Reports were also included, and (4) SARS-CoV-2 reproduction numbers and COVID-19 case growth rates were retrieved from the Our World in Data-COVID-19 data set. Mandates increased mask use by 8.81 percentage points (P=.006) on average, and SARS-CoV-2 reproduction numbers declined on average by -0.31 units (P=.008). Although no significant average effect of mask mandates was observed for growth rates of COVID-19 cases (-0.98 percentage points; P=.56), the results indicate incremental effects on days 26 (-1.76 percentage points; P=.04), 27 (-1.89 percentage points; P=.05), 29 (-1.78 percentage points; P=.04), and 30 (-2.14 percentage points; P=.02) after mandate implementation. For self-reported face mask use and reproduction numbers, incremental effects are seen 6 and 13 days after mandate implementation. Both incremental effects persist for >30 days. Furthermore, mask recommendations increased self-reported mask use on average (5.84 percentage points; P<.001). However, there were no effects of recommendations on SARS-CoV-2 reproduction numbers or COVID-19 case growth rates (-0.06 units; P=.70 and -2.45 percentage points; P=.59). Single incremental effects on self-reported mask use were observed on days 11 (3.96 percentage points; P=.04), 13 (3.77 percentage points; P=.04) and 25 to 27 (4.20 percentage points; P=.048 and 5.91 percentage points; P=.01) after recommendation. Recommendations also affected reproduction numbers on days 0 (-0.07 units; P=.03) and 1 (-0.07 units; P=.03) and between days 21 (-0.09 units; P=.04) and 28 (-0.11 units; P=.05) and case growth rates between days 1 and 4 (-1.60 percentage points; P=.03 and -2.19 percentage points; P=.03) and on day 23 (-2.83 percentage points; P=.05) after publication. Contrary to recommendations, mask mandates can be used as an effective measure to reduce SARS-CoV-2 reproduction numbers. However, mandates alone are not sufficient to reduce growth rates of COVID-19 cases. Our study adds external validity to the existing randomized controlled trials on the effectiveness of face masks to reduce the spread of SARS-CoV-2.

Development of New Stringency Indices for Nonpharmacological Social Distancing Policies Implemented in Korea During the COVID-19 Pandemic: Random Forest Approach.

In the absence of an effective treatment method or vaccine, the outbreak of the COVID-19 pandemic elicited a wide range of unprecedented restriction policies aimed at mitigating and suppressing the spread of the SARS-CoV-2 virus. These policies and their Stringency Index (SI) of more than 160 countries were systematically recorded in the Oxford COVID-19 Government Response Tracker (OxCGRT) data set. The SI is a summary measure of the overall strictness of these policies. However, the OxCGRT SI may not fully reflect the stringency levels of the restriction policies implemented in Korea. Korea implemented 33 COVID-19 restriction policies targeting 4 areas: public facilities, public events, social gatherings, and religious gatherings. This study aims to develop new Korea Stringency Indices (KSIs) that reflect the stringency levels of Korea's restriction policies better and to determine which government-implemented policies were most effective in managing the COVID-19 pandemic in Korea. The random forest method was used to calculate the new KSIs using feature importance values and determine their effectiveness in managing daily COVID-19 confirmed cases. Five analysis periods were considered, including November 01, 2020, to January 20, 2021 (Period 1), January 20, 2021, to June 27, 2021 (Period 2), November 01, 2020, to June 27, 2021 (Period 3), June 27, 2021, to November 01, 2021 (Period 4), and November 01, 2021, to April 24, 2022 (Period 5). Among the KSIs, public facilities in period 4, public events in period 2, religious gatherings in periods 1 and 3, and social gatherings in period 5 had the highest importance. Among the public facilities, policies associated with operation hour restrictions in cinemas, restaurants, PC rooms, indoor sports facilities, karaoke, coffee shops, night entertainment facilities, and baths or saunas had the highest importance across all analysis periods. Strong positive correlations were observed between daily confirmed cases and public facilities, religious gatherings, and public events in period 1 of the pandemic. From then, weaker and negative correlations were observed in the remaining analysis periods. The comparison with the OxCGRT SI showed that the SI had a relatively lower feature importance and correlation with daily confirmed cases than the proposed KSIs, making KSIs more effective than SI. Restriction policies targeting public facilities were the most effective among the policies analyzed. In addition, different periods call for the enforcement of different policies given their effectiveness varies during the pandemic.

Volunteering and instrumental support during the first phase of the pandemic in Europe: the significance of COVID-19 exposure and stringent country’s COVID-19 policy

BackgroundThe COVID-19 control policies might negatively impact older adults’ participation in volunteer work, instrumental support provision, and the likelihood of receiving instrumental support. Studies that quantify changes in these activities and the related factors are limited. The current study aimed to examine the level of volunteering, instrumental support provision and receipt before and during the first phase of the COVID-19 pandemic in Europe and to determine whether older adults’ volunteering, instrumental support provision and receipt were associated with individual exposure to COVID-19 and the stringency of country’s COVID-19 control policy during the first phase of the COVID-19 pandemic.MethodsA cross-sectional survey using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) Corona Survey 1 was designed to focus on community-dwelling Europeans aged ≥50 years. History of participation in volunteering work and instrumental support provision or receipt was assessed from the previous SHARE Wave data. The country’s COVID-19 control policy stringency index (S-Index) was from the Oxford COVID-19 Government Response Tracker database. A total of 45,669 respondents from 26 European countries were included in the volunteering analysis. Seventeen European countries were included in the analyses of instrumental support provision (N = 36,518) and receipt (N = 36,526). The multilevel logistic regression model was fitted separately to analyse each activity.ResultsThe level of volunteering and instrumental support provision was lower during the pandemic, but instrumental support receipt was higher. The country S-Index was positively associated with support provision (OR:1.13;95%CI:1.02–1.26) and negatively associated with support receipt (OR:0.69;95%CI:0.54–0.88). Exposure to COVID-19 was positively associated with support receipt (OR:1.64;95%CI:1.38–1.95). COVID-19 exposure on close ones positively associated with volunteering (OR:1.47;95%CI:1.32–1.65), support provision (OR:1.28;95%CI:1.19–1.39), and support receipt (OR:1.25;95%CI:1.15–1.35).ConclusionsThe COVID-19 pandemic impacted older Europeans’ volunteering, instrumental support provision, and instrumental support receipt from outside their household. When someone close to them was exposed to COVID-19, older Europeans were likely to receive instrumental support and to volunteer and provide instrumental support. A stricter country’s COVID-19 control policy might motivate older adults to provide instrumental support, but it prevents them from receiving instrumental support from outside their households.

The impact of the COVID-19 pandemic on mortality in Sweden—Did it differ across socioeconomic groups?

The characterization of the socioeconomic profile of COVID-19 mortality is limited. Likewise, the mapping of potential indirect adverse outcomes of the pandemic, such as suicide and alcohol abuse, along socioeconomic lines is still meagre. The main aim of this paper is to (i) depict SES-differences in COVID-19 mortality, and (ii) to assess the impact of the COVID-19 pandemic on suicide and alcohol mortality across socioeconomic groups. We used Swedish monthly data spanning the period January 2016–December 2021. We chose education as indicator of socioeconomic status (SES). The following causes of deaths were included in the analysis: COVID-19, all-cause mortality excluding COVID-19, suicide and a composite index of alcohol-specific deaths. SARIMA-modelling was used to assess the impact of the pandemic on suicide and alcohol-specific mortality. Two alternative measures of the pandemic were used: (1) a dummy that was coded 1 during the pandemic (March 2020 and onwards), and 0 otherwise, and (2) the Oxford COVID-19 Government Response Tracker’s Stringency Index. There was a marked SES-gradient in COVID-19 mortality in the working-age population (25–64) which was larger than for other causes of death. A SES-gradient was also found in the old-age population, but this gradient did not differ from the gradient for other causes of death. The outcome from the SARIMA time-series analyses suggested that the pandemic did not have any impact on suicide or alcohol-specific mortality in any of the educational and gender groups.

Do Scholars Respond Faster Than Google Trends in Discussing COVID-19 Issues? An Approach to Textual Big Data.

Background: The COVID-19 pandemic has posed various difficulties for policymakers, such as the identification of health issues, establishment of policy priorities, formulation of regulations, and promotion of economic competitiveness. Evidence-based practices and data-driven decision-making have been recognized as valuable tools for improving the policymaking process. Nevertheless, due to the abundance of data, there is a need to develop sophisticated analytical techniques and tools to efficiently extract and analyze the data. Methods: Using Oxford COVID-19 Government Response Tracker, we categorize the policy responses into 6 different categories: (a) containment and closure, (b) health systems, (c) vaccines, (d) economic, (e) country, and (f) others. We proposed a novel research framework to compare the response times of the scholars and the general public. To achieve this, we analyzed more than 400,000 research abstracts published over the past 2.5 years, along with text information from Google Trends as a proxy for topics of public concern. We introduced an innovative text-mining method: coherent topic clustering to analyze the huge number of abstracts. Results: Our results show that the research abstracts not only discussed almost all of the COVID-19 issues earlier than Google Trends did, but they also provided more in-depth coverage. This should help policymakers identify core COVID-19 issues and act earlier. Besides, our clustering method can better reflect the main messages of the abstracts than a recent advanced deep learning-based topic modeling tool. Conclusion: Scholars generally have a faster response in discussing COVID-19 issues than Google Trends.

PoliSEAmaking: Accountabilities in Economic Responses to COVID-19 of Southeast Asian Governments

This paper examines the connection between governments’ accountability and their responses to the global economic crisis caused by COVID-19 through the lens of competing principals approach. Given that governments’ sense of accountability towards groups of principals may vary, it may affect the policy outcomes as well. In the case of Covid-19 pandemic, the dilemma manifests in the extent to which the governments spend their resources on economic assistance to the people. By using the ever-growing corpus of data on economic responses, such as The Oxford COVID-19 Government Response Tracker (OxCGRT) as well as the compilation of several measures for political accountabilities, regime types, and COVID-related public health, this study finds that, unlike other regions in the world, the only type of accountability predicting Southeast Asian (SEA) governments’ level of economic support to the people is diagonal accountability leveraged by the media and civil societies (CSOs).  This finding not only illustrates the dilemma faced by the governments as an agent in a multi-principal scenario, but also indicate that a) SEA governments generally do not feel directly liable to its people; b) they do not feel pressured by the check and balances mechanisms of formal institutions, either; and c) they only feel obligated to do something when the issue is being publicized in the news or mobilized by the CSOs.  

The mortality and years of life lost for community-acquired pneumonia before and during COVID-19 pandemic in China

Community-acquired pneumonia (CAP) is a leading cause of mortality worldwide, but disease burden of CAP is not clear so far. We aim to explore the spatial and temporal trends of mortality and years of life lost (YLL) due to CAP during 2013-2021 in mainland China, especially the mortality changes before and during COVID-19 pandemic due to COVID-19 related non-pharmaceutical interventions (NPIs). We used data from the National Mortality Surveillance System to estimate the age-standardized rates of death and YLL of CAP at national and provincial level in China during 2013-2021. Monthly and provincial NPIs data were obtained from Oxford COVID-19 Government Response Tracker. The Average annual percentage change (AAPC) and mortality reduction were estimated by log-linear regression and interrupted time series, respectively. In China, most CAP that caused deaths had no clear etiology, and bacterial pneumonia and viral pneumonia were the leading 2 causes among CAP deaths with determined etiology before and during COVID-19 pandemic. The age-standardized CAP mortality rate decreased from 11.18 per 100,000 in 2013 to 8.76 per 100,000 in 2019, and to 5.74 per 100,000 in 2021 (AAPC-4.51% vs-7.89%). Trends were similar in age-standardized rate of YLL. Both rates declined more for viral pneumonia, compared with bacterial pneumonia. After adjusting for NPIs at provincial level after 2020, the NPIs for COVID-19 was associated with significant reductions in CAP mortality (-0.34 per 100,000,-0.41 to-0.27; p<0.0001), and provinces that economically developed and conducted strict regular NPIs against COVID-19 contributed the most reduction. We observed a decreasing trend of age-standardized CAP mortality from 2013 to 2019, and a dramatical reduction during COVID-19 pandemic, especially for viral pneumonia. Our study provided the evidence for the effectiveness of regular NPIs on the significant reductions in CAP mortality. This work has been supported by Beijing Municipal Science and Technology Project Z191100006619101, Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS 2021-I2M-1-048), CAMS Institute of Respiratory Medicine Grant for Young Scholars (2023-ZF-8) and the New Cornerstone Science Foundation.

Similarities and Differences in the Manifestations of the COVID-19 Epidemic Process in Some Countries

Relevance. The pandemic of a new coronavirus infection has become an unprecedented challenge for modern society. It took the entire population of the Earth by surprise, changing the lives of millions of people in the world in record time. Governments of different countries have reacted differently to the pandemic. The list of preventive measures and the timeliness of their adoption differed. Comparing and evaluating the experience of different countries and emergency response systems will help in the future to use best practices and models to combat future biological threats. The aim of the study was to identify and describe the features of the manifestation of the COVID-19 epidemic process in a number of countries, taking into account the ongoing anti-epidemic and preventive measures, and to hypothesize about the main factors that could potentially influence the differences in the manifestation of the COVID-19 epidemic process. Materials and methods. The choice of countries was conditioned by the purpose to compare the manifestations of epidemic process in our country with the great powers and economies of the world - USA and China and countries (Republic of Belarus and Sweden), which did not introduce lockdown and did not follow all WHO recommendations. To achieve this goal, a descriptive research method was used based on open source data, an analysis of relevant Russian and foreign literature was carried out (scientific electronic libraries PubMed and Elibrary; open sources of statistical information: Yandex DataLens Public: Coronavirus: Dashboard, Johns Hopkins University website, United Nations Population Division, World Bank, Global Panel Database on COVID-19 Pandemic Policy (Oxford COVID-19 Government Response Tracker), as well as the website of the World Health Organization (WHO), Our World in Data, Rospotrebnadzor and some media). Conclusion. The lowest incidence rate is observed in China (on average 315.1 per 100 thousand population [95% CI 314.8–315.4]), and the highest is in the USA (9957.7 per 100 thousand population [95% CI 9954.5–9960.9]). In terms of the number of tests conducted, the United States and Russia are in the lead. To date, the highest vaccination coverage and vaccination rate are observed in the PRC and amount to 92.4% and 90.1%, respectively. In general, these indicators do not reach 95% in all countries, which requires improving the quality of immunoprophylaxis measures. Anti-epidemic measures in the studied countries differed in their set, scope and severity of implementation. In China, Russia and the USA were held in full, and in Belarus and Sweden only partially, some of the events were not held at all. Thanks to the rapid creation of effective vaccines in Russia and China, it was possible to delay the onset of pronounced increases in morbidity at a later date, which, in turn, helped to reduce the burden on the healthcare system. At the same time, despite the obvious relevance of COVID-19, the question of a comprehensive study of the alleged risk factors (biological, social and natural) is still open. There is a certain probability that the virus will now be permanently present in the global population (it will become a seasonal disease).

Were public interventions relevant for containing the covid-19 pandemic in Brazil in 2020?

Flattening the curve was the most promoted public health strategy worldwide, during the pandemic, to slow down the spread of the SARS-CoV-2 virus, and, consequently, to avoid overloading the healthcare systems. In Brazil, a relative success of public policies was evidenced. However, the association between public policies and the "flatten the curve" objectives remain unclear, as well as the association of different policies to reach this aim. This study aims to verify if the adoption of different public policies was associated with the flattening of the infection and death curves by covid-19 first wave in 2020. Data from the Sistema de Informação da Vigilância Epidemiológica da Gripe (Influenza Epidemiological Surveillance Information System - SIVEP-Gripe) and the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics - IBGE) were used to compute standardized incidence and mortality rates. The Oxford Covid-19 Government Response Tracker (OxCGRT) was used to obtain information about governmental responses related to the mitigation of pandemic effects, and the Human Development Index (HDI) was used as a measure of socioeconomic status. A non-linear least-square method was used to estimate parameters of the five-parameter sigmoidal curve, obtaining the time to reach the peak and the incremental rate of the curves. Additionally, ordinary least-square linear models were used to assess the correlation between the curves and the public policies adopted. Out of 51 municipalities, 261,326 patients had SARS-CoV-2 infection. Stringency Index was associated with reducing covid-19 incremental incidence and death rates,in addition to delaying the time to reach the peak of both pandemic curves. Considering both parameters, economic support policies did not affect the incidence nor the mortality rate curves. The evidence highlighted the importance and effectiveness of social distancing policies during the first year of the pandemic in Brazil, flattening the curves of mortality and incidence rates. Other policies, such as those focused on economic support, were not effective in flattening the curves but met humanitarian and social outcomes.

Vaccine uptake and effectiveness: Why some African countries performed better than the others?

ObjectiveThis study examines the factors influencing vaccination rollout and its effectiveness in reducing infectious disease outbreaks in African countries. It aims to understand why some countries performed better in vaccination coverage than others and explores the impact of COVID-19 vaccinations in conjunction with the stringency index in Africa. MethodsTwo data sources were utilized. Firstly, a scoping review of relevant studies and gray literature was conducted using the Arksey H & O'Malley L methodological framework. Additionally, data from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset) were analysed to explore the effect of COVID-19 vaccines in Africa. Regression discontinuity in time was employed to assess the effects of COVID-19 vaccination on new COVID-19 cases, deaths, and reproduction rate. ResultsThe study found that the number of vaccinated individuals increased from March 2021, while the stringency index steadily declined since January 2021. Despite higher vaccination coverage, new COVID-19 cases and deaths peaked in late 2021 and early 2022, indicating the continued need for non-pharmaceutical interventions. After considering country fixed effects and other covariates, the number of new cases and deaths were negatively associated with the stringency index and vaccine introduction. ConclusionCOVID-19 vaccination was shown to be crucial in reducing new cases and deaths in Africa. However, vaccination progress in the region remains low and is influenced by factors at both structural and micro levels. Further research is required to disentangle the effects of non-pharmaceutical interventions and other measures from vaccination campaigns in the context of Africa while accounting for other contributing factors. Lay summaryThis study aimed to understand why some African countries did better than others in their COVID-19 vaccination efforts and how these vaccinations affected the spread of the virus. Researchers reviewed existing studies and government data along with the Oxford COVID-19 Government Response Tracker. While vaccinations increased from March 2021 and strict measures eased from January 2021, new cases and deaths remained high in late 2021 and early 2022, indicating the need for additional measures. Stricter government actions and higher vaccination rates were linked to fewer cases and deaths. In Africa, COVID-19 vaccinations are crucial, but progress is slow due to various factors at both macro and individual levels. Further research is required to understand the interplay between vaccinations, other measures, and controlling the virus.

Factors associated with hospital service access during COVID-19: A longitudinal study in Uganda

Abstract Background A global review summarized that the failure of healthcare systems and the capability of pandemic responses affected adverse health outcomes more than restricted movement policies. Studies on sub-Saharan Africa reported that lockdowns directly impeded access to necessary health services. We examined the factors associated with the accessibility of hospital services in Uganda. Methods We performed a multiple linear regression analysis. The outcome variable is the number of monthly outpatients (NMPs) at eight services (obstetrics, maternal care, family planning, malaria testing, HIV testing, antiretroviral therapy, diabetes, and child immunization) in four regional referral hospitals (Kabale, Lira, Soroti, and Naguru), comprising 32 services. Explanatory variables included the stringency index (SI) and vaccination policy (VP) from the Oxford COVID-19 government response tracker, and COVID-19 confirmed cases (CC). The data covered the period from January 2019 to December 2021. Statistical significance was set at 0.05. Results The SI showed a significantly negative association with NMPs (16/32 services, 50.0%) in four hospitals. The CC also showed similar trends (8/32 services) in three hospitals. In contrast, VP was positively associated with NMPs (8/32 services). Of the eight services, both malaria and HIV testing were negatively associated with SI in all hospitals. Naguru hospital in the capital city, where health facilities were sufficient, was the least affected by SI (2/8 services) while Kabale and Lira hospitals in local cities were negatively impacted regarding SI (5/8 services). Conclusions This study showed that the restrictive measures to control COVID-19 transmission had the greatest impact on the disruption of hospital service access, more than the COVID-19 infection itself. Innovative service delivery systems for all necessary populations should be developed during mobility restrictions in health-resource-limited settings for future health crises. Key messages • Stringency, public health and social measures, showed the strongest association with the disruption of hospital service access in Uganda, particular in areas with insufficient health facilities. • Innovative service delivery systems for all necessary populations should be developed in health-resource-limited settings for future health crises.

Impacts of public health and social measures on COVID-19 in Europe: a review and modified Delphi technique.

The emergence of the COVID-19 pandemic in early 2020 led countries to implement a set of public health and social measures (PHSMs) attempting to contain the spread of the SARS-CoV-2 virus. This study aims to review the existing literature regarding key results of the PHSMs that were implemented, and to identify the PHSMs considered to have most impacted the epidemiological curve of COVID-19 over the last years during different stages of the pandemic. The PHSM under study were selected from the Oxford COVID-19 Government Response Tracker (OxCGRT), supplemented by topics presented during the Rapid Exchange Forum (REF) meetings in the scope of the Population Health Information Research Infrastructure (PHIRI) project (H2020). The evidence- based review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify which reviews have already been published about each PHSMs and their results. In addition, two modified Delphi panel surveys were conducted among subject matter experts from 30 European countries to uphold the results found. There were 3,212 studies retrieved from PubMed, 162 full texts assessed for eligibility and 35 included in this PHSMs summary. The measures with clearest evidence on their positive impact from the evidence-based review include social distancing, hygiene measures, mask measures and testing policies. From the modified Delphi panel, the PHSMs considered most significant in the four periods analyzed were case isolation at home, face coverings, testing policy, and social distancing, respectively. The evidence found has significant implications for both researchers and policymakers. The study of PHSMs' impact on COVID-19 illustrates lessons learned for future pan- and epidemics, serving as a contribution to the health systems resilience discussion. These lessons, drawn from both the available scientific evidence and the perspectives of relevant subject matter experts, should also be considered in educational and preparedness programs and activities in the public health space.

Vaccination and non-pharmaceutical interventions during COVID-19: Impact on health and non-health outcomes in the US

ObjectiveLittle is known about the relative effectiveness of COVID-19 vaccination and its interaction with non-pharmaceutical interventions (NPIs) in reducing infections, deaths, COVID-19 reproduction rate, and job losses. This study examined the relative effectiveness of vaccination and NPIs on COVID-19 infection, deaths, reproduction rate, and unemployment rate in the US. MethodsRetrospective US data at the national level were obtained from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset). Unemployment rate data were obtained from the US Bureau of Labor Statistics. Time-trend analyses of the policy variables and epidemiological outcomes were performed. A regression discontinuity in time was used to investigate the effects of policy variables on health outcomes and unemployment rate. ResultsBased on time-trend analyses, the number of people vaccinated increased starting in March 2021, while the stringency index had steadily declined since early January 2021. A decrease in new COVID-19 cases and deaths was observed during this period. However, despite higher vaccination coverage, new COVID-19 cases and deaths peaked in late 2021 and early 2022. We found that the interaction between treatment effects (vaccinations) and stringency measures was negatively associated with total COVID-19 cases and deaths, implying that some restrictions might be required to reduce rising infections during vaccination campaigns. We also found a negative association between vaccinations and the unemployment rate. ConclusionThe study findings suggested that vaccinations alone were insufficient to reduce virus spread and deaths, and that some NPIs might be required during the vaccination campaigns.

Assessment of the impact of COVID-19 lockdown measures on electricity consumption – Evidence from Portugal and Spain

The COVID-19 pandemic caused unheard-of shifts in socioeconomic norms and interpersonal connections. Governments were compelled to place limitations on the way of life of residents and companies in order to stem the virus' spread in order to deal with this new threat. These led to stay-at-home orders in many nations and reduced industry activities to their bare minimum, which had an immediate impact on the electricity systems.This article investigates the influence of COVID-19 on electricity consumption in Portugal and Spain, with the goal of shedding light on consumption shifts and how these are related to the stringency degree of government-imposed measures, as well as providing an overview of the first post-pandemic data. We cross information between observed electricity consumption data and numerous factors, including the Stringency Index (SI) given by the Oxford COVID-19 Government Response Tracker (OxCGRT), using an econometric model. We also investigate how government-issued alert levels influenced electricity use.We concluded that, although Spain only felt the repercussions in 2020, Portugal saw a negative and considerable impact from restriction measures and lockdowns in 2020 and 2021. The decision to close schools was found to be the specific step that significantly reduced electricity consumption in both countries.

Variation in the stringency of COVID-19 public health measures on self-reported health, stress, and overall wellbeing in Canada

Evidence is building regarding the association between government implemented public health measures aimed at combating COVID-19 and their impacts on health. This study investigated the relationship between the stringency of public health measures implemented in Canada and self-reported mental health, physical health, stress, and wellbeing among a random sample of 6647 Canadians 18 years of age and older. The analysis was based on self-reported health data from the Canadian Perspectives on Environmental Noise Survey. This data was combined with the Oxford COVID-19 Government Response Tracker database, which included overall stringency index (SI), and four of its sub-components, i.e., school and business closures, restrictions on gatherings, and stay at home policies. Adjusted multivariate logistic regression models indicated that the magnitude of the overall SI was associated with higher or lower odds of reporting worse physical health, mental health, stress and/or overall wellbeing, depending on the measure evaluated. Similarly, policy directed at the four sub-components had varying impacts on the odds of reporting worse health, depending on the sub-component, the strength of the policy restriction, and the health outcome evaluated. The association between the strength of the public health measures and self-reported health, and how this may inform future policy, is discussed.

Digital capacity and employment outcomes: Microdata evidence from pre- and post-COVID-19 Europe

This paper examines the relationship between employment outcomes and broadband Internet access, education and digital skills using the pre- and post-COVID-19 survey waves of the Eurostat Community Statistics on Information Society from 2017, 2019, and 2021 in 27 European countries. Joint estimates of individuals’ employment status and skills employ external controls based on Eurostat and COVID-19 European Regional Tracker NUTS1-level regional statistics and Oxford COVID-19 Government Response Tracker information on governments’ containment and economic support measures. Broadband access, digital skills and educational attainment combine to raise employment outcomes, but COVID-19 has changed these relationships in distinct ways. It has increased employment benefits from formal education and roughly tripled the labor market advantages from having household members with tertiary education. The pandemic has increased the employment value of having at least some digital skills, while the relative benefits of more advanced digital skills shrank.

Linking government interventions to firm performance: the influence of stringency and support during the COVID-19 pandemic

PurposeThis study uncovers how government interventions, in terms of stringency and support, shape coronavirus disease 2019's (COVID-19) detrimental impact on organizations' performance. Specifically, this paper studies whether stringency and support play complementary or substitutive roles in lowering COVID-19's impact on organizations' performance.Design/methodology/approachThe authors gathered primary data from USA manufacturing companies and combined this with secondary data from the Oxford COVID-19 Government Response Tracker (OxCGRT) to test the proposed model with structural equation modeling (SEM).FindingsThe results show that the stringency approach increases the detrimental impact on both operational and financial performance, while economic support (to households) and fiscal spending (to organizations) work differently on lowering the impacts of COVID-19. Further, these combinative effects only influence the firm's operational performance, albeit in opposite directions.Originality/valueThis study advances the knowledge of government interventions by examining stringency and support's direct and interaction effects on firm performance as a result of the COVID-19 pandemic. The findings contribute to the literature by uncovering the unique roles of both supportive policies, thus differentiating economic support (to individuals/households) from fiscal spending (to organizations) and providing important academic, managerial and policy insights into how government should best initiate and blend stringency and support policies during the COVID-19 pandemic.