Faculty of Management, Economics and Social Science, University of Cologne, Cologne, Germany.
Front Public Health. 2020 Dec 16;8:607832. doi: 10.3389/fpubh.2020.607832. eCollection 2020.
Different coping strategies have been implemented by various governments worldwide to address the emerging health crisis of COVID-19. While most developed countries count on supporting healthcare and social systems, developing countries face additional challenges due to low macro indicators. The implementation of measurements such as quarantine are shown to be successful to flatten the curve of infection and death. In this context, it is important to test whether those measurements have an impact on the distribution of cases of COVID-19 in developing countries that face additional challenges such as lack of social security due to informal employment. A country comparison for Colombia, Costa Rica, Peru, Ecuador, Mexico, and Chile has therefore been conducted. The healthcare systems and macro indicator as well as the distribution of death due to COVID-19 per thousand inhabitants are compared descriptively. Using Multiple Interrupted Time Series Analysis with synthetic control units the impact of the General Mandatory Quarantine in Colombia, Peru, and Ecuador as well as the impact of Mask Obligation in public in Colombia and Chile have been tested. No clear impact of the poverty headcount ratio at the national poverty line and urban population on the percentage of death within the confirmed cases has been found. The out-of-pocked spending within health expenditure as a barrier in access to healthcare can be considered as a determinant of death within the confirmed cases of COVID-19. The implementation of a general mandatory quarantine did not show a curve-flattening effect in Ecuador and Peru but did so in Colombia. The implementation of Mask obligation in public spaced showed positive impact on the distribution of confirmed case in both countries tested. The implementation of a general mandatory quarantine does not guarantee the curve-flattening effect. Various macro indicators should therefore always be considered while analyzing the effect of policies.
不同的政府在全球范围内实施了不同的应对策略，以应对 COVID-19 这一新兴的卫生危机。虽然大多数发达国家依靠支持医疗保健和社会系统，但发展中国家由于宏观指标较低而面临额外的挑战。实施隔离等措施已被证明有助于减缓感染和死亡曲线。在这种情况下，重要的是要测试这些措施是否对面临额外挑战（如由于非正规就业导致社会保障不足）的发展中国家的 COVID-19 病例分布产生影响。因此，对哥伦比亚、哥斯达黎加、秘鲁、厄瓜多尔、墨西哥和智利进行了国家比较。描述性地比较了医疗保健系统和宏观指标以及每千名居民因 COVID-19 死亡的分布。使用具有合成控制单元的多个中断时间序列分析，测试了哥伦比亚、秘鲁和厄瓜多尔的一般强制性隔离以及哥伦比亚和智利的公共口罩义务的影响。没有发现国家贫困线和城市人口的贫困人口比例对确诊病例中的死亡率百分比有明显影响。卫生支出中自费支出作为获得医疗保健的障碍，可以被认为是 COVID-19 确诊病例死亡的决定因素。在厄瓜多尔和秘鲁实施一般强制性隔离并没有显示出曲线变平的效果，但在哥伦比亚却显示出了这种效果。在公共场合实施口罩义务显示出对两国确诊病例分布的积极影响。实施一般强制性隔离并不能保证曲线变平的效果。因此，在分析政策效果时，应始终考虑各种宏观指标。
