Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada.
Department of Environmental Health, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
PLoS One. 2021 Apr 1;16(4):e0248828. doi: 10.1371/journal.pone.0248828. eCollection 2021.
On January 30th 2020, the World Health Organization (WHO) declared a international health emergency due to the unprecedented phenomenon of COVID-19. After this declaration countries swiftly implemented a variety of health policies. In this work we examine how rapid countries responded to this pandemic using two events: the day in which the first case of COVID-19 was reported, and first day in which countries used school closure as one of the measures to avoid outbreaks. We also assessed how countries' health systems, globalization, economic development, political systems, and economic integration to China, Republic of Korea and Italy increased the speed of adoption.
We compiled information from multiple sources, from December 31st 2019 to June 1st 2020, to trace when 172 countries reported their first COVID-19 case and implemented school closure to contain outbreaks. We applied cross-national Weibull survival analysis to evaluate the global speed of detection of first COVID-19 reported cases and school closure.
Ten days after WHO declared COVID-19 to be an international emergency, relative to seven days from this declaration, countries were 28 (95% CI: 12-77) times more likely to report first COVID-19 cases and 42 (95% CI: 22-90) times more likely to close schools. One standard deviation increase in the epidemic security index rises the rate of report first cases by 37% (Hazard Ratio (HR) 1.37 (95% CI: 1.09-1.72) and delays the adoption for school closures by 36% (HR 0.64 (95% CI:0.50-0.82). One standard deviation increase in the globalization index augments the adoption for school closures by 74% (HR 1.74 (95% CI:1.34-2.24).
After the WHO declared a global emergency, countries were unprecedently acting very rapidly. While countries more globally integrated were swifter in closing schools, countries with better designed health systems to tackle epidemics were slower in adopting it. More studies are needed to assess how the speed of school closures and other policies will affect the development of the pandemic.
2020 年 1 月 30 日，世界卫生组织（WHO）宣布 COVID-19 为国际卫生紧急事件。此后，各国迅速实施了各种卫生政策。在这项工作中，我们通过两个事件来考察各国对这一流行病的反应速度：报告首例 COVID-19 病例的日期，以及首次将学校关闭作为避免疫情爆发的措施之一的日期。我们还评估了各国的卫生系统、全球化、经济发展、政治制度以及与中国、韩国和意大利的经济一体化程度如何加快了这一措施的采用。
我们从 2019 年 12 月 31 日至 2020 年 6 月 1 日，从多个来源汇编信息，以追踪 172 个国家报告首例 COVID-19 病例和实施学校关闭以遏制疫情爆发的时间。我们应用跨国 Weibull 生存分析来评估全球首次报告 COVID-19 病例和学校关闭的检测速度。
在世界卫生组织宣布 COVID-19 为国际卫生紧急事件后的十天内，与从该声明起的七天相比，各国报告首例 COVID-19 病例的可能性增加了 28 倍（95%置信区间：12-77），关闭学校的可能性增加了 42 倍（95%置信区间：22-90）。传染病安全指数每增加一个标准差，报告首例病例的速度就会提高 37%（风险比（HR）1.37（95%置信区间：1.09-1.72），而学校关闭的时间则会延迟 36%（HR 0.64（95%置信区间：0.50-0.82）。传染病安全指数每增加一个标准差，学校关闭的采用率就会增加 74%（HR 1.74（95%置信区间：1.34-2.24）。
世界卫生组织宣布全球卫生紧急事件后，各国的行动速度前所未有地迅速。尽管全球化程度较高的国家关闭学校的速度较快，但在应对疫情方面设计较好的卫生系统的国家在采用该措施时速度较慢。需要更多的研究来评估学校关闭和其他政策的速度将如何影响大流行的发展。
