Zweig Sophia Alison, Zapf Alexander John, Xu Hanmeng, Li Qingfeng, Agarwal Smisha, Labrique Alain Bernard, Peters David H
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
JMIR Public Health Surveill. 2021 Jun 2;7(6):e27917. doi: 10.2196/27917.
The United States of America has the highest global number of COVID-19 cases and deaths, which may be due in part to delays and inconsistencies in implementing public health and social measures (PHSMs).
In this descriptive analysis, we analyzed the epidemiological evidence for the impact of PHSMs on COVID-19 transmission in the United States and compared these data to those for 10 other countries of varying income levels, population sizes, and geographies.
We compared PHSM implementation timing and stringency against COVID-19 daily case counts in the United States and against those in Canada, China, Ethiopia, Japan, Kazakhstan, New Zealand, Singapore, South Korea, Vietnam, and Zimbabwe from January 1 to November 25, 2020. We descriptively analyzed the impact of border closures, contact tracing, household confinement, mandated face masks, quarantine and isolation, school closures, limited gatherings, and states of emergency on COVID-19 case counts. We also compared the relationship between global socioeconomic indicators and national pandemic trajectories across the 11 countries. PHSMs and case count data were derived from various surveillance systems, including the Health Intervention Tracking for COVID-19 database, the World Health Organization PHSM database, and the European Centre for Disease Prevention and Control.
Implementing a specific package of 4 PHSMs (quarantine and isolation, school closures, household confinement, and the limiting of social gatherings) early and stringently was observed to coincide with lower case counts and transmission durations in Vietnam, Zimbabwe, New Zealand, South Korea, Ethiopia, and Kazakhstan. In contrast, the United States implemented few PHSMs stringently or early and did not use this successful package. Across the 11 countries, national income positively correlated (r=0.624) with cumulative COVID-19 incidence.
Our findings suggest that early implementation, consistent execution, adequate duration, and high adherence to PHSMs represent key factors of reducing the spread of COVID-19. Although national income may be related to COVID-19 progression, a country's wealth appears to be less important in controlling the pandemic and more important in taking rapid, centralized, and consistent public health action.
美国是全球新冠肺炎病例数和死亡数最多的国家，这可能部分归因于实施公共卫生和社会措施（PHSMs）时的延误和不一致。
在这项描述性分析中，我们分析了PHSMs对美国新冠肺炎传播影响的流行病学证据，并将这些数据与其他10个不同收入水平、人口规模和地理位置的国家的数据进行比较。
我们将2020年1月1日至11月25日期间美国实施PHSMs的时间和严格程度与新冠肺炎每日病例数进行比较，并与加拿大、中国、埃塞俄比亚、日本、哈萨克斯坦、新西兰、新加坡、韩国、越南和津巴布韦的情况进行比较。我们描述性地分析了边境关闭、接触者追踪、家庭隔离、强制佩戴口罩、检疫和隔离、学校关闭、限制集会和紧急状态对新冠肺炎病例数的影响。我们还比较了11个国家的全球社会经济指标与国家疫情轨迹之间的关系。PHSMs和病例数数据来自各种监测系统，包括新冠肺炎健康干预跟踪数据库、世界卫生组织PHSM数据库和欧洲疾病预防控制中心。
观察到越南、津巴布韦、新西兰、韩国、埃塞俄比亚和哈萨克斯坦早期严格实施一套特定的4种PHSMs（检疫和隔离、学校关闭、家庭隔离和限制社交集会）与较低的病例数和传播持续时间相吻合。相比之下，美国很少早期且严格地实施PHSMs，也没有采用这个成功的方案。在这11个国家中，国民收入与新冠肺炎累计发病率呈正相关（r = 0.624）。
我们的研究结果表明，早期实施、持续执行、足够的持续时间以及对PHSMs的高度遵守是减少新冠肺炎传播的关键因素。虽然国民收入可能与新冠肺炎的进展有关，但一个国家的财富在控制疫情方面似乎不那么重要，而在采取迅速、集中和一致的公共卫生行动方面更为重要。
