Gauffin Karl, Östergren Olof, Cederström Agneta
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2025 May 15;20(5):e0322692. doi: 10.1371/journal.pone.0322692. eCollection 2025.
It is well known that countries differed in their response to the COVID-19 pandemic in terms of the timing and intensity of specific measures such as lockdowns, face masks and vaccine rollout. However, previous studies have not investigated systematic differences in the overall pandemic strategies. We use daily data from the Oxford COVID-19 Government Response Tracker (OxCGRT), between January 2020 and December 2022 focusing on 16 key pandemic policies, including containment, economic, and health system measures, and apply a three-dimensional k-means clustering algorithm to identify distinct overarching strategies based on the type, intensity, and timing of the response adopted by different countries. We identify four distinct strategies; 1) the traditional infectious disease control approach, adopted by a wide range of high- and middle-income countries, which emphasises strict containment policies and movement restrictions, 2) the public health-oriented approach, adopted by developed welfare states with ageing populations and high health care expenditures, which is more flexible over time and focuses more on economic and health policies, such as income support and testing strategies, with less emphasis on stringent containment, 3) high stringency with gradual relaxation, and 4) reactive policies at a minimal level, both adopted by less democratic low- and middle income countries with substantial inequalities and with younger and less vulnerable populations. The findings contribute to understanding how different countries adapted to the pandemic and how these responses may relate to broader socio-political contexts, including welfare state arrangements and economic resilience.
众所周知,各国在应对新冠疫情时,在诸如封锁、口罩佩戴和疫苗推广等具体措施的时间和强度方面存在差异。然而,此前的研究并未调查整体疫情应对策略中的系统性差异。我们使用了牛津新冠疫情政府应对追踪器(OxCGRT)在2020年1月至2022年12月期间的每日数据,重点关注16项关键的疫情政策,包括遏制、经济和卫生系统措施,并应用三维k均值聚类算法,根据不同国家采取的应对措施的类型、强度和时间来确定不同的总体策略。我们识别出四种不同的策略:1)传统传染病控制方法,被广泛的高收入和中等收入国家采用,强调严格的遏制政策和行动限制;2)以公共卫生为导向的方法,被人口老龄化且医疗保健支出高的发达福利国家采用,随着时间推移更加灵活,更注重经济和卫生政策,如收入支持和检测策略,对严格遏制的强调较少;3)高度严格并逐步放松;4)最低限度的反应性政策,均被存在严重不平等且人口较年轻、较不易受影响的民主程度较低的低收入和中等收入国家采用。这些发现有助于理解不同国家如何适应疫情,以及这些应对措施如何与更广泛的社会政治背景相关联,包括福利国家安排和经济韧性。