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Impact of non-pharmaceutical interventions on COVID-19 incidence and deaths: cross-national natural experiment in 32 European countries

2024-08-28Journal article Open access
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dc.contributor.authorCosta, Diogo
dc.contributor.authorRohleder, Sven
dc.contributor.authorBozorgmehr, Kayvan
dc.date.accessioned2024-09-04T17:12:31Z
dc.date.available2024-09-04T17:12:31Z
dc.date.issued2024-08-28
dc.description.abstractPurpose Non-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis. We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor – COV-PPM, and the Oxford Covid-19 Government Response Tracker – OxCGRT. Methods NPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5–25, and C4-C6, weeks 35–52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others). Results During the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries. Conclusion In the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1186/s12889-024-19799-7pt_PT
dc.identifier.eid85202620448
dc.identifier.issn1471-2458
dc.identifier.urihttp://hdl.handle.net/10400.14/46382
dc.identifier.wos001300711200003
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectNon-pharmaceutical interventionspt_PT
dc.subjectCovid-19pt_PT
dc.subjectEuropept_PT
dc.subjectNatural experimentpt_PT
dc.subjectMulti-level modellingpt_PT
dc.subjectInfectious diseasespt_PT
dc.titleImpact of non-pharmaceutical interventions on COVID-19 incidence and deaths: cross-national natural experiment in 32 European countriespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleBMC Public Healthpt_PT
oaire.citation.volume24pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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