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Does Governance Quality Matter for the Selection of Policy Stringency to Fight COVID-19?

ABSTRACT: Independent of different national conditions, an indisputable fact is that the worldwide governments should play a role in fighting the ongoing COVID-19. To make clear the determinants of government response to tackle COVID-19, I investigate the impact of governance quality. To do so, I newly create an overall governance index based on six dimensions of Worldwide Governance Indicators (WGI) from the World Bank to proxy governance quality. I regress the overall governance index with controls on the stringency index from the Oxford COVID-19 Government Response Tracker database. Using pooled and panel data models with individual and time fixed effects, I find that the relationship between governance quality and policy stringency for 339 days across 163 countries is significantly nonmonotonic. Countries with middle governance quality select a high level of policy stringency in contrast to those with high and low governance quality. I also find that policy stringency significantly increases when daily new cases increase. The findings highlight the role of governance quality in deciding the stringency level of public health policies.

SUBMITTER: Wang Y

PROVIDER: S-EPMC9180495 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Does Governance Quality Matter for the Selection of Policy Stringency to Fight COVID-19?

Wang Yan Y

International journal of environmental research and public health 20220530 11

Independent of different national conditions, an indisputable fact is that the worldwide governments should play a role in fighting the ongoing COVID-19. To make clear the determinants of government response to tackle COVID-19, I investigate the impact of governance quality. To do so, I newly create an overall governance index based on six dimensions of Worldwide Governance Indicators (WGI) from the World Bank to proxy governance quality. I regress the overall governance index with controls on t ...[more]

PMID: 35682263

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Project description:BackgroundTo date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and mental health during the COVID-19 pandemic.MethodsIn this longitudinal analysis, we combined daily policy stringency data from the Oxford COVID-19 Government Response Tracker with psychological distress scores and life evaluations captured in the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from samples of 15 countries between April 27, 2020, and June 28, 2021. The mental health questions provided a sample size of 432 642 valid responses, with an average of 14 918 responses every 2 weeks. To investigate how policy stringency was associated with mental health, we considered two potential mediators: observed physical distancing and perceptions of the government's handling of the pandemic. Countries were grouped on the basis of their response to the COVID-19 pandemic as those pursuing an elimination strategy (countries that aimed to eliminate community transmission of SARS-CoV-2 within their borders) or those pursuing a mitigation strategy (countries that aimed to control SARS-CoV-2 transmission). Using a combined dataset of country-level and individual-level data, we estimated linear regression models with country-fixed effects (ie, dummy variables representing the countries in our sample) and with individual and contextual covariates. Additionally, we analysed data from a sample of Nordic countries, to compare Sweden (that pursued a mitigation strategy) to other Nordic countries (that adopted a near-elimination strategy).FindingsControlling for individual and contextual variables, higher policy stringency was associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients β=0·014 [95% CI 0·005 to 0·023] for psychological distress; β=-0·010 [-0·015 to -0·004] for life evaluation). Pandemic intensity (number of deaths per 100 000 inhabitants) was also associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients β=0·016 [0·008 to 0·025] for psychological distress; β=-0·010 [-0·017 to -0·004] for life evaluation). The negative association between policy stringency and mental health was mediated by observed physical distancing and perceptions of the government's handling of the pandemic. We observed that countries pursuing an elimination strategy used different policy timings and intensities compared with countries pursuing a mitigation strategy. The containment policies of countries pursuing elimination strategies were on average less stringent, and fewer deaths were observed.InterpretationChanges in mental health measures during the first 15 months of the COVID-19 pandemic were small. More stringent COVID-19 policies were associated with poorer mental health. Elimination strategies minimised transmission and deaths, while restricting mental health effects.FundingNone.

Project description:BackgroundNew data on COVID-19 may influence the stringency of containment policies, but these potential effect are not understood. We aimed to understand the associations of new COVID-19 cases and deaths with policy stringency globally and regionally.MethodsWe modelled the marginal effects of new COVID-19 cases and deaths on policy stringency (scored 0-100) in 175 countries and territories, adjusting for gross domestic product (GDP) per capita and health expenditure (% of GDP), and public expenditure on health. The time periods examined were March to August 2020, September 2020 to February 2021, and March to August 2021.ResultsPolicy response to new cases and deaths was faster and more stringent early in the COVID-19 pandemic (March to August 2020) compared to subsequent periods. New deaths were more strongly associated with stringent policies than new cases. In an average week, one new death per 100 000 people was associated with a stringency increase of 2.1 units in the March to August 2020 period, 1.3 units in the September 2020 to February 2021 period, and 0.7 units in the March to August 2021 period. New deaths in Africa and the Western Pacific were associated with more stringency than in other regions. Higher health expenditure as a percentage of GDP was associated with less stringent policies. Similarly, higher public expenditure on health by governments was mostly associated with less stringency across all three periods. GDP per capita did not have consistent patterns of associations with stringency.ConclusionsThe stringency of COVID-19 policies was more strongly associated with new deaths than new cases. Our findings demonstrate the need for enhanced mortality surveillance to ensure policy alignment during health emergencies. Countries that invest less in health or have a lower public expenditure on health may be inclined to enact more stringent policies. This new empirical understanding of COVID-19 policy drivers can help public health officials anticipate and shape policy responses in future health emergencies.

Dataset Information

Does Governance Quality Matter for the Selection of Policy Stringency to Fight COVID-19?

Publications

Does Governance Quality Matter for the Selection of Policy Stringency to Fight COVID-19?

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