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Impact of the Healthcare System, Macro Indicator, General Mandatory Quarantine, and Mask Obligation on COVID-19 Cases and Death in Six Latin American Countries: An Interrupted Time Series Study.

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  • Author(s): Poppe A;Poppe A
  • Source:
    Frontiers in public health [Front Public Health] 2020 Dec 16; Vol. 8, pp. 607832. Date of Electronic Publication: 2020 Dec 16 (Print Publication: 2020).
  • Publication Type:
    Comparative Study; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Frontiers Editorial Office Country of Publication: Switzerland NLM ID: 101616579 Publication Model: eCollection Cited Medium: Internet ISSN: 2296-2565 (Electronic) Linking ISSN: 22962565 NLM ISO Abbreviation: Front Public Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: Lausanne : Frontiers Editorial Office
    • Subject Terms:
      Physical Distancing*; COVID-19/*prevention & control ; Delivery of Health Care/*statistics & numerical data ; Mandatory Programs/*statistics & numerical data ; Masks/*statistics & numerical data ; Pandemics/*prevention & control ; Quarantine/*methods; Chile/epidemiology ; Colombia/epidemiology ; Costa Rica/epidemiology ; Ecuador/epidemiology ; Humans ; Interrupted Time Series Analysis ; Mexico/epidemiology ; Pandemics/statistics & numerical data ; Peru/epidemiology ; SARS-CoV-2
    • Abstract:
      Background: Different coping strategies have been implemented by various governments worldwide to address the emerging health crisis of COVID-19. While most developed countries count on supporting healthcare and social systems, developing countries face additional challenges due to low macro indicators. The implementation of measurements such as quarantine are shown to be successful to flatten the curve of infection and death. In this context, it is important to test whether those measurements have an impact on the distribution of cases of COVID-19 in developing countries that face additional challenges such as lack of social security due to informal employment. A country comparison for Colombia, Costa Rica, Peru, Ecuador, Mexico, and Chile has therefore been conducted. Method: The healthcare systems and macro indicator as well as the distribution of death due to COVID-19 per thousand inhabitants are compared descriptively. Using Multiple Interrupted Time Series Analysis with synthetic control units the impact of the General Mandatory Quarantine in Colombia, Peru, and Ecuador as well as the impact of Mask Obligation in public in Colombia and Chile have been tested. Results: No clear impact of the poverty headcount ratio at the national poverty line and urban population on the percentage of death within the confirmed cases has been found. The out-of-pocked spending within health expenditure as a barrier in access to healthcare can be considered as a determinant of death within the confirmed cases of COVID-19. The implementation of a general mandatory quarantine did not show a curve-flattening effect in Ecuador and Peru but did so in Colombia. The implementation of Mask obligation in public spaced showed positive impact on the distribution of confirmed case in both countries tested. Conclusion: The implementation of a general mandatory quarantine does not guarantee the curve-flattening effect. Various macro indicators should therefore always be considered while analyzing the effect of policies.
      Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
      (Copyright © 2020 Poppe.)
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    • Contributed Indexing:
      Keywords: COVID-19; ITSA = interrupted time-series analysis; Latin America; coping strategies; country comparison; macro indicators; mandatory quarantine; mask obligation
    • Publication Date:
      Date Created: 20210104 Date Completed: 20210120 Latest Revision: 20210120
    • Publication Date:
      20240105
    • Accession Number:
      PMC7772477
    • Accession Number:
      10.3389/fpubh.2020.607832
    • Accession Number:
      33392142