A descriptive analysis of the impact of public health and social measures on COVID-19: How the U.S. compares to other countries.

BACKGROUND: The United States of America (US) 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). OBJECTIVE: In this descriptive analysis, we analyzed the epidemiological evidence for PHSM impact on COVID-19 transmission in the US compared to that in ten other countries of varying income levels, population sizes, and geographies. METHODS: We compared PHSM implementation timing and stringency against COVID-19 daily case counts in the US to that 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. PHSM and case count data were derived from various surveillance systems - the Health Intervention Tracking for COVID-19 database, the World Health Organization PHSM database, and the European Centre for Disease Prevention and Control. RESULTS: Implementing a specific package of four PHSM (quarantine and isolation, school closures, household confinement, and limiting social gatherings) early and stringently was observed to coincide with lower cases and transmission duration in Vietnam, Zimbabwe, New Zealand, South Korea, Ethiopia, and Kazakhstan. In contrast, the US implemented few PHSM stringently or early and did not utilize this successful package. Across countries, national income was positively correlated (r=0.624) with cumulative COVID-19 incidence. CONCLUSIONS: Our findings suggest that early implementation, consistent execution, adequate duration, and high adherence to PHSMs represent key factors in reducing the spread of COVID-19. While national income may be related to COVID-19 progression, a country's wealth appears less important in controlling the pandemic than taking rapid, centralized, and consistent public health action.