A Comparative Analysis of COVID-19 Physical Distancing Policies in Botswana, India, Jamaica, Mozambique, Namibia, Ukraine, and the United States

Lane, J.; Means, A.; Bardosh, K.; Shapoval, A.; Vio, F.; Anderson, C.; Cushnie, A.; Forster, N.; Ledikwe, J.; OMalley, G.; Mawandia, S.; Parvez, A.; Perrone, L.; Mudender, F.

BackgroundUnderstanding the differences in timing and composition of physical distancing policies is important to evaluate the early global response to COVID-19. A physical distancing intensity framework comprising 16 domains was recently published to compare physical distancing approaches between U.S. States. We applied this framework to a diverse set of low and middle-income countries (LMICs) (Botswana, India, Jamaica, Mozambique, Namibia, and Ukraine) to test the appropriateness of this framework in the global context and to compare the policy responses in this set of LMICs and with a sample of U.S. States during the first 100-days of the epidemic. ResultsAll six of the LMICs in our sample adopted wide ranging physical distancing policies. The highest peak daily physical distancing intensity in each country was: Botswana (4.60); India (4.40); Ukraine (4.40); Namibia (4.20); and Jamaica (3.80). The number of days each country stayed at peak intensity ranged from 12-days (Jamaica) to more than 67-days (Mozambique). We found some key similarities and differences, including substantial differences in whether and how countries expressly required certain groups to stay at home. We also found that the LMICs generally implemented physical distancing policies when there were few confirmed cases and the easing of physical distancing policies did not discernably correlate with change in COVID-19 incidence. The physical distancing responses in the LMIC sample were generally more intense than in a sample of U.S. States, but results vary depending on the U.S. State. For example, California had a peak intensity of 4.29, which would place California below the peak intensity for Botswana, India, and Ukraine but above Mozambique, Namibia and Jamaica. The U.S. State of Georgia had a peak intensity of 3.07, which would place it lower than all of the LMICs in this sample. The peak intensity for the U.S. 12-state average was 3.84, which would place it lower than every LMIC in this sample except Jamaica. ConclusionThis analysis helps to highlight the differing paths taken by the countries in this sample and may provide lessons to other countries regarding options for structuring physical distancing policies in response to COVID-19 and future outbreaks.