Policy determinants of COVID-19 pandemic-induced fatality rates across nations

Teixeira da Silva, Jaime A.; Tsigaris, Panagiotis

Abstract Objectives COVID-19 is the most devastating pandemic to affect humanity in a century. In this paper, we assessed tests as a policy instrument and policy enactment to contain COVID-19 and potentially reduce mortalities. Study design A model was devised to estimate the factors that influenced the death rate across 121 nations and by income group. Results Nations with a higher proportion of people age 65+ had a higher fatality rate (p = 0.00014). Delaying policy enactment led to a higher case fatality rate (p = 0.0013). A 10% delay time to act resulted in a 3.7% higher case fatality rate. This study found that delaying policies for international travel restrictions, public information campaigns, and testing policies increased the fatality rate. Tests also impacted the case fatality rate, and nations with 10% more cumulative tests per million people resulted in a 2.8% lower mortality rate. Citizens of nations who can access more destinations without the need to have a prior visa have a significant higher mortality rate than those that need a visa to travel abroad (p = 0.0040). Conclusion Tests, as a surrogate of policy action and earlier policy enactment, matter for saving lives from pandemics as such policies reduce the transmission rate of the pandemic.