Public Health Policies and Global COVID-19 Outbreak

The objective of our observational study is to evaluate the association between public health non-pharmaceutical interventions (exposure) against the COVID-19 outbreak and the incidence of confirmed COVID-19 cases (outcome) from five countries: France, Italy, Japan, South Korea, and the USA, December 31, 2019 through April 12, 2020. The incidence of COVID-19 would be significantly greater without lockdown (1.89 times, p-value less than.0001), public health and economic measures (25.17, p-value less than.0001), and using masks (11.93, p-value=0.002), assuming that all other public health policies are the same. The effectiveness increases with earlier time of implementation. Among considered countries, South Korea was the most efficacious, where all measures were statistically significantly efficacious. The experience from South Korea should be studied further as the most effective non-pharmacological approach to fight the disease. This paper is the first step to develop the standardized approach utilizing the public health interventions to be applied effectively to the globe population.