Proceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences ( IF 2.741 ) Pub Date : 2021-04-07 , DOI: 10.1098/rspa.2020.0440 Han Yan, Yuru Zhu, Jia Gu, Yaxuan Huang, Haoxuan Sun, Xinyu Zhang, Yuqing Wang, Yumou Qiu, Song Xi Chen
We study epidemiological characteristics of 25 early COVID-19 outbreak countries, which emphasizes on the reproduction of infection and effects of government control measures. The study is based on a vSIADR model which allows asymptomatic and pre-diagnosis infections to reflect COVID-19 clinical realities, and a linear mixed-effect model to analyse the association between each country’s control measures and the effective reproduction number Rt. It finds significant effects of higher stringency measures in lowering the reproduction, and a significant shortening effect on the time to the epidemic turning point by applying stronger early counter measures. Epidemic projections under scenarios of the counter measures (China and Korea, the USA and the UK) show substantial reduction in the epidemic size and death by taking earlier and forceful actions. The governments’ response before and after the start of the second wave epidemics were alarmingly weak, which made the average duration of the second wave more than doubled that of the first wave. We identify countries which urgently need to restore to at least the maximum stringency measures implemented so far in the pandemic in order to avoid even higher infection size and death.