# COVID-19 prevention and control effect of non-pharmaceutical interventions—fuzzy-sets qualitative comparative analysis based on 69 countries in the world

## TL;DR

This study analyzes how different combinations of non-pharmaceutical interventions affect the spread of COVID-19 in 69 countries.

## Contribution

The study introduces a fuzzy-sets qualitative comparative analysis to evaluate the effectiveness of NPI combinations during the early pandemic phase.

## Key findings

- Non-strict face covering combined with social isolation and travel restrictions leads to high morbidity.
- Strict mask wearing alone is sufficient to prevent high morbidity.
- Strict testing and contact tracing combined with containment measures improve prevention and control.

## Abstract

Coronavirus disease 2019 occurred unexpectedly in late December 2019, it was difficult to immediately develop an effective vaccine or propose targeted medical interventions in the early stages of the outbreak. At this point, non-pharmaceutical interventions (NPIs) are essential components of the public health response to COVID-19. How to combine different NPIs in the early stages of an outbreak to control the spread of epidemics and ensure that the policy combination does not incur high socio-economic costs became the focus of this study.

We mainly used the fuzzy set qualitative comparative analysis to assess the impact of different combinations of NPIs on the effectiveness of control in the COVID-19 pandemic early stage, using open datasets containing case numbers, country populations and policy responses.

We showed that the configuration of high morbidity results includes one, which is the combination of non-strict face covering, social isolation and travel restrictions. The configuration of non-high morbidity results includes three, one is strict mask wearing measures, which alone constitute sufficient conditions for interpreting the results; the second is strict testing and contact tracing, social isolation; the third is strict testing and contact tracing, travel restriction. The results of the robustness test showed that the number, components and consistency of the configurations have not changed after changing the minimum case frequency, which proved that the analysis results are reliable.

In the early stages of the epidemic, the causes of high morbidity are not symmetrical with the causes of non-high morbidity. Strict face covering is the most basic measure required to prevent and control epidemics, and the combination of non-strict face covering and containment is the most important factor leading to poor prevention and control, and the combination of strict containment and proactive pursuit is the way to achieve superior prevention and control, timely and proactive containment strategies have better prevention and control, and should mobilize the public to cooperate.