Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022

Objectives: Global countries often apply containment policies (CPs) to combat infectious disease surges. Whether countries with longer cumulative duration of CPs are associated with slower long-term epidemic progression necessitates a thorough evaluation. Methods: We collected CP and COVID-19 data o...

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Main Authors: Zhiyao Li, Zhen Wang, Xin Wang, Senke Chen, Wenxue Xiong, Chaonan Fan, Wenjuan Wang, Meng Zheng, Kunpeng Wu, Qun He, Wen Chen, Li Ling
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971225000943
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author Zhiyao Li
Zhen Wang
Xin Wang
Senke Chen
Wenxue Xiong
Chaonan Fan
Wenjuan Wang
Meng Zheng
Kunpeng Wu
Qun He
Wen Chen
Li Ling
author_facet Zhiyao Li
Zhen Wang
Xin Wang
Senke Chen
Wenxue Xiong
Chaonan Fan
Wenjuan Wang
Meng Zheng
Kunpeng Wu
Qun He
Wen Chen
Li Ling
author_sort Zhiyao Li
collection DOAJ
description Objectives: Global countries often apply containment policies (CPs) to combat infectious disease surges. Whether countries with longer cumulative duration of CPs are associated with slower long-term epidemic progression necessitates a thorough evaluation. Methods: We collected CP and COVID-19 data of 185 territories during 2020-2022, with a total of 23 CPs. Using the target trial emulation and cloning-censoring-weighting approaches, we assessed the effectiveness of CPs with different cumulative durations in delaying countries from reaching the 1% and 10% cumulative infection incidence end points (i.e. 10,000 and 100,000 COVID-19 cases per million population, respectively) over a 3-year observation period. Results: For reaching the 1% cumulative infection incidence, recommending closing workplaces and limiting gatherings to 10 people, each presented that a longer cumulative duration of those CPs is associated with a lower proportion of countries achieving this end point throughout 2020-2022. For reaching the 10% cumulative infection incidence, mandatory bans on public events and domestic movements, closing public transports, and screening and quarantining inbound tourists, each showed similar associations. Notably, long-lasting border bans upon high-risk regions are associated with a higher proportion of countries reaching the 10% cumulative infection incidence. Conclusions: From the long-term perspective, we highlight CPs that warrant extending the duration to achieve slower epidemic progression. By contrast, our findings demonstrate the limited effectiveness of the ban on regions in slowing the long-term epidemic progression.
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spelling doaj-art-d2c59e37b57b42c2bb6d758b15595af52025-08-20T03:09:09ZengElsevierInternational Journal of Infectious Diseases1201-97122025-05-0115410787110.1016/j.ijid.2025.107871Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022Zhiyao Li0Zhen Wang1Xin Wang2Senke Chen3Wenxue Xiong4Chaonan Fan5Wenjuan Wang6Meng Zheng7Kunpeng Wu8Qun He9Wen Chen10Li Ling11Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, ChinaDepartment of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Clinical Research Design Division, Clinical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Corresponding author: Tel.:+86 20 87333319; fax: +86 20 87335524.Objectives: Global countries often apply containment policies (CPs) to combat infectious disease surges. Whether countries with longer cumulative duration of CPs are associated with slower long-term epidemic progression necessitates a thorough evaluation. Methods: We collected CP and COVID-19 data of 185 territories during 2020-2022, with a total of 23 CPs. Using the target trial emulation and cloning-censoring-weighting approaches, we assessed the effectiveness of CPs with different cumulative durations in delaying countries from reaching the 1% and 10% cumulative infection incidence end points (i.e. 10,000 and 100,000 COVID-19 cases per million population, respectively) over a 3-year observation period. Results: For reaching the 1% cumulative infection incidence, recommending closing workplaces and limiting gatherings to 10 people, each presented that a longer cumulative duration of those CPs is associated with a lower proportion of countries achieving this end point throughout 2020-2022. For reaching the 10% cumulative infection incidence, mandatory bans on public events and domestic movements, closing public transports, and screening and quarantining inbound tourists, each showed similar associations. Notably, long-lasting border bans upon high-risk regions are associated with a higher proportion of countries reaching the 10% cumulative infection incidence. Conclusions: From the long-term perspective, we highlight CPs that warrant extending the duration to achieve slower epidemic progression. By contrast, our findings demonstrate the limited effectiveness of the ban on regions in slowing the long-term epidemic progression.http://www.sciencedirect.com/science/article/pii/S1201971225000943COVID-19 epidemic progressionTarget trial emulationCloning-censoring-weightingHealth policyNon-pharmacologic intervention
spellingShingle Zhiyao Li
Zhen Wang
Xin Wang
Senke Chen
Wenxue Xiong
Chaonan Fan
Wenjuan Wang
Meng Zheng
Kunpeng Wu
Qun He
Wen Chen
Li Ling
Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022
International Journal of Infectious Diseases
COVID-19 epidemic progression
Target trial emulation
Cloning-censoring-weighting
Health policy
Non-pharmacologic intervention
title Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022
title_full Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022
title_fullStr Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022
title_full_unstemmed Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022
title_short Global containment policy duration and long-term epidemic progression: A target trial emulation using COVID-19 data from 2020 to 2022
title_sort global containment policy duration and long term epidemic progression a target trial emulation using covid 19 data from 2020 to 2022
topic COVID-19 epidemic progression
Target trial emulation
Cloning-censoring-weighting
Health policy
Non-pharmacologic intervention
url http://www.sciencedirect.com/science/article/pii/S1201971225000943
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