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Original Research ARTICLE

Front. Public Health | doi: 10.3389/fpubh.2020.607832

Impact of Healthcare System, Macro Indicator, General Mandatory Quarantine and Mask Obligation on COVID-19 cases and death in six Latin American Countries: an interrupted time series study Provisionally accepted The final, formatted version of the article will be published soon. Notify me

  • 1University of Cologne, Germany

Background: Different coping strategies have been implemented by the governments worldwide to address the emerging health crisis of COVID-19. While most developed countries count with supporting healthcare and social systems, developing countries face additional challenges due to low macro indicators. The implementation of measurements such as quarantine are shown to be successful to flatten the curve of infection and death. In this context, it is important to test whether those measurements have an impact on the distribution of cases of COVID-19 in developing countries which face additional challenges such as lack of social security due to informal employment. Therefore, a country comparison for Colombia, Costa Rica, Peru, Ecuador, Mexico and Chile has been conducted.
Method: The healthcare systems and macro indicator, as well as the distribution of death due to COVID-19 per thousand inhabitants are compared descriptively. Using Multiple Interrupted Time Series Analysis with synthetic control units the impact of the General Mandatory Quarantine in Colombia, Peru and Ecuador as well as the impact of Mask Obligation in public in Colombia and Chile has been tested.
Results: No clear impact of the poverty headcount ratio at national poverty line and urban population on the percentage of death within the confirmed cases has been found. The out-of-pocked spending within the health expenditure as barrier in access to healthcare can be considered as determinant of the death within the confirmed cases of COVID-19. The implementation of a general mandatory quarantine did not show a curve flatten effect in Ecuador and Peru, but in Colombia. The implementation of Mask obligation in public spaced showed positive impact on the distribution of confirmed case in both countries tested.
Conclusion: The implementation of a general mandatory quarantine does not guarantee curve flatten effect. Therefore, various macro indicators should always be considered while analyzing the effect of policies.

Keywords: COVID-19, Latin America, coping strategies, macro indicators, ITSA = interrupted time-series analysis, Country comparison, Mandatory quarantine, Mask Obligation

Received: 18 Sep 2020; Accepted: 10 Nov 2020.

Copyright: © 2020 Poppe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Miss. Adriana Poppe, University of Cologne, Cologne, 50923, North Rhine-Westphalia, Germany,