COVID-19 case doubling time associated with non-pharmaceutical interventions and vaccination: A global experience.

backgroundEvidence has revealed that nonpharmaceutical interventions (NPIs) were effective in attenuating the spread of COVID-19. However, policymakers have encountered difficulty in identifying the most effective policies under different circumstances. This study investigated the relative effectiveness of different NPIs and vaccination in prolonging COVID-19 case doubling time (DT).

methodsThe study sample consisted of observations from 137 countries during 1 January 2020 to 13 June 2021. DT was calculated on a daily basis per country. Data were retrieved from the Oxford COVID-19 Government Response Tracker, World Development Indicators, and Worldwide Governance Indicators. To capture policy intervention dynamics, we combined a random-effect growth-curve model with nonstandard interrupted time series analysis. We also evaluated the association of policy measures with DT for different outbreak stages and levels of government effectiveness.

resultsVaccine rollouts, workplace closures, and school closures were relatively effective. For each day that these measures were implemented, the DT increased by 1.96% (95% confidence interval (CI) = 0.63 to 3.29;

conclusionsThe effectiveness of vaccine rollouts outweighed that of NPIs, especially in the later outbreak stages. However, vaccination was not associated with prolonged case DT in countries with lower levels of government effectiveness, probably due to low vaccine coverage. Among the NPIs examined, workplace closures were highly effective across all outbreak stages and levels of government effectiveness. Our findings suggest that mass vaccination is critical to reducing SARS-CoV-2 transmission, especially in countries where NPIs are less effective.