Policy Responses Against the COVID-19 Pandemic in Latin America

NCT04816318 | Unknown

• 1 other identifier: ANID-COVID 0960
• Study Type: observational
• Target: 10,000
• Locations: 1 country
• Sites: 1

Brief Summary

Latin America is one of the worst-hit areas from the COVID-19 pandemic worldwide. Policy responses to COVID-19 in Latin America have sought to reduce viral spread, increase the capacity of the health system response, mitigate negative consequences, and strengthen governance. Few studies have examined the effectiveness of COVID-19 policies in Latin America or explored subnational variation in their effectiveness. In this observational study, the investigators will use a two-stage interrupted time series to estimate the effectiveness of nonpharmaceutical interventions in third-tier subnational units on SARS-COV2 transmission and COVID-19 mortality in Latin America. The investigators will estimate the effects in each local government, and then run a random-effects meta-analysis to obtain pooled effects for each intervention (and combinations of) and heterogeneity estimates. Finally, the investigators will explore potential explanations for the heterogeneity at the local level.

Conditions

Covid19; Infectious Disease; Death; SARS-CoV Infection

Keywords

Effectiveness; Health policy; Heterogeneity; Latin America

Outcome Measures

Primary Outcomes (3)

• 7-day moving average of daily confirmed cases of COVID-19/SARS-CoV-2

  Intervention period of up to 30 days (intervention periods lower than 7 days will be considered as a combined set of interventions)

• Time-varying reproductive number of confirmed cases of COVID-19/SARS-CoV-2

  Intervention period of up to 30 days (intervention periods lower than 7 days will be considered as a combined set of interventions)

• 7-day moving average of daily confirmed deaths of COVID-19/SARS-CoV-2

  Intervention period of up to 30 days (intervention periods lower than 7 days will be considered as a combined set of interventions)

Study Arms (2)

Social and public health measures against COVID-19

Public Health and Social measures against COVID-19. This group refers to the population exposed to public health and social measures against COVID-19

Other: Social and public health measures against COVID-19

Control

The comparator is the pre-intervention period

Other: Control

Interventions

Social and public health measures against COVID-19 OTHER

1. Viral spread (for both outcomes) 1.1. Total lockdown 1.2 Partial lockdown (geographical, step-wise/graduated response) 1.3 Curfew 1.4 School closure 1.5 Closure of shopping malls, gyms, churches, parks 1.6 Remote work 1.7 Restrictions to national/subnational mobility 1.8 Prohibition of mass gatherings 2. Health systems response (for COVID-19 deaths outcome) 2.1 Interventions to increase testing capacity 2.2 Interventions to increase the number of ICU/critical beds 3. Mitigation strategies (for both outcomes) 3.1 Direct social assistance (in-kind/cash) 3.2 Cash transfer 3.3 Withdrawal of pension funds

Also known as: Non-pharmaceutical interventions against COVID-19

Social and public health measures against COVID-19

Control OTHER

The comparator is a counterfactual outcome defined as the projection of the pre-intervention trend to simulate what would have happened if the policy had not occurred (see Statistical Analysis Plan for definitions)

Control

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study covers the population of included countries in Latin America. Preliminarily this represents nine countries, covering 80.9% of the total population in Latin America

You may qualify if:

• Country will be eligible if they are (1) Spanish or Portuguese speaking countries in Latin America, (2) availability of open data at the subnational level for any of the outcomes

You may not qualify if:

• None

Sponsors & Collaborators

• University of Chile: lead

Study Sites (1)

Escuela de Salud Pública

Santiago, Santiago Metropolitan, 8380453, Chile

Location

Related Publications (20)

• United Nations Department of Economic and Social Affairs. World Social Report 2020: Inequality in a rapidly changing world. New York, United States: United Nations; 2020

  BACKGROUND

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• Martinez-Gutierrez S., Cuadrado C., Peña S. Chile's response to the coronavirus pandemic. 2020. Available at: https://www.cambridge.org/core/blog/2020/04/11/chiles-response-to-the-coronavirus-pandemic/ (accessed April 12, 2020)

  BACKGROUND

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  PMID: 32275295 BACKGROUND

• Salvatore M, Basu D, Ray D, Kleinsasser M, Purkayastha S, Bhattacharyya R, Mukherjee B. Comprehensive public health evaluation of lockdown as a non-pharmaceutical intervention on COVID-19 spread in India: national trends masking state-level variations. BMJ Open. 2020 Dec 10;10(12):e041778. doi: 10.1136/bmjopen-2020-041778.

  PMID: 33303462 BACKGROUND

• Flaxman S, Mishra S, Gandy A, Unwin HJT, Mellan TA, Coupland H, Whittaker C, Zhu H, Berah T, Eaton JW, Monod M; Imperial College COVID-19 Response Team; Ghani AC, Donnelly CA, Riley S, Vollmer MAC, Ferguson NM, Okell LC, Bhatt S. Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe. Nature. 2020 Aug;584(7820):257-261. doi: 10.1038/s41586-020-2405-7. Epub 2020 Jun 8.

  PMID: 32512579 BACKGROUND

• Hyafil A, Morina D. Analysis of the impact of lockdown on the reproduction number of the SARS-Cov-2 in Spain. Gac Sanit. 2021 Sep-Oct;35(5):453-458. doi: 10.1016/j.gaceta.2020.05.003. Epub 2020 May 23.

  PMID: 32571528 BACKGROUND

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  PMID: 33022016 BACKGROUND

• Islam N, Sharp SJ, Chowell G, Shabnam S, Kawachi I, Lacey B, Massaro JM, D'Agostino RB Sr, White M. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries. BMJ. 2020 Jul 15;370:m2743. doi: 10.1136/bmj.m2743.

  PMID: 32669358 BACKGROUND

• Candido DS, Claro IM, de Jesus JG, Souza WM, Moreira FRR, Dellicour S, Mellan TA, du Plessis L, Pereira RHM, Sales FCS, Manuli ER, Theze J, Almeida L, Menezes MT, Voloch CM, Fumagalli MJ, Coletti TM, da Silva CAM, Ramundo MS, Amorim MR, Hoeltgebaum HH, Mishra S, Gill MS, Carvalho LM, Buss LF, Prete CA Jr, Ashworth J, Nakaya HI, Peixoto PS, Brady OJ, Nicholls SM, Tanuri A, Rossi AD, Braga CKV, Gerber AL, de C Guimaraes AP, Gaburo N Jr, Alencar CS, Ferreira ACS, Lima CX, Levi JE, Granato C, Ferreira GM, Francisco RS Jr, Granja F, Garcia MT, Moretti ML, Perroud MW Jr, Castineiras TMPP, Lazari CS, Hill SC, de Souza Santos AA, Simeoni CL, Forato J, Sposito AC, Schreiber AZ, Santos MNN, de Sa CZ, Souza RP, Resende-Moreira LC, Teixeira MM, Hubner J, Leme PAF, Moreira RG, Nogueira ML; Brazil-UK Centre for Arbovirus Discovery, Diagnosis, Genomics and Epidemiology (CADDE) Genomic Network; Ferguson NM, Costa SF, Proenca-Modena JL, Vasconcelos ATR, Bhatt S, Lemey P, Wu CH, Rambaut A, Loman NJ, Aguiar RS, Pybus OG, Sabino EC, Faria NR. Evolution and epidemic spread of SARS-CoV-2 in Brazil. Science. 2020 Sep 4;369(6508):1255-1260. doi: 10.1126/science.abd2161. Epub 2020 Jul 23.

  PMID: 32703910 BACKGROUND

• Bennett M. All things equal? Heterogeneity in policy effectiveness against COVID-19 spread in chile. World Dev. 2021 Jan;137:105208. doi: 10.1016/j.worlddev.2020.105208. Epub 2020 Sep 24.

  PMID: 32994662 BACKGROUND

• Silva L, Figueiredo Filho D, Fernandes A. The effect of lockdown on the COVID-19 epidemic in Brazil: evidence from an interrupted time series design. Cad Saude Publica. 2020 Oct 19;36(10):e00213920. doi: 10.1590/0102-311X00213920. eCollection 2020.

  PMID: 33084836 BACKGROUND

• Peña S., Cuadrado C., Rivera-Aguirre A., Hasdell R., Nazif-Munoz J., Yusuf M. et al. PoliMap: A taxonomy proposal for mapping and understanding the global policy response to COVID-19. OSF Preprint. 2020. Available at: https://osf.io/h6mvs (accessed March 22, 2021)

  BACKGROUND

• Li Y, Campbell H, Kulkarni D, Harpur A, Nundy M, Wang X, Nair H; Usher Network for COVID-19 Evidence Reviews (UNCOVER) group. The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 131 countries. Lancet Infect Dis. 2021 Feb;21(2):193-202. doi: 10.1016/S1473-3099(20)30785-4. Epub 2020 Oct 22.

  PMID: 33729915 BACKGROUND

• Gebski V, Ellingson K, Edwards J, Jernigan J, Kleinbaum D. Modelling interrupted time series to evaluate prevention and control of infection in healthcare. Epidemiol Infect. 2012 Dec;140(12):2131-41. doi: 10.1017/S0950268812000179. Epub 2012 Feb 16.

  PMID: 22335933 BACKGROUND

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  PMID: 26058820 BACKGROUND

• Taljaard M, McKenzie JE, Ramsay CR, Grimshaw JM. The use of segmented regression in analysing interrupted time series studies: an example in pre-hospital ambulance care. Implement Sci. 2014 Jun 19;9:77. doi: 10.1186/1748-5908-9-77.

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Related Links

• PoliMap mapping visualisation tool and database

MeSH Terms

Conditions

COVID-19; Communicable Diseases; Death; Severe Acute Respiratory Syndrome

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Sebastián Peña, MD, PhD

  Escuela de Salud Pública

  PRINCIPAL INVESTIGATOR

• Cristóbal Cuadrado, MD, PhD

  Escuela de Salud Pública

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sebastián Peña, MD, PhD

CONTACT

+358452451360; sebastian.penafajuri@thl.fi

Study Design

• Study Type: observational
• Observational Model: ECOLOGIC OR COMMUNITY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Co-investigator

Study Record Dates

• First Submitted: March 23, 2021
• First Posted: March 25, 2021
• Study Start: April 28, 2021
• Primary Completion: May 31, 2021
• Study Completion: May 31, 2021
• Last Updated: April 28, 2021

Record last verified: 2021-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ANALYTIC CODE
• Time Frame: The Study Protocol and SAP will be available in the project OSF repository upon publication of the registration in ClinicalTrials.gov. The Statistical code will be published as a Supplementary Appendix with the publish paper or preprint.
• Access Criteria: Any interested party can access the data and documents

Locations

CL (1)