Exploring the Impact of Government Interventions on COVID-19 Pandemic Spread in Kuwait

Exploring the Impact of Government Interventions on COVID-19 Pandemic Spread in Kuwait

Sana S. BuHamra, Jehad Al Dallal
DOI: 10.4018/IJHISI.288893
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Abstract

To model the trajectory of the pandemic in Kuwait from February 24, 2020 to February 28, 2021, we used two modeling procedures: Auto Regressive Integrated Moving Average (ARIMA) with structural breaks and Multivariate Adaptive Regression Splines (MARS), and then mapped the key breakpoints of the models to the set of government-enforced interventions. The MARS model, as opposed to the ARIMA model, provides a more precise interpretation of the intervention's effects. It demonstrates that partial and total lockdown interventions were highly effective in reducing the number of confirmed cases. When some interventions, such as enforcing regional curfews, closing workplaces, and imposing travel restrictions, were combined, their impact became significant. MARS method is recommended to be applied when exploring the impact of interventions on the spread of a disease. It does not require any prior assumptions about the statistical distribution of data, does not affect data collinearity, has simple and transparent functions, and allows for a more accurate analysis of intervention results.
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1. Introduction

After the first novel coronavirus infection case was detected in Wuhan, China, in December 2019 (Zhu et al., 2020), the virus widely and rapidly spread across the world, leading the World Health Organization (WHO) to declare COVID-19 a pandemic on March 11, 2020 (Cucinotta & Vanelli, 2020). Since then, the pandemic has become the most serious challenge for human societies and has negatively affected the world’s healthcare and financial systems (McKibbin & Fernando, 2020). By May 20, 2021, more than 165 million confirmed cases and 3.4 million deaths were reported globally (WHO Coronavirus Disease [COVID-19] Dashboard, 2021).

To slow down the spread of the virus and relieve health systems, health authorities adopted clinical practices, such as applying robust testing programs and, lately, speeding up vaccination. In addition, government authorities enforced physical nonpharmaceutical interventions (NPIs) and measures, such as mask-wearing, social distancing, quarantines, and lockdowns. However, applying these measures for long periods of time have social and economic consequences, such as high unemployment rates and bankruptcy (Policy Brief, 2020).

Kuwait started to suffer from the COVID-19 pandemic after its first infection case was detected on February 24, 2020. Since then, the government of Kuwait has enforced several precautionary measures, including banning flights; closing workplaces, schools, and shopping malls; and applying total and partial lockdowns. As of May 20, 2021, Kuwait reported 295,861 confirmed infections, 281,920 recovered cases, and 1,711 deaths (WHO Coronavirus Disease [COVID-19] Dashboard, 2021).

Several studies have shown that interventions considered by health and government authorities are important and effective in controlling previous outbreaks (Leach, 2008; World Health Organization, Food and Agriculture Organization of the United Nations & United Nations Children’s Fund [UNICEF], 2012; Funk et al. 2017; Turner et al., 2020; Bernal et al., 2017). The interrupted time series (ITS) study design was widely and successfully used in some of these studies (Turner et al., 2020; Bernal et al., 2017). Several research studies used various statistical techniques to explore the impact of government precautionary measures on the spread of COVID-19 in different countries, such as China (Al-Rousan & Al-Najjar, 2020), the UK (Ferguson et al., 2020), the US (Ferguson et al., 2020), Taiwan (Hsieh et al., 2020), Bahrain (Al Dallal et al., 2021), and Kuwait (Almeshal et al., 2020). These studies considered the pandemic at its early stage when its trajectory had a single wave. Therefore, it is not clear whether the same techniques are still applicable for analyzing current pandemic trajectories that contain multiple waves. In addition, the study of the case in Kuwait (Almeshal et al., 2020) only considered government precautionary measures enforced during the early pandemic days.

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