Effects of government policies and the Nowruz holidays on confirmed COVID-19 cases in Iran: An intervention time series analysis

Abstract

Background Public health policies with varying degrees of restriction have been imposed around the world to prevent the spread of coronavirus disease 2019 (COVID-19). In this study, we aimed to evaluate the effects of the implementation of government policies and the Nowruz holidays on the containment of the COVID-19 pandemic in Iran, using an intervention time series analysis. Methods Daily data on COVID-19 cases registered between February 19 and May 2, 2020 were collected from the World Health Organization (WHO)’s website. Using an intervention time series modeling, the effect of two government policies on the number of confirmed cases were evaluated, namely the closing of schools and universities, and the implementation of social distancing measures. Furthermore, the effect of the Nowruz holidays as a non-intervention factor for the spread of COVID-19 was also analyzed. Results The results showed that, after the implementation of the first intervention, i.e., the closing of universities and schools, no statistically significant change was found in the number of new confirmed cases. The Nowruz holidays was followed by a significant increase in new cases (1,872.20; 95% CI, 1,257.60 to 2,476.79; p<0.001)), while the implementation of social distancing measures was followed by a significant decrease in such cases (2,182.80; 95% CI, 1,556.56 to 2,809.04; p<0.001). Conclusion The Nowruz holidays and the implementation of social distancing measures in Iran were related to a significant increase and decrease in COVID-19 cases, respectively. These results highlight the necessity of measuring the effect of health and social interventions for their future implementations.

Comparative Analysis of Epidemiological Outcome of Incidence, Mortality and Lethality by COVID-19 between the States of Espírito Santo and Minas Gerais, Brazil

“…This expected time is directly related to the period of manifestation of symptoms and/or the results of the exam performed. Another study, carried out by Hadianfar et al, [21] also agrees with the results found, where an approximate increase of up to 1,872 new cases was observed after holidays (p<0.001).…”

Comparative Analysis of Epidemiological Outcome of Incidence, Mortality and Lethality by COVID-19 between the States of Espírito Santo and Minas Gerais, Brazil

“…This expected time is directly related to the period of manifestation of symptoms and/or the results of the exam performed. Another study, carried out by Hadianfar et al [21] also agrees with the results found, where an approximate increase of up to 1872 new cases was observed after holidays (p < 0.001).…”

Identify successful restrictions in suppressing the early outbreak of COVID-19 in Arizona, United States: Interrupted time series analysis

“…This is in agreement with another study showing that social distancing implemented in 28 European countries decreased daily COVID-19 cases growth rate from 24% to less than 2% [39]. A research on the social distancing order in Iran revealed that it could significantly decrease new cases by an average of 2128 per day [8]. How the strategy is implemented and how strictly it is enforced is more important than the specific strategy chosen to combat the pandemic.…”

“…Each country implemented different policies to suppress the pandemic like closing schools and universities in Iran, Zambia [8][9][10], prohibiting restaurant dine-in services in US and Brazil [11][12][13], closing gyms in Saudi Arabia and US [14,15], ban travelers in Europe and US [16][17][18][19] and total or partial lockdowns to completely prevent any contact between people in France, Germany, Italy, Russia, Denmark and many other countries [20,21]. Furthermore, implementing some strategies has economical and mental costs [22,23].…”