Our study found that the population prevention and control measures implemented by the government had an impact on the change of Rt value. In most countries, the Rt value has a clear upward trend in October. The most important factor in personal prevention and control is the mobility index. Group prevention and control on the total testing, closure of educational facilities, restrictions on large-scale gatherings, commercial restrictions and other government interventions are very important for prevention and control. The number of ICU beds and the average number of doctors in medical resources are also key elements. Basic sanitation, such as the proportion of safe drinking water, also has a certain impact on the COVID-19 epidemic.
The rate of masks using in individual prevention has not been found to be related to cumulative mortality or morbidity. It does not mean that the use of masks has no effect on prevention and control. Research on the effectiveness of masks for prevention and control has been confirmed4. The lasso regression finds variables with a very large degree of correlation, so the mobility index generated by personal behavior in the movement of personal behavior in prevention and control may be more important than wearing a mask. Secondly, we think the possible reason is that the data on the rate using of masks comes from social surveys and there may be large errors.
Some studies have reached conclusions consistent with ours. The results of the dynamic SEIR model show that the lockdown control measures implemented by China on January 23, 2020 are essential to ultimately reduce the scale of the COVID- 19 epidemic 32. A study found that the effectiveness of different interventions varies. They estimated that early detection and isolation of cases prevented more infections than restrictions on travel and reduced contact. Non-drug interventions should be combined to achieve rapid results. Our research also found that there is a certain relationship between cumulative mortality and testing33 .Some scholars even proposed that the best strategy is to use both robot recognition and migration restriction strategies. In China, robots are assigned multiple tasks to minimize the spread of COVID-19, such as using them to clean and prepare food in epidemic areas that are harmful to humans. European countries can also take this approach to reduce exposure to infection and provide help for the prevention and control of diseases34. Once the initial pandemic is under control, we must turn our attention to how to improve the adverse effects of the lockdown35.
Studies have also shown that medical resources are related to the mortality rate of COVID-19, which is close to our research conclusions. We have found that the number of doctors per capita and the number of hospital beds per capita are related to the incidence or death of COVID-19 36. The experience in Wuhan suggests that if the medical resources become scarce, the government should establish temporary hospitals and Medical staff will be deployed from areas where the epidemic is relatively mild to ease the pressure in severely affected areas. Effective quarantine via quick detection prevent a larger outbreak37,38. It is necessary to eatablish medically necessary, time-sensitive procedures scoring system during the COVID-19 Pandemic39. Within days or weeks, the health system is reorganized. We must optimize health resources. Fight for disease in a joint medical team composed of doctors, nurses, pharmacists, and respiratory therapists40.
The ratio of safe drinking water in basic health resources has a certain relationship with the cumulative morbidity and mortality of COVID-19, which may be related to the fact that hand washing can reduce the number of hand viruses and achieve a certain prevention and control effect. Basic cleaning services are a basic prerequisite for compliance with the principles of infection prevention and control, which are necessary to protect patients, health workers and susceptible people41.
Some indicators, such as nurses per capita, pharmacists per capita, GDP and GHS, are not included in the regression model, which may be due to the relatively low correlation degree. After the Ebola outbreak in 2014, the Global Health Security Index (GHSI) was developed to measure the ability of countries to respond to infectious disease outbreaks. Six core elements were evaluated: prevention, detection and reporting, response, health system, compliance with norms and the risk of infectious disease outbreaks. The score higher of GHSI, the better the preparation.
Studies have shown that GHSI and JEE (Joint External Evaluation) have low predictive value for the death outcome of COVID-19, and we have reached the same conclusion42,43. For example, UK, which ranks second in GHSI score, also bears a huge burden of disease44. However, some studies have shown that GHSI has a predictive effect on the burden of COVID-19, but in the opposite direction45.
Our research has some advantages. First, this study describes the prevalence and control of COVID-19 in European countries and the workload is relatively large. Secondly, this study included many independent variables to analyze their relationship with dependent variables. The independent variables mainly include individual prevention and control, group prevention and control, medical resources, basic health facilities, and comprehensive indicators. Thirdly, this paper uses lasso regression to screen variables with a smaller error than traditional regression and the results are more accurate. Quantile regression is further used to quantify the specific situation of each divided point, which provides more information than traditional regression. Of course, our article also has some shortcomings. For example, a small number of proven effective prevention and control measures have not entered our regression model, which may be related to the accuracy of the data and the impact of variables.