Effective measures coping with COVID-19 pandemic based on fsQCA: Evidence from China

5 Background: Faced with the global outbreak and spread of COVID-19 pandemic, the 6 government of each country has adopted different emergency measures, but the effectiveness 7 assessment of these emergency measures is still lacked. This paper aimed to study the 8 effectiveness of emergency measures for emergent infectious diseases to look for key measures 9 and effective combinations. 10 Methods: We took COVID 19 pandemic management and control measures in China as an 11 example, and selected five high frequency emergency measures including controlling 12 population mobility, patient admission, appropriation of pandemic prevention funds, legal 13 regulations and resumption of production from the perspective of Epidemiology. Using fuzzy 14 set qualitative comparative analysis (fsQCA), we conducted necessary condition analysis and 15 configuration analysis on these measures using official statistical data. And robustness test was 16 performed by changing consistency threshold. 17 Results: We found that: (1) The consistency of the five emergency measures was less than 18 0.9, indicating that none of these measures can be used separately as a necessary condition for 19 the strong pandemic prevention and control effects. (2) There were three combinations of 20 emergency measures to achieve strong pandemic prevention and control effects, with solution 21 consistency of 0.92 and solution coverage of 0.6: when all patients are admitted to hospitals, the 22 government provides sufficient pandemic prevention funds, and severely crack down on 23 criminal cases; when resume production under the measures of strictly controlling population 24 mobility and severely cracking down on criminal cases; when strictly control population 25 mobility and all patients are admitted to hospitals without resumption production. 26 Conclusions: These findings suggest that fsQCA model can be applied to comprehensive 27 effectiveness assessment of infectious diseases emergency measures. The results of our study 28 not only help various countries prevent and control COVID-19 pandemic and its resurgence, 29 but also have important reference significance for the emergency management of other 30 emergent infectious diseases in the world. 31

FsQCA has quantitative expressions in qualitative analysis, it is good at dealing with the 128 multiple conjunctural outcome evaluation and the cause analysis for the strength or weakness of 129 management effects. Therefore, we use fsQCA to study the effect of COVID-19 pandemic 7 emergency measures. The basic thought of fsQCA is to use set theory and Boolean operations 131 as the cornerstones of its methodology, to explore the general characteristics of multiple cases 132 by discussing the membership relationship between sets, and to analyze the set relationship 133 between condition sets and outcome sets of cases [14,16].  The key step in performing fsQCA analysis is the selection of variables. We select the

Data preprocess
190 Data preprocessing in this paper includes two aspects.

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Due to the different population distribution and the risk of pandemic, the level of each 193 indicator varies greatly. Therefore, in order to ensure the comparability and reliability of the data, we carried out the dimensionless processing of the original data by the extreme value 195 method. Here is the formula: represents the set of outcome variables. It is generally believed that the consistency detection 214 standard is reached when the consistency score is greater than 0.9, that is, the variable Perform necessary condition analysis on the calibrated data, the results are shown in Table 2.
217 Table 2 Necessary condition analysis for the strong prevention and control effect of   Table 3.

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The core condition refers to a condition that has an essential meaning to the interpretation of the  Notes:Black circles indicate the presence of a condition, and circles with "×" indicate its absence.

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Large circles indicate core conditions; small ones, peripheral conditions. Short horizontal lines indicate 251 "don't care." 252 Four paths that can explain the effects of strong pandemic prevention and control are 253 presented in Table 3. The solution consistency is 0.92, which means that in all the pandemic 254 prevention and control cases that meet these four configurations, 92% of those are at a high the four configurations can explain 60% of the cases of strong pandemic prevention and control 257 effects. The solution consistency and solution coverage both are higher than the critical value, 258 indicating that the empirical analysis is effective.   270 We group configurations which has same core conditions to be the following three

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(1) None of the five emergency measures can be used as a necessary condition for strong 357 pandemic prevention and control effects, or the ability to independently explain strong 358 pandemic prevention and control effects is weak. In other words, the emergency management of 359 infectious diseases cannot be completed by a certain department or a certain measure, but it 360 needs collaboration of various subjects including governments, professional institutions and 361 social organizations in order to obtain efficacious prevention and control effect.

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(2) The government should increase the input of pandemic prevention funds to ensure that 363 pandemic prevention needs such as medical treatment, procurement of medical materials, and 364 vaccine research and development are met. Timely expansion and reconstruction of treatment 365 hospitals should be carried out to ensure that patients are tested and treated immediately. It also 366 should severely crack down on illegal acts that disturb the medical order and interfere with 367 pandemic prevention, such as manufacturing and selling counterfeit and shoddy medical 368 supplies, raising prices, and spreading rumors.

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(3) Under the measures of strictly controlling population mobility and severely cracking 20 down on criminal cases that violate laws and regulations, resumption of production can still 371 achieve a high-intensity pandemic prevention and control effect, and it will not bring a negative 372 impact on pandemic prevention and control. Measures to control population movement include 373 mandatory isolation of diagnosed, suspected patients and close contacts, banned gathering 374 activities such as dinners, parties, and exhibitions, and temporarily closing places other than the 375 public places necessary to guarantee the lives of the masses. You can also formulate relevant 376 laws or issue legally effective notices to ensure the smooth implementation of the above