RESEARCH ARTICLE Effectiveness of government policies in response to the first COVID-19 outbreak Theologos Dergiades 1 , Costas Milas ID 2 , Elias Mossialos ID 3 , Theodore Panagiotidis ID 4 * 1 Department of International & European Studies, University of Macedonia, Thessaloniki, Greece, 2 Management School, University of Liverpool, Liverpool, United Kingdom, 3 Department of Health Policy, London School of Economics and Political Science, London, United Kingdom, 4 Department of Economics, University of Macedonia, Thessaloniki, Greece * tpanag@uom.edu.gr Abstract This paper assesses the quantitative impact of government interventions on deaths related to the first COVID-19 outbreak. Using daily data for 32 countries and relying on the strin- gency of the conducted policies, we find that the greater the strength of government inter- ventions at an early stage, the more effective these are in slowing down or reversing the growth rate of deaths. School closures have a significant impact on reducing the growth rate of deaths, which is less powerful compared to the case where a number of policy interven- tions are combined together. These results can be informative for governments in respond- ing to future pandemics. 1. Introduction As evident by the tremendous media attention, the COVID-19 pandemic has triggered severe social and economic costs. The Financial Times, for instance, has a dedicated website which provides free access to its analysis (https://www.ft.com/coronavirusfree). At the time of writ- ing, there were around 353 million confirmed cases of COVID-19 infections and 5.6 million deaths (https://covid19.who.int/). Lessons learned from previous pandemics imply a huge impact on economic activity. Barro etal.[1] use data for 43 countries to find that the ‘Spanish flu’ of the 1918–1920 period generated real per capita GDP declines of 6% for countries on average. Using data stretching back to the 14th century for France, Germany, Italy, the Nether- lands, Spain, and the UK, Jordà etal.[2] show that pandemics depress the real rate of interest for years after a pandemic, perhaps as many as 40 years (wars do not have such effects). To bring down COVID-19-related infections and deaths in the pandemic thus far, govern- ments have responded with a number of interventions. Among others, Cowling et al.[3] show that non-pharmaceutical interventions (including border restrictions, quarantine and isola- tion, distancing, and changes in population behavior) were associated with reduced transmis- sion of COVID-19 in Hong Kong. Using data for Germany, Hartl etal.[4] find a reduction in the growth rate of COVID-19, seven days after the implementation of containment policies on 13 March 2020 and again eight days after the implementation of further measures on 22 March 2020. Chen and Qiu [5] rely on a dynamic panel epidemiological model of nine PLOS GLOBAL PUBLIC HEALTH PLOS Global Public Health | https://doi.org/10.1371/journal.pgph.0000242 April 13, 2022 1 / 19 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Dergiades T, Milas C, Mossialos E, Panagiotidis T (2022) Effectiveness of government policies in response to the first COVID-19 outbreak. PLOS Glob Public Health 2(4): e0000242. https:// doi.org/10.1371/journal.pgph.0000242 Editor: Habib Hasan Farooqui, Public Health Foundation of India, INDIA Received: August 20, 2021 Accepted: March 9, 2022 Published: April 13, 2022 Copyright: © 2022 Dergiades et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: This study uses publicly available data. The data on the daily deaths come from the European Centre for Disease Prevention and Control (ECDC), available at: https://www.ecdc.europa.eu/en/publications-data/ download-todays-data-geographic-distribution- covid-19-cases-worldwide. For the case of France, due to the late and at the same time cumulative report of deaths from retirement homes and assisted living facilities we use the officially reported deaths in hospitals, available at: https:// dashboard.covid19.data.gouv.fr/. The data for the COVID-19 Government Response Tracker