Journal articles on the topic 'Oxford Stringency Index'

AbstractThis study uses a step-wise regression model to identify the socioeconomic variables most significant in explaining COVID-19 death rates on a state-level basis. The regression tests cover the 1/1/2020 to 12/1/2020 period as well as the first and second halves of 2020. This study also uses the Oxford stringency index to measure more precisely the efficacy of governmental mandates at the state level. The results in this study rigorously showed that while the density variables were the most significant explanatory variables during the first half of the year, their significance fell during the second half. Use of the Oxford stringency index revealed that more stringent mandates led to significant reductions in COVID-19 death rates, especially during the second half of the year. The study’s findings also reveal that a higher poverty rate in a state is significantly associated with higher COVID-19 death rates during all three periods tested.

International governments’ COVID-19 responses must balance human and economic health. Beyond slowing viral transmission, strict lockdowns have severe economic consequences. This work investigated response stringency, quantified by the Oxford COVID-19 Government Response Tracker’s Stringency Index, and examined how restrictive interventions affected infection rates and gross domestic product (GDP) in China and OECD countries. Accounting for response timing, China imposed the most stringent restrictions, while Sweden and Japan were the least stringent. Expected GDP declines range from −8% (Japan) to −15.4% (UK). While greater restrictions generally slowed viral transmission, they failed to reach statistical significance and reduced GDP (p = 0.006). Timing was fundamental: governments who responded to the pandemic faster saw greater reductions in viral transmission (p = 0.013), but worse decreases in GDP (p = 0.044). Thus, response stringency has a greater effect on GDP than infection rates, which are instead affected by the timing of COVID-19 interventions. Attempts to mitigate economic impacts by delaying restrictions or decreasing stringency may buoy GDP in the short term but increase infection rates, the longer-term economic consequences of which are not yet fully understood. As highly restrictive interventions were successful in some but not all countries, decision-makers must consider whether their strategies are appropriate for the country on health and economic grounds.

Aim: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Synthesizing and analyzing these responses is vital for disease control evidence-based policymaking. Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from 1 January to 30 May 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT). Results: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74.2), followed by Singapore (67.4), Vietnam (66.8), Hong Kong (66.2), South Korea (62.3), Taiwan (52.1), and Japan (50.3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI > 50.0), while Japan (42.4) and Mainland China (4.2) followed. Conclusions: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.

This paper examines relative stock market performance following the onset of the coronavirus pandemic for a sample of 80 stock markets. Weekly data on coronavirus cases and deaths are employed alongside Oxford indices on each nation’s stringency and government support intensity. The results are broken down both by month and by geographical region. The full sample results show that increased coronavirus cases exert the expected overall effect of worsening relative stock market performance, but with little consistent impact of rising deaths. There is some evidence of significantly negative stock market effects arising from lockdowns as reflected in the Oxford stringency index. There are also positive reactions to government support in March and December in the overall sample—combined with some additional pervasive effects seen in mid-2020 in Latin America.

The Governments of the different countries are taking a wide range of measures in response to the COVID-19 outbreak. For assessing the rigour of quarantine measures, the Blavatnik School of Government at the University of Oxford has launched the world`s first COVID-19 government response tracker—the Oxford Coronavirus Government Response Tracker – OxCGRT). This tool aims to track and compare policy responses of governments around the world, rigorously and consistently. According to the COVID-19 Government Response Stringency Index (GRSI) the strictest measures are in India (97.37 points) and less stringent ones are in the Russian Federation (63.89 points). The study compares restrictive measures in India and Russia, analyses their impact on the spread of COVID-19; and estimates mortality rates. Besides, the study also probes population coverage aimed at diagnosing through the use of testing methods and possible economic consequences of quarantine measures.

Social distancing is a powerful non-pharmaceutical intervention used as a way to slow the spread of the SARS-CoV-2 virus around the world since the end of 2019 in China. Taking that into account, this work aimed to identify variations on population mobility in South America during the pandemic (15 February to 27 October 2020). We used a data-driven approach to create a community mobility index from the Google Covid-19 Community Mobility and relate it to the Covid stringency index from Oxford Covid-19 Government Response Tracker (OxCGRT). Two hypotheses were established: countries which have adopted stricter social distancing measures have also a lower level of circulation (H1), and mobility is occurring randomly in space (H2). Considering a transient period, a low capacity of governments to respond to the pandemic with more stringent measures of social distancing was observed at the beginning of the crisis. In turn, considering a steady-state period, the results showed an inverse relationship between the Covid stringency index and the community mobility index for at least three countries (H1 rejected). Regarding the spatial analysis, global and local Moran indices revealed regional mobility patterns for Argentina, Brazil, and Chile (H1 rejected). In Brazil, the absence of coordinated policies between the federal government and states regarding social distancing may have played an important role for several and extensive clusters formation. On the other hand, the results for Argentina and Chile could be signals for the difficulties of governments in keeping their population under control, and for long periods, even under stricter decrees.

Abstract Objectives The COVID-19 crisis has disrupted economies and health systems across the globe and has brought substantial challenges for food systems. Government responses key to minimizing disease spread have included a number of movement restriction policies (e.g., school closures, stay at home measures, etc.). Such policies have impacted food consumption and purchasing behaviours and have harmed much of the face-to-face type of labour required for food retailing, which in turn may have impacted the affordability of diets. We use evidence from 133 countries to investigate the association between stringency in movement restriction policies and retail price levels for food and other consumer goods. Methods We use the International Monetary Fund's monthly national consumer price index (CPI), and food and non-alcoholic beverage index (FCPI), as well as a ratio of FCPI to CPI—the food price index (FPI)—for 133 countries from January 2017 to November 2020. Data on stringency in movement restriction policies and COVID-19 cases and mortality per million were obtained from the Oxford COVID-19 Government Response Tracker and the European Centre for Disease Prevention and Control, respectively. Fixed effects regression models were used to estimate the association between stringency of COVID-19 movement restrictions and monthly differences in 2020 retail price levels (from average 2017–2019 levels) of foods and other consumer goods, while controlling for pandemic severity in each country and month. Results Regression models yielded a positive and significant relationship between stringency level and FCPI level (coeff. = 1.24–1.91; 95% CIs: 0.25–2.79) or FPI level (coeff. = 1.24–2.14; 95% CIs: 0.60–2.53). Alternatively, stringency level was either negatively associated with CPI level (coeff. = −0.57; 95% CI: −1.06 – −0.07) or not significantly associated with CPI level. Conclusions Government response stringency in COVID-19 movement restriction policies is linked with higher retail food price levels. Governments could consider implementing these policies alongside other measures (e.g., food assistance) to mitigate negative spillovers into the domain of food security and nutrition. Funding Sources This work was supported by the Bill & Melinda Gates Foundation and UKAid through the Foreign, Commonwealth & Development Office of the UK.

The U.S. with only 4% of the world’s population, bears a disproportionate share of infections in the COVID-19 pandemic. To understand this puzzle, we investigate how mitigation strategies and compliance can work together (or in opposition) to reduce (or increase) the spread of COVID-19 infection. Building on the Oxford index, we create state-specific stringency indices tailored to U.S. conditions, to measure the degree of strictness of public mitigation measures. A modified time-varying SEIRD model, incorporating this Stringency Index as well as a Compliance Indicator is then estimated with daily data for a sample of 6 U.S. states: New York, New Hampshire, New Mexico, Colorado, Texas, and Arizona. We provide a simple visual policy tool to evaluate the various combinations of mitigation policies and compliance that can reduce the basic reproduction number to less than one, the acknowledged threshold in the epidemiological literature to control the pandemic. Understanding of this relationship by both the public and policy makers is key to controlling the pandemic. This tool has the potential to be used in a real-time, dynamic fashion for flexible policy options. Our methodology can be applied to other countries and has the potential to be extended to other epidemiological models as well. With this first step in attempting to quantify the factors that go into the “black box” of the transmission factor β, we hope that our work will stimulate further research in the dual role of mitigation policies and compliance.

Since the outbreak of novel SARS-COV-2, each country has implemented diverse policies to mitigate and suppress the spread of the virus. However, no systematic evaluation of these policies in their alleviation of the pandemic has been done. We investigate the impact of five indices derived from 12 policies in the Oxford COVID-19 Government Response Tracker dataset and the Korean government’s index, which is the social distancing level implemented by the Korean government in response to the changing pandemic situation. We employed segmented Poisson model for this analysis. In conclusion, health and the Korean government indices are most consistently effective (with negative coefficients), while the restriction and stringency indexes are mainly effective with lagging (1~10 days), as intuitively daily confirmed cases of a given day is affected by the policies implemented days before, which shows that a period of time is required before the impact of some policies can be observed. The health index demonstrates the importance of public information campaign, testing policy and contact tracing, while the government index shows the importance of social distancing guidelines in mitigating the spread of the virus. These results imply the important roles of these polices in mitigation of the spread of COVID-19 disease.

Abstract Introduction Lockdowns imposed to stem the spread of COVID-19 have disrupted the lifestyles of many worldwide, but studies to date are mostly confined to observations within a limited number of countries, based on subjective reports and survey from a narrow time window. In the present study, we investigate associations between the severity of lockdown policies and objective sleep and resting-heart rate measures. Methods Data from 113,000 users of a consumer sleep tracker across 20 countries were gathered between Jan–Jul 2020 and compared with an equivalent period in 2019 as a control for naturally occurring seasonal fluctuations. Lockdown stringency was derived using scores from the Oxford Government Response Tracker. Multilevel growth curve models were used to quantify the effect of lockdown stringency on changes to sleep patterns (midsleep time and midsleep variability) and resting heart rate changes, and to predict changes in resting heart rate from changes to sleep patterns. Results Lockdown severity modulated the size of shifts in sleep midpoint and regularity during this period. Midsleep times were delayed in all countries during strict lockdowns, particularly on weekdays, while midsleep variability reduced. The largest shifts in midsleep time (+0.09 to +0.58 hours), midsleep variability (–0.12 to –0.26 hours) and resting heart rate (–0.35 to –2.08 bpm) occurred in April and May - when most countries imposed their strictest lockdown measures. In addition, multilevel modelling revealed that for each unit increase in stringency index, midsleep time was delayed by 0.96 min, midsleep variability decreased by 0.46 min and resting heart rate decreased by 0.06 bpm. Finally, in models predicting changes in resting heart rate from changes to sleep patterns, midsleep variability was shown to be the strongest predictor of resting heart rate, wherein an hour increase in the standard deviation of midsleep variability predicted a 5.12 increase in bpm, while an hour increase in midsleep time only predicted a 1.25 decrease in bpm. Conclusion Our findings demonstrate the utility of large-scale data from consumer wearables in providing population-level insights into how lockdown severity directly impacts sleep health during this pandemic period. Support (if any) Work conducted at NUS is supported by a grant awarded to Michael Chee (NMRC/STAR19may-0001).

Introduction: The extraordinary impact caused by the COVID-19 pandemic in Latin America gives special importance to the analysis of the control policies implemented. Objectives: 1) To update the evolution of the characteristics of COVID-19 control policies in Latin America, and 2) to analyze the sequence in which these policies are implemented. Methods: Data from the Government Response Stringency Index (GRSI), developed by the Blavatnik School of Government at Oxford University, was analyzed for the 20 Latin American countries in the period January 21 to November 9, 2020. The evolution of the GRSI, as well as of some of its components, was taken into account. The sequence of implementation in three countries (Uruguay, Argentina, and Panama) was also analyzed. Results: The vast majority of the region’s countries recorded an average GRSI of over 57 (out of 100) for the period. In 15 countries of the region, the mandatory closure of educational institutions was in effect on 75 % of the days. Eighteen countries implemented mandatory closures of businesses at some point. Ten countries applied requirements to remain in the home on more than 80 % of the days. The sequence of policies implemented by Uruguay reveals greater flexibility in application than those implemented by Argentina and Panama. Discussion: Uruguay’s experience shows that control of the pandemic was possible, and that differences with other countries may be related to structural (pre-pandemic) factors, and management performance. Conclusions: Health systems in the region must identify in detail the institutional constraints evident in controlling the pandemic, both to meet the challenges of health services in the coming months, and to improve preparedness for future pandemics.

Purpose This paper aims to provide a country case study of South Africa’s response during the first six months following its first COVID-19 case. The focus is on the government’s (mis-)management of its non-pharmaceutical interventions (NPIs) (or “lockdown”) to stem the pandemic and the organized business sector’s resistance against the lockdown. Design/methodology/approach This paper makes use of a literature review and provides descriptive statistics and quantitative analysis of COVID-19 and the lockdown stringency in South Africa, based on data from Google Mobility Trends, Oxford University’s Stringency Index, Johns Hopkins University’s COVID-19 tracker and Our World in Data. Findings This paper finds that both the government and the business sector’s responses to the COVID-19 pandemic have been problematic. These key actors have been failing to “pull together,” leaving South Africa’s citizens in-between corrupt and incompetent officials on the one hand, and lockdown skeptics on the other. This paper argues that to break through this impasse, the country should change direction by agreeing on a smart or “Goldilocks” lockdown, based on data, testing, decentralization, demographics and appropriate economic support measures, including export support. Such a Goldilocks lockdown is argued, based on available evidence from the emerging scientific literature, to be able to save lives, improve trust in government, limit economic damages and moreover improve the country’s long-term recovery prospects. Research limitations/implications The pandemic is an unprecedented crisis and moreover was still unfolding at the time of writing. This has two implications. First, precise data on the economic impact and certain epidemiological parameters was not (yet) available. Second, the causes of the mismanagement by the government are not clear yet, within such a short time frame. More research and better data may be able in future to allow conclusions to be drawn whether the problems that were besetting the country’s management of COVID-19 are unique or perhaps part of a more general problem across developing countries. Practical implications The paper provides clear practical implications for both government and organized business. The South African Government should not altogether end its lockdown measures, but follow a smart and flexible lockdown. The organized business sector should abandon its calls for ending the lockdown while the country is still among the most affected countries in the world, and no vaccine is available. Social implications There should be better collaboration between government, business and civil society to manage a smart lockdown. Government should re-establish lost trust because of the mismanagement of the lockdown during the first six months of the pandemic. Originality/value The outline of the smart lockdown that is proposed for the country combines NPIs with the promotion of exports, as a policy intervention to help aggregate demand to recover. The paper provides advice on how to resolve an impasse created by mismanagement of COVID-19, which could be valuable for decision-making during a crisis, particularly in developing countries.

Background:Loss of articular cartilage is one of the major signs of osteoarthritis (OA). Aggrecan, the main proteoglycan component of the extracellular matrix of articular cartilage is cleaved by ADAMTS-5 (A Disintegrin And Metalloproteinase with ThromboSpondin-motif-5).1GLPG1972/S201086, a potent and highly selective inhibitor of ADAMTS-5, is an oral Disease-Modifying OsteoArthritis Drug (DMOAD) candidate. In a pooled Phase 1 safety analysis involving 171 participants GLPG1972/S201086 was shown to be well tolerated.Objectives:To present the study design of ROCCELLA, a large Phase 2 clinical trial in knee OA (KOA) patients, evaluating the efficacy and safety of GLPG1972/S201086 in reducing cartilage loss in OA.Methods:ROCCELLA is a multinational 52-week, multicentre randomized double-blind placebo-controlled dose-ranging phase 2 trial for the treatment of OA (NCT03595618). Eligible patients were aged 40–75 years with a diagnosis of primary femorotibial KOA, a pain score of 40–90mm on a 100 mm Visual Analogue Scale (VAS), predominant medial disease and a combined Kellgren/Lawrence (KL) 2 or 3 and Osteoarthritis Research Society International (OARSI) medial joint space narrowing (JSN) 1 or 2 severity grading range upon central reading of the X-ray. If both knees were eligible, the target knee was selected based first on the highest KL grade, then on the highest JSN grade and finally on the highest pain VAS score at baseline. Patients were randomized 1:1:1:1 to take placebo or three dose levels of GLPG1972/S201086 orally once daily for 52 weeks. The target knee was evaluated by quantitative Magnetic Resonance Imaging (qMRI) at baseline visit, week 28 and week 52, or at early withdrawal.The primary endpoint of the study is change from baseline to week 52 in cartilage thickness of the central medial tibio-femoral compartment (cMTFC) of the target knee. Secondary objectives are safety and tolerability including treatment emergent serious adverse events. Additional secondary structural and clinical efficacy objectives are based on changes from baseline in the target knee: cartilage thickness and bone area on qMRI, KOA “progressor” rates, Joint Space Width on X-ray, pain VAS, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total and sub scores, Patient Global Assessment VAS and the proportion of Outcome Measures in Rheumatology (OMERACT)-OARSI responders. Blood will be collected to assess the pharmacokinetics of GLPG1972/S201086. Planned, exploratory analyses include biochemical biomarkers of cartilage and bone turn-over. The study is designed to maintain the experiment wise type I error at 5%. A Mixed-effects Model for Repeated Measures will be used for the primary analysis. The randomisation was stratified by geographic region.Results:The study started in August 2018 and was fully recruited (N=938) by June 2019. Large numbers of patients with KOA had to be screened to meet the stringent pre-specified selection criteria. The study completion is expected by end of 2020.Conclusion:This is the first large Phase 2 study where patients with primary KOA are treated for 52 weeks with GLPG1972/S201086, an orally administered DMOAD candidate. This clinical trial was designed with a combination of two radiological selection criteria to ensure sufficient structural progression (cartilage loss) in the study population.References:[1]Durigova Met al.Osteoarthritis Cartilage2008;16:1245–52.Acknowledgments:This study was funded by Galapagos NV. Editorial support was provided by Oxford PharmaGenesis and funded by Galapagos NV.Disclosure of Interests:Henri Deckx Employee of: Galapagos, Ellen van der Aar Employee of: Galapagos, Marjolijne van der Stoep Employee of: Galapagos, Marianne Wooning Employee of: Galapagos NV, Katy Bernard Employee of: Institut de Recherches Internationales Servier, Sergey GRANKOV Employee of: Institut de Recherches Internationales Servier, Olivier Imbert Employee of: Institut de Recherches Internationales Servier, Maria Pueyo Employee of: Institut de Recherches Internationales Servier, Felix Eckstein Grant/research support from: Merck, Orthotrphix, Servier, Galapagos, Kolon Tissuegene, Samumed, Novartis, Consultant of: Merck, Bioclinica, Servier, Samumed, Roche, Kolon Tissuegene, Galapagos and Novartis, Employee of: co-owner and employment with Chondrometrics

Abstract Background The health, social and economic consequences of the severe acute respiratory syndrome coronavirus (SARS-CoV-2, henceforth COVID-19) pandemic have loomed large as every national government made decisions about how to respond. The 40 Health Systems, COVID-19 (40HS, C-19) study aimed to investigate relationships between governments’ capacity to respond (CTR), their response stringency, scope of COVID-19 testing and COVID-19 outcomes. Methods Data over March and April 2020 were extracted for 40 national health systems on prepandemic government CTR (Global Competitiveness Index), stringency measures (Oxford COVID-19 Government Response Tracker Stringency Index), approach to COVID-19 testing and COVID-19 cases and deaths (Our-World-in-Data). Multidimensional scaling (MDS) and cluster analysis were applied to examine latent dimensions and visualize country similarities and dissimilarities. Outcomes were tested using multivariate and one-way analyses of variances and Kruskal–Wallis H tests. Results The MDS model found three dimensions explaining 91% of the variance and cluster analysis identified five national groupings. There was no association between national governments’ prepandemic CTR and the adoption of early stringent public health measures or approach to COVID-19 testing. Two national clusters applied early stringency measures and reported significantly lower cumulative deaths. The best performing national cluster (comprising Australia, South Korea, Iceland and Taiwan) adopted relatively early stringency measures but broader testing earlier than others, which was associated with a change in disease trajectory and the lowest COVID-19 death rates. Two clusters (one with high CTR and one low) both adopted late stringency measures and narrow testing and performed least well in COVID-19 outcomes. Conclusion Early stringency measures and intrinsic national capacities to deal with a pandemic are insufficient. Extended stringency measures, important in the short term, are not economically sustainable. Broad-based testing is key to managing COVID-19.

Purpose: The impact of the COVID-19 pandemic has already been felt worldwide, disrupting the unremarkable life of individuals. Social consequences and viral transmission are challenges that must be resolved to effectively overcome the problems that occur throughout this pandemic. The COVID-19 infection data about India were represented using different statistical models. In this paper, the authors focus on the data collected between 1st January 2020 and 12th April 2021, try analyzing the different indexes related to India, and predict the number of infected people in the near future. Based on the infection rate, it is possible to classify a country as “fixed,” “evolving” and “exponential.” Based on the prediction, some recommendations are proposed to contain the outbreak of the disease. This will also help the government and policymakers to identify and analyze various risks associated with 'opening up' and 'shutting down' in response to the outbreak of the disease. With the help of these models, it is possible to predict the number of cases in the near future. Methodology: COVID-19 Stringency Index, Government Response Index, and Containment Health Index calculated, published, and updated real-time by a research group from Oxford University (https://www.bsg.ox.ac.uk/research/research-projects/covid-19-government-response-tracker) on 21 mitigation and suppression measures employed by different countries were analyzed using a few mathematical models to find the relationship between Stringency Index and infection rates and forecast trends. A new model was proposed after analyzing a few mathematical models proposed by the researchers. Data analytics was also conducted using AI-based data analytics tools available online. The dataset was kept updated until the date April 20, 2021, was downloaded for this purpose. The appropriate values were extracted from the original dataset and used to construct a sub-dataset, which was then used for the analytics. An AI-based online Data Analytics tool provided by datapine was used to forecast trends. Findings/Result: It was observed that in India, as in other countries, there is a close association between Stringency Level and COVID-19 cases. The higher the degree of stringency, the lower the cases, and vice versa. The same can be said about the government's role and degree of containment & health. Originality: In this paper, we analyzed various mathematical models for predicting the total number of COVID-19 cases and deaths due to COVID-19 in India. We also examined the relationship between total cases and the Government's Response Index, Containment & Health Index, and Stringency Index indicators. The model we proposed to predict COVID-19 cases on a day-by-day basis had a 98 percent accuracy rate and a 2% error rate. Paper Type: Analytical. With prerecorded datasets obtained from online resources, and data analysis was conducted using mathematical models and AI-based analytical tools.

Abstract Objectives Restricting mobility is a central aim for lowering contact rates and preventing COVID-19 transmission. Yet the impact on mobility of different non-pharmaceutical countermeasures in the earlier stages of the pandemic is not well-understood. Design Trends were evaluated using Citymapper’s mobility index covering 2nd to 26th March 2020, expressed as percentages of typical usage periods from 0% as the lowest and 100% as normal. China and India were not covered. Multivariate fixed effects models were used to estimate the association of policies restricting movement on mobility before and after their introduction. Policy restrictions were assessed using the Oxford COVID-19 Government Response Stringency Index as well as measures coding the timing and degree of school and workplace closures, transport restrictions, and cancellation of mass gatherings. Setting 41 cities worldwide. Main outcome measures Citymapper’s mobility index. Results Mobility declined in all major cities throughout March. Larger declines were seen in European than Asian cities. The COVID-19 Government Response Stringency Index was strongly associated with declines in mobility (r = − 0.75, p < 0.001). After adjusting for time-trends, we observed that implementing non-pharmaceutical countermeasures was associated with a decline of mobility of 10.0% for school closures (95% CI: 4.36 to 15.7%), 15.0% for workplace closures (95% CI: 10.2 to 19.8%), 7.09% for cancelling public events (95% CI: 1.98 to 12.2%), 18.0% for closing public transport (95% CI: 6.74 to 29.2%), 13.3% for restricting internal movements (95% CI: 8.85 to 17.8%) and 5.30% for international travel controls (95% CI: 1.69 to 8.90). In contrast, as expected, there was no association between population mobility changes and fiscal or monetary measures or emergency healthcare investment. Conclusions Understanding the effect of public policy on mobility in the early stages is crucial to slowing and reducing COVID-19 transmission. By using Citymapper’s mobility index, this work provides the first evidence about trends in mobility and the impacts of different policy interventions, suggesting that closure of public transport, workplaces and schools are particularly impactful.

Abstract We used big data analytics for exploring the relationship between government response policies, human mobility trends and numbers of coronavirus disease 2019 (COVID-19) cases comparatively in Poland, Turkey and South Korea. We collected daily mobility data of retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residential areas. For quantifying the actions taken by governments and making a fairness comparison between these countries, we used stringency index values measured with the ‘Oxford COVID-19 government response tracker’. For the Turkey case, we also developed a model by implementing the multilayer perceptron algorithm for predicting numbers of cases based on the mobility data. We finally created scenarios based on the descriptive statistics of the mobility data of these countries and generated predictions on the numbers of cases by using the developed model. Based on the descriptive analysis, we pointed out that while Poland and Turkey had relatively closer values and distributions on the study variables, South Korea had more stable data compared to Poland and Turkey. We mainly showed that while the stringency index of the current day was associated with mobility data of the same day, the current day’s mobility was associated with the numbers of cases 1 month later. By obtaining 89.3% prediction accuracy, we also concluded that the use of mobility data and implementation of big data analytics technique may enable decision-making in managing uncertain environments created by outbreak situations. We finally proposed implications for policymakers for deciding on the targeted levels of mobility to maintain numbers of cases in a manageable range based on the results of created scenarios.

AbstractThe COVID-19 pandemic has resulted in over 33 million confirmed cases and over 1 million deaths globally, as of 1 October 2020. During the lockdown and restrictions placed on public activities and gatherings, green spaces have become one of the only sources of resilience amidst the coronavirus pandemic, in part because of their positive effects on psychological, physical and social cohesion and spiritual wellness. This study analyzes the impacts of COVID-19 and government response policies to the pandemic on park visitation at global, regional and national levels and assesses the importance of parks during this global pandemic. The data we collected primarily from Google’s Community Mobility Reports and the Oxford Coronavirus Government Response Tracker. The results for most countries included in the analysis show that park visitation has increased since February 16th, 2020 compared to visitor numbers prior to the COVID-19 pandemic. Restrictions on social gathering, movement, and the closure of workplace and indoor recreational places, are correlated with more visits to parks. Stay-at-home restrictions and government stringency index are negatively associated with park visits at a global scale. Demand from residents for parks and outdoor green spaces has increased since the outbreak began, and highlights the important role and benefits provided by parks, especially urban and community parks, under the COVID-19 pandemic. We provide recommendations for park managers and other decision-makers in terms of park management and planning during health crises, as well as for park design and development. In particular, parks could be utilized during pandemics to increase the physical and mental health and social well-being of individuals.

If you cannot understand my argument, and declare “It’s Greek to me,” you are quoting Shakespeare.Bernard LevinPsoriatic arthritis, in its acute or “generalised” stage, is unbearably painful. Exacerbating the crippling of the joints, the entire surface of the skin is covered with lesions only moderately salved by anti-inflammatory ointment, the application of which is as painful as the ailment it seeks to relieve: NURSE MILLS: I’ll be as gentle as I can.Marlow’s face again fills the screen, intense concentration, comical strain, and a whispered urgency in the voice over—MARLOW: (Voice over) Think of something boring—For Christ’s sake think of something very very boring—Speech a speech by Ted Heath a sentence long sentence from Bernard Levin a quiz by Christopher Booker a—oh think think—! Really boring! A Welsh male-voice choir—Everything in Punch—Oh! Oh! — (Potter 17-18)Marlow’s collation of boring things as a frantic liturgy is an attempt to distract himself from a tumescence that is both unwanted and out of place. Although bed-ridden and in constant pain, he is still sensitive to erogenous stimulation, even when it is incidental. The act of recollection, of garnering lists of things that bore him, distracts him from his immediate situation as he struggles with the mental anguish of the prospect of a humiliating orgasm. Literary lists do many things. They provide richness of detail, assemble and corroborate the materiality of the world of which they are a part and provide insight into the psyche and motivation of the collator. The sheer desperation of Dennis Potter’s Marlow attests to the arbitrariness of the list, the simple requirement that discrete and unrelated items can be assembled in linear order, without any obligation for topical concatenation. In its interrogative form, the list can serve a more urgent and distressing purpose than distraction:GOLDBERG: What do you use for pyjamas?STANLEY: Nothing.GOLDBERG: You verminate the sheet of your birth.MCCANN: What about the Albigensenist heresy?GOLDBERG: Who watered the wicket in Melbourne?MCCANN: What about the blessed Oliver Plunkett?(Pinter 51)The interrogative non sequitur is an established feature of the art of intimidation. It is designed to exert maximum stress in the subject through the use of obscure asides and the endowing of trivial detail with profundity. Harold Pinter’s use of it in The Birthday Party reveals how central it was to his “theatre of menace.” The other tactic, which also draws on the logic of the inventory to be both sequential and discontinuous, is to break the subject’s will through a machine-like barrage of rhetorical questions that leave no time for answers.Pinter learned from Samuel Beckett the pitiless, unforgiving logic of trivial detail pushed to extremes. Think of Molloy’s dilemma of the sucking stones. In order for all sixteen stones that he carries with him to be sucked at least once to assuage his hunger, a reliable system has to be hit upon:Taking a stone from the right pocket of my greatcoat, and putting it in my mouth, I replaced it in the right pocket of my greatcoat by a stone from the right pocket of my trousers, which I replaced with a stone from the left pocket of my trousers, which I replaced by a stone from the left pocket of my greatcoat, which I replaced with the stone that was in my mouth, as soon as I had finished sucking it. Thus there were still four stones in each of my four pockets, but not quite the same stones. And when the desire to suck took hold of me again, I drew again on the right pocket of my greatcoat, certain of not taking the same stone as the last time. And while I sucked it I rearranged the other stones in the way I have just described. And so on. (Beckett, Molloy 69)And so on for six pages. Exhaustive permutation within a finite lexical set is common in Beckett. In the novel Watt the eponymous central character is charged with serving his unseen master’s dinner as well as tidying up afterwards. A simple and bucolic enough task it would seem. But Beckett’s characters are not satisfied with conjecture, the simple assumption that someone must be responsible for Mr. Knott’s dining arrangements. Like Molloy’s solution to the sucking stone problem, all possible scenarios must be considered to explain the conundrum of how and why Watt never saw Knott at mealtime. Twelve possibilities are offered, among them that1. Mr. Knott was responsible for the arrangement, and knew that he was responsible for the arrangement, and knew that such an arrangement existed, and was content.2. Mr. Knott was not responsible for the arrangement, but knew who was responsible for the arrangement, and knew that such an arrangement existed, and was content.(Beckett, Watt 86)This stringent adherence to detail, absurd and exasperating as it is, is the work of fiction, the persistence of a viable, believable thing called Watt who exists as long as his thought is made manifest on a page. All writers face this pernicious prospect of having to confront and satisfy “fiction’s gargantuan appetite for fact, for detail, for documentation” (Kenner 70). A writer’s writer (Philip Marlow) Dennis Potter’s singing detective struggles with the acute consciousness that words eventually will fail him. His struggle to overcome verbal entropy is a spectre that haunts the entire literary imagination, for when the words stop the world stops.Beckett made this struggle the very stuff of his work, declaring famously that all he wanted to do as a writer was to leave “a stain upon the silence” (quoted in Bair 681). His characters deteriorate from recognisable people (Hamm in Endgame, Winnie in Happy Days) to mere ciphers of speech acts (the bodiless head Listener in That Time, Mouth in Not I). During this process they provide us with the vocabulary of entropy, a horror most eloquently expressed at the end of The Unnamable: I can’t go on, you must go on, I’ll go on, you must say words, as long as there are any, until they find me, until they say me, strange pain, strange sin, you must go on, perhaps it’s done already, perhaps they have said me already, perhaps they have carried me to the threshold of my story, before the door that opens on my story, that would surprise me, if it opens, it will be I, it will be the silence, where I am, I don’t know, I’ll never know, in the silence you don’t know, you must go on, I can’t go on, I’ll go on. (Beckett, Molloy 418)The importance Beckett accorded to pauses in his writing, from breaks in dialogue to punctuation, stresses the pacing of utterance that is in sync with the rhythm of human breath. This is acutely underlined in Jack MacGowran’s extraordinary gramophone recording of the above passage from The Unnamable. There is exhaustion in his voice, but it is inflected by an urgent push for the next words to forestall the last gasp. And what might appear to be parsimony is in fact the very commerce of writing itself. It is an economy of necessity, when any words will suffice to sustain presence in the face of imminent silence.Hugh Kenner has written eloquently on the relationship between writing and entropy, drawing on field and number theory to demonstrate how the business of fiction is forever in the process of generating variation within a finite set. The “stoic comedian,” as he figures the writer facing the blank page, self-consciously practices their art in the full cognisance that they select “elements from a closed set, and then (arrange) them inside a closed field” (Kenner 94). The nouveau roman (a genre conceived and practiced in Beckett’s lean shadow) is remembered in literary history as a rather austere, po-faced formalism that foregrounded things at the expense of human psychology or social interaction. But it is emblematic of Kenner’s portrait of stoicism as an attitude to writing that confronts the nature of fiction itself, on its own terms, as a practice “which is endlessly arranging things” (13):The bulge of the bank also begins to take effect starting from the fifth row: this row, as a matter of fact, also possesses only twenty-one trees, whereas it should have twenty-two for a true trapezoid and twenty-three for a rectangle (uneven row). (Robbe-Grillet 21)As a matter of fact. The nouveau roman made a fine if myopic art of isolating detail for detail’s sake. However, it shares with both Beckett’s minimalism and Joyce’s maximalism the obligation of fiction to fill its world with stuff (“maximalism” is a term coined by Michel Delville and Andrew Norris in relation to the musical scores of Frank Zappa that opposes the minimalism of John Cage’s work). Kenner asks, in The Stoic Comedians, where do the “thousands on thousands of things come from, that clutter Ulysses?” His answer is simple, from “a convention” and this prosaic response takes us to the heart of the matter with respect to the impact on writing of Isaac Newton’s unforgiving Second Law of Thermodynamics. In the law’s strictest physical sense of the dissipation of heat, of the loss of energy within any closed system that moves, the stipulation of the Second Law predicts that words will, of necessity, stop in any form governed by convention (be it of horror, comedy, tragedy, the Bildungsroman, etc.). Building upon and at the same time refining the early work on motion and mass theorised by Aristotle, Kepler, and Galileo, inter alia, Newton refined both the laws and language of classical mechanics. It was from Wiener’s literary reading of Newton that Kenner segued from the loss of energy within any closed system (entropy) to the running silent out of words within fiction.In the wake of Norbert Wiener’s cybernetic turn in thinking in the 1940s, which was highly influenced by Newton’s Second Law, fiction would never again be considered in the same way (metafiction was a term coined in part to recognise this shift; the nouveau roman another). Far from delivering a reassured and reassuring present-ness, an integrated and ongoing cosmos, fiction is an isometric exercise in the struggle against entropy, of a world in imminent danger of running out of energy, of not-being:“His hand took his hat from the peg over his initialled heavy overcoat…” Four nouns, and the book’s world is heavier by four things. One, the hat, “Plasto’s high grade,” will remain in play to the end. The hand we shall continue to take for granted: it is Bloom’s; it goes with his body, which we are not to stop imagining. The peg and the overcoat will fade. “On the doorstep he felt in his hip pocket for the latchkey. Not there. In the trousers I left off.” Four more things. (Kenner 87)This passage from The Stoic Comedians is a tour de force of the conjuror’s art, slowing down the subliminal process of the illusion for us to see the fragility of fiction’s precarious grip on the verge of silence, heroically “filling four hundred empty pages with combinations of twenty-six different letters” (xiii). Kenner situates Joyce in a comic tradition, preceded by Gustave Flaubert and followed by Beckett, of exhaustive fictive possibility. The stoic, he tells us, “is one who considers, with neither panic nor indifference, that the field of possibilities available to him is large perhaps, or small perhaps, but closed” (he is prompt in reminding us that among novelists, gamblers and ethical theorists, the stoic is also a proponent of the Second Law of Thermodynamics) (xiii). If Joyce is the comedian of the inventory, then it is Flaubert, comedian of the Enlightenment, who is his immediate ancestor. Bouvard and Pécuchet (1881) is an unfinished novel written in the shadow of the Encyclopaedia, an apparatus of the literate mind that sought complete knowledge. But like the Encyclopaedia particularly and the Enlightenment more generally, it is fragmentation that determines its approach to and categorisation of detail as information about the world. Bouvard and Pécuchet ends, appropriately, in a frayed list of details, pronouncements and ephemera.In the face of an unassailable impasse, all that is left Flaubert is the list. For more than thirty years he constructed the Dictionary of Received Ideas in the shadow of the truncated Bouvard and Pécuchet. And in doing so he created for the nineteenth century mind “a handbook for novelists” (Kenner 19), a breakdown of all we know “into little pieces so arranged that they can be found one at a time” (3): ACADEMY, FRENCH: Run it down but try to belong to it if you can.GREEK: Whatever one cannot understand is Greek.KORAN: Book about Mohammed, which is all about women.MACHIAVELLIAN: Word only to be spoken with a shudder.PHILOSOPHY: Always snigger at it.WAGNER: Snigger when you hear his name and joke about the music of the future. (Flaubert, Dictionary 293-330)This is a sample of the exhaustion that issues from the tireless pursuit of categorisation, classification, and the mania for ordered information. The Dictionary manifests the Enlightenment’s insatiable hunger for received ideas, an unwieldy background noise of popular opinion, general knowledge, expertise, and hearsay. In both Bouvard and Pécuchet and the Dictionary, exhaustion was the foundation of a comic art as it was for both Joyce and Beckett after him, for the simple reason that it includes everything and neglects nothing. It is comedy born of overwhelming competence, a sublime impertinence, though not of manners or social etiquette, but rather, with a nod to Oscar Wilde, the impertinence of being definitive (a droll epithet that, not surprisingly, was the title of Kenner’s 1982 Times Literary Supplement review of Richard Ellmann’s revised and augmented biography of Joyce).The inventory, then, is the underlining physio-semiotics of fictional mechanics, an elegiac resistance to the thread of fiction fraying into nothingness. The motif of thermodynamics is no mere literary conceit here. Consider the opening sentence in Borges:Of the many problems which exercised the reckless discernment of Lönnrot, none was so strange—so rigorously strange, shall we say—as the periodic series of bloody events which culminated at the villa of Triste-le-Roy, amid the ceaseless aroma of the eucalypti. (Borges 76)The subordinate clause, as a means of adjectival and adverbial augmentation, implies a potentially infinite sentence through the sheer force of grammatical convention, a machine-like resistance to running out of puff:Under the notable influence of Chesterton (contriver and embellisher of elegant mysteries) and the palace counsellor Leibniz (inventor of the pre-established harmony), in my idle afternoons I have imagined this story plot which I shall perhaps write someday and which already justifies me somehow. (72)In “Pierre Menard, Author of the Quixote,” a single adjective charmed with emphasis will do to imply an unseen network:The visible work left by this novelist is easily and briefly enumerated. (Borges 36)The annotation of this network is the inexorable issue of the inflection: “I have said that Menard’s work can be easily enumerated. Having examined with care his personal files, I find that they contain the following items.” (37) This is a sample selection from nineteen entries:a) A Symbolist sonnet which appeared twice (with variants) in the review La conque (issues of March and October 1899).o) A transposition into alexandrines of Paul Valéry’s Le cimitière marin (N.R.F., January 1928).p) An invective against Paul Valéry, in the Papers for the Suppression of Reality of Jacques Reboul. (37-38)Lists, when we encounter them in Jorge Luis Borges, are always contextual, supplying necessary detail to expand upon character and situation. And they are always intertextual, anchoring this specific fictional world to others (imaginary, real, fabulatory or yet to come). The collation and annotation of the literary works of an imagined author (Pierre Menard) of an invented author (Edmond Teste) of an actual author (Paul Valéry) creates a recursive, yet generative, feedback loop of reference and literary progeny. As long as one of these authors continues to write, or write of the work of at least one of the others, a persistent fictional present tense is ensured.Consider Hillel Schwartz’s use of the list in his Making Noise (2011). It not only lists what can and is inevitably heard, in this instance the European 1700s, but what it, or local aural colour, is heard over:Earthy: criers of artichokes, asparagus, baskets, beans, beer, bells, biscuits, brooms, buttermilk, candles, six-pence-a-pound fair cherries, chickens, clothesline, cockles, combs, coal, crabs, cucumbers, death lists, door mats, eels, fresh eggs, firewood, flowers, garlic, hake, herring, ink, ivy, jokebooks, lace, lanterns, lemons, lettuce, mackeral, matches […]. (Schwartz 143)The extended list and the catalogue, when encountered as formalist set pieces in fiction or, as in Schwartz’s case, non-fiction, are the expansive equivalent of le mot juste, the self-conscious, painstaking selection of the right word, the specific detail. Of Ulysses, Kenner observes that it was perfectly natural that it “should have attracted the attention of a group of scholars who wanted practice in compiling a word-index to some extensive piece of prose (Miles Hanley, Word Index to Ulysses, 1937). More than any other work of fiction, it suggests by its texture, often by the very look of its pages, that it has been painstakingly assembled out of single words…” (31-32). In a book already crammed with detail, with persistent reference to itself, to other texts, other media, such formalist set pieces as the following from the oneiric “Circe” episode self-consciously perform for our scrutiny fiction’s insatiable hunger for more words, for invention, the Latin root of which also gives us the word inventory:The van of the procession appears headed by John Howard Parnell, city marshal, in a chessboard tabard, the Athlone Poursuivant and Ulster King of Arms. They are followed by the Right Honourable Joseph Hutchinson, lord mayor Dublin, the lord mayor of Cork, their worships the mayors of Limerick, Galway, Sligo and Waterford, twentyeight Irish representative peers, sirdars, grandees and maharajahs bearing the cloth of estate, the Dublin Metropolitan Fire Brigade, the chapter of the saints of finance in their plutocratic order of precedence, the bishop of Down and Connor, His Eminence Michael cardinal Logue archbishop of Armagh, primate of all Ireland, His Grace, the most reverend Dr William Alexander, archbishop of Armagh, primate of all Ireland, the chief rabbi, the Presbyterian moderator, the heads of the Baptist, Anabaptist, Methodist and Moravian chapels and the honorary secretary of the society of friends. (Joyce, Ulysses 602-604)Such examples demonstrate how Joycean inventories break from narrative as architectonic, stand-alone assemblages of information. They are Rabelaisian irruptions, like Philip Marlow’s lesions, that erupt in swollen bas-relief. The exaggerated, at times hysterical, quality of such lists, perform the hallucinatory work of displacement and condensation (the Homeric parallel here is the transformation of Odysseus’s men into swine by the witch Circe). Freudian, not to mention Stindberg-ian dream-work brings together and juxtaposes images and details that only make sense as non-sense (realistic but not real), such as the extraordinary explosive gathering of civic, commercial, political, chivalric representatives of Dublin in this foreshortened excerpt of Bloom’s regal campaign for his “new Bloomusalem” (606).The text’s formidable echolalia, whereby motifs recur and recapitulate into leitmotifs, ensures that the act of reading Ulysses is always cross-referential, suggesting the persistence of a conjured world that is always already still coming into being through reading. And it is of course this forestalling of Newton’s Second Law that Joyce brazenly conducts, in both the textual and physical sense, in Finnegans Wake. The Wake is an impossible book in that it infinitely sustains the circulation of words within a closed system, creating a weird feedback loop of cyclical return. It is a text that can run indefinitely through the force of its own momentum without coming to a conclusion. In a text in which the author’s alter ego is described in terms of the technology of inscription (Shem the Penman) and his craft as being a “punsil shapner,” (Joyce, Finnegans 98) Norbert Wiener’s descriptive example of feedback as the forestalling of entropy in the conscious act of picking up a pencil is apt: One we have determined this, our motion proceeds in such a way that we may say roughly that the amount by which the pencil is not yet picked up is decreased at each stage. (Wiener 7) The Wake overcomes the book’s, and indeed writing’s, struggle with entropy through the constant return of energy into its closed system as a cycle of endless return. Its generative algorithm can be represented thus: “… a long the riverrun …” (628-3). The Wake’s sense of unending confounds and contradicts, in advance, Frank Kermode’s averring to Newton’s Second Law in his insistence that the progression of all narrative fiction is defined in terms of the “sense of an ending,” the expectation of a conclusion, whereby the termination of words makes “possible a satisfying consonance with the origins and with the middle” (Kermode 17). It is the realisation of the novel imagined by Silas Flannery, the fictitious author in Italo Calvino’s If on a winter’s night a traveller, an incipit that “maintains for its whole duration the potentiality of the beginning” (Calvino 140). Finnegans Wake is unique in terms of the history of the novel (if that is indeed what it is) in that it is never read, but (as Joseph Frank observed of Joyce generally) “can only be re-read” (Frank 19). With Wiener’s allegory of feedback no doubt in mind, Jacques Derrida’s cybernetic account of the act of reading Joyce comes, like a form of echolalia, on the heels of Calvino’s incipit, his perpetual sustaining of the beginning: you stay on the edge of reading Joyce—for me this has been going on for twenty-five or thirty years—and the endless plunge throws you back onto the river-bank, on the brink of another possible immersion, ad infinitum … In any case, I have the feeling that I haven’t yet begun to read Joyce, and this “not having begun to read” is sometimes the most singular and active relationship I have with his work. (Derrida 148) Derrida wonders if this process of ongoing immersion in the text is typical of all works of literature and not just the Wake. The question is rhetorical and resonates into silence. And it is silence, ultimately, that hovers as a mute herald of the end when words will simply run out.Post(script)It is in the nature of all writing that it is read in the absence of its author. Perhaps the most typical form of writing, then, is the suicide note. In an extraordinary essay, “Goodbye, Cruel Words,” Mark Dery wonders why it has been “so neglected as a literary genre” and promptly sets about reviewing its decisive characteristics. Curiously, the list features amongst its many forms: I’m done with lifeI’m no goodI’m dead. (Dery 262)And references to lists of types of suicide notes are among Dery’s own notes to the essay. With its implicit generic capacity to intransitively add more detail, the list becomes in the light of the terminal letter a condition of writing itself. The irony of this is not lost on Dery as he ponders the impotent stoicism of the scribbler setting about the mordant task of writing for the last time. Writing at the last gasp, as Dery portrays it, is a form of dogged, radical will. But his concluding remarks are reflective of his melancholy attitude to this most desperate act of writing at degree zero: “The awful truth (unthinkable to a writer) is that eloquent suicide notes are rarer than rare because suicide is the moment when language fails—fails to hoist us out of the pit, fails even to express the unbearable weight” (264) of someone on the precipice of the very last word they will ever think, let alone write. Ihab Hassan (1967) and George Steiner (1967), it would seem, were latecomers as proselytisers of the language of silence. But there is a queer, uncanny optimism at work at the terminal moment of writing when, contra Dery, words prevail on the verge of “endless, silent night.” (264) Perhaps when Newton’s Second Law no longer has carriage over mortal life, words take on a weird half-life of their own. Writing, after Socrates, does indeed circulate indiscriminately among its readers. There is a dark irony associated with last words. When life ceases, words continue to have the final say as long as they are read, and in so doing they sustain an unlikely, and in their own way, stoical sense of unending.ReferencesBair, Deirdre. Samuel Beckett: A Biography. London: Jonathan Cape, 1978.Beckett, Samuel. Molloy Malone Dies. The Unnamable. London: John Calder, 1973.---. Watt. London: John Calder, 1976.Borges, Jorge Luis. Labyrinths. Selected Stories & Other Writings. Ed. Donald A. Yates & James E. Irby. New York: New Directions, 1964.Calvino, Italo. If On A Winter’s Night A Traveller. Trans. 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