Iranian Journal of Medical Sciences

Document Type: Review Article


1 Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Non‐Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran


Background: The outbreak of Coronavirus disease 2019 (COVID-19) has posed a significant threat to many countries. Since the disease does not currently have a particular treatment, there is a compelling need to find substitute means to dominate its expansion. In this rapid review, we aimed to determine some countries’ public responses to the COVID-19 epidemic.
Methods: In this study, academic databases, including MEDLINE, Scopus, and Embase, were investigated. The keywords applied in the search strategy besides the names of each country were: “Public Health,” “Public Response”, “Health Policy”, “COVID-19”, “Novel Coronavirus,” “2019-nCoV”, and “SARS-COV-2”. The countries included China, Italy, Iran, Spain, South Korea, Germany, France, United States, Australia, Canada, Japan, and Singapore.
Results: The total number of retrieved articles in MEDLINE, Scopus, and Embase in April 2020 was 594, and after removing 259 duplicate articles, 335 papers were screened by the experts. After this investigation, 50 articles, in addition to 12 webpages, were extensively reviewed for the results section. Public health strategies and responses can be divided into four main areas, including monitoring, public education, crowd controlling, and care facilities.
Conclusion: According to the results of the management decisions of some governments on quarantining, social isolation, screening methods, and flight suspensions due to the severity and anonymity of COVID-19, it is highly assured that these strategies would be the most successful approaches to confront the present pandemic. Governments should put in place timely and strict measures to halt the spread and diminish its unintended deadly consequences.


What’s Known

Emergency situations like outbreaks have caused various issues globally. National and international responses to the outbreaks have had a critical role in reducing the infection rates and preventing the diseases from spreading. Social isolation and quarantining were beneficial in the previous epidemics.

What’s New

Some countries were well- prepared for the outbreak of Coronavirus disease 2019 (COVID-19). However, other regions need to be more promptly adapted to the situation. According to the results, quarantine and social isolation would be successful techniques to confront the COVID-19 pandemic and an immediate response is a key factor to halt the spread.


Brief background and objectives

At the end of December 2019, Novel Coronavirus-infected pneumonia cases were recognized in Wuhan City, China. 1 - 3 These cases, with unspecified etiology, presented with symptoms of dyspnea, fever, dry cough, and bilateral lung infiltration on radiographs. The virus was named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the disease was called Coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). In late January 2020, WHO announced the COVID-19 outbreak as a Public Health Emergency of International Concern in which countries with vulnerable healthcare facilities may be at an excessive hazard. The disease transmission may be disrupted by early diagnosis, social isolation, instantaneous therapy, and other control measures. 1 This infection has imposed remarkable perils on the global health systems and economic sectors of countries. Since the disease does not currently have a particular treatment, there is a compelling need to find substitute means to dominate its expansion. 4

COVID-19 outbreak has led the public health officials of several countries to enact policies and manage the spread of the disease by employing different strategies, including encouraging people for self-isolating and quarantining. This rapid review aims to summarize these strategies and responses in some countries and, subsequently, discuss how these measures could help in curbing the virus transmission and comparing the effectiveness of their policies looking at the number of total cases in each of the mentioned countries. The extracted results may be helpful for both policymakers and researchers.


Search Strategy

In this rapid review, academic databases, including MEDLINE, Scopus, and Embase, were investigated. The keywords applied in the search strategy besides the names of each country were: “Public Health,” “Public Response”, “Health Policy”, “COVID-19”, “Novel Coronavirus,” “2019-nCoV”, and “SARS-CoV-2”. The countries included China, Italy, Iran, Spain, South Korea, Germany, France, United States, Australia, Canada, Japan, and Singapore. In addition to this search, the official government websites of some countries, creditable news websites, and LitCovid literature hub 5 were also reviewed to acquire additional data about the recent national responses and control strategies. After removing duplicate articles, the abstracts of the remaining papers were screened by four experts, including an epidemiologist, a medical informatics expert, a statistician, and an infectious disease expert. Those relevant articles meeting the inclusion criteria were consequently selected to include in the study.

Inclusion and Exclusion Criteria

The inclusion criteria were as follows: 1) Articles reported public health responses to COVID-19 outbreak or control measures when experiencing the virus outbreak, 2) Articles written in the English language, and 3) Articles published in 2020. The papers lacking these measures and out of scope ones were excluded from the study.


The total number of retrieved articles in MEDLINE, Scopus, and Embase in April 2020 was 594, and after removing 259 duplicate articles, 335 papers were screened by the experts. After this investigation, 50 articles, in addition to 12 webpages, were extensively reviewed for the results section. In Table 1, public health responses to the COVID-19 outbreak based on each country are categorized. There are various means by which preventing further transmission of the virus can be conducted, including investigating, categorizing, monitoring, and managing contacts by identifying the patients’ travel routes. Many countries enacted policies on travel restrictions, such as flight suspensions 6 - 14 or close monitoring of the incoming travelers on their arrival at the international airports. 13 , 15 - 17 Some other countries have implemented social distancing and quarantine policies to fight this highly contagious disease 18 - 20 as well as encouraging the limitation of social contacts, postponing events, locking down schools, and isolating suspected cases. 14 , 21 Technological approaches such as telemedicine for remote consultation or monitoring have also been utilized in some regions in the period of the outbreak. 20 , 22 - 24

Country Main control measures Reference Publication/cite date
China Implementing strict movement limitations and absolute lockdowns in some cities Anzai et al.26 February 24, 2020
A travel ban was started on January 23, 2020. Chen et al.14 February 20, 2020
Social contacts were limited.
Government policies were enacted during the Chinese New Year holiday, such as social distancing policies.
People were encouraged to stay at home and avoided being in crowds.
Crowded public events were postponed or canceled; schools, universities, government offices, libraries, museums, and factories were closed.
Containment strategies and core measures such as social distancing, case isolation, close contact tracking management, closing epidemic areas, and traffic controls were used to diminish movements and environmental actions were done to increase personal protection. Chen et al.27 February 17, 2020
Wuhan - the outbreak’s epicenter, was quarantined. Du et al.28 May 2020 early release
Online and offline wildlife sales and transportations (except fish and seafood) were prohibited in China due to Coronavirus outbreak. In case of any violation, lawbreakers were severely penalized. Loeb29 February 8, 2020
By January 26, 2020, the first-level emergency response system for public health and safety had been triggered by 30 provinces in China. Zhang et al.30 March 25, 2020
China provided extra funds for public health, prevention, and management of the epidemics.
The Spring Festival holiday was extended, the spring term was deferred, mass meeting events were canceled, and transportation capacity regulations were enacted to diminish mass movement of people.
Residents of each community were isolated by civil society organizations.
Social isolation, home quarantine, and provision of personal safety devices such as facemasks were introduced to deter widespread transmission of the virus to the nation.
Providing simple and easy access to credible information and expert advice to help diminish speculations and misconceptions. It was brought to people by technological advancements.
The approaches to prevention and management have been modified throughout time to adapt to the challenging and modifiable circumstances.
China underwent extreme and massive lockdowns. Cyranoski31 March 17, 2020
Borders were restricted, and international visits were limited.
Trains and flights were suspended, and roads were closed.
People were soon advised to stay at their houses and to come out solely in case of necessity.
Large-scale, temporary, well-equipped Fangcang shelter hospitals were established in China for patient isolation purposes. Chen et al.32 April 2, 2020
Initial measures in Wenzhou, China: Ruan et al.33 April 3, 2020
Assigning suspected and confirmed cases to pre-specific hospitals.
Investigation and tracking new arrivals from Wuhan through the utilization of a big-data network- They were subsequently convinced to go through a 14-day quarantine at their own houses.
Gathering and monitoring people who exposed to COVID-19 confirmed cases.
Secondary measures in Wenzhou, China:
Traffic shut down of trains, buses, and planes.
All public gathering sites were closed, and community activities were canceled.
High-risk individuals were investigated and monitored promptly.
Seriously-ill patients were transferred to a specialized hospital for intensive care, and their close contacts were medically observed.
Italy On February 21, the Italian government established an emergency task force of Lombardy and the policies of local health to respond to the virus outbreak. Grasselli et al.34 March 13, 2020
National measures to restrict viral spread including the air travel ban from China, quarantining Italian passengers in China, and severe controls at international airports’ arrival terminals were implemented Spina et al.13 February 28, 2020
An algorithm for the recognition of the suspected cases was designed.
A surveillance system was launched at the beginning of the virus outbreak to gather information about the infected Italian people. Onder et al.35 March 23, 2020
Social isolation became obligatory. Sani et al.19 April 4, 2020
A response plan was recognized by a task force: Carenzo et al.36 April 4, 2020
Setting up ICUs for COVID-19 confirmed cases.
Modeling suitable methods for detecting, isolating, and pre-triage of COVID-19 confirmed or suspected cases
ICU staff training in the field of personal protection and patient management.
Northern Italy entered an emergency shutdown on 8 March, and three days later, the government applied the quarantine to the entire country. Subsequently, it was announced that the lockdown would continue to at least April 3. Paterlini37 April 2, 2020
National and regional governments established urgent control measures, including the development of quarantined areas that covered more than 50000 residents. Guzzetta et al.38 March 25, 2020
Rapid institutional responses. Sorbello et al.24 March 27, 2020
Announcing the condition of national emergency on 31 January 2020
Applying restrictions on public events and activities- which had an impact on colleges, conferences, and sports activities
Locking down of hospital wards, limiting the entrance to hospitals by visitors, establishing alternative triage areas, designating mobility and segregation locations for patients, and canceling several elective procedures to diminish the burden on critical care capacity.
Designating all Italian regions as “red zones” with imposing severe restrictions on any public event on 11 March 2020
Utilization of tele-counseling sessions
Home isolation of COVID-19 patients who were not terribly ill
Creation and broadcasting informative video clips.
Iran New restrictions were imposed on the intercity traffic. Iran Ministry of Health39 March 14, 2020
The control and management of COVID-19 have become a major priority for Iran’s ministry of health and medical education. It has established control strategies to curb the virus spread: Abdi40 March 20, 2020
Establishing the corona fight national committee
Informing the public about the virus and protective measures through media platforms
Limiting congestion in crowded regions, such as religious sites and stores
Shutting down educational institutes (e.g., schools and universities).
Diminishing working hours in many offices and departments
Calling off sports events
Disinfecting and sterilizing crowded areas including bus stations and subways
Controlling and detecting COVID-19 suspected individuals at entries and exits of several cities
A novel detection and triage technique was developed and volunteer radiologists offered teleconsultation services. Davarpanah et al.22 March 24, 2020
All industries were required by the Iranian authorities to collaborate with the Ministry Health and Medical Education and provide all needed facilities. Seddighi41 March 27, 2020
A self-monitoring website was developed for individuals. Raeisi et al.42 April 1, 2020
Two hotlines with more than 10000 lines were established for teleconsultations and phone screenings over COVID-19 issues.
National executive teams were created to aid in preventive and controlling processes against the virus.
The public was encouraged for self-isolating at their houses. Moradzadeh43 April 3, 2020
Intelligent social distancing would be implemented following the previous phases. President of Iran official website44 April 4, 2020
Spain In January, a health screening protocol was implemented by the government. Government of Spain official website45 March 18, 2020
Transparent information was ordered to be released.
The protection of highly exposed people to the disease was prioritized.
Support of health workers, families, and companies was planned.
The president demanded unity and social responsibility.
The global lockdown was extended as the death rate surged. The Guardian News46 March 28, 2020
Non-essential employees were forced to stay home.
Japan Travel restrictions were conducted to and from Wuhan city. Nishiura et al.12 February 4, 2020
The authorities held the process of evacuation for the passengers of the flights dated from 29 to 31 January 2020, and they were screened with portable thermoscanners and tested for COVID-19.
Systems to diagnose the virus were urgently developed. Real-time RT-PCR and nested RT-PCR assays were adjusted. Shirato et al.47 February 18, 2020
All 3,711 passengers and crew members of the Diamond Princess ship were quarantined by the order of the Japanese government. Sawano et al.48 March 14, 2020
A month-long emergency state was declared by Japan’s prime minister (until 6th May). The Guardian News49 April 7, 2020
People were asked to limit their contacts with other individuals and obey social distancing policies.
France An increased observation was performed on January 10, 2020, to detect imported cases early and prevent secondary transmission of the virus in the community or health workers. Stoecklin et al.50 February 13, 2020
France approved, reimbursed, and strongly encouraged the utilization of telemedicine (e.g., tele-expertise and remote-consultation). Ohannessian et al.23 April 2, 2020
The president of France announced that the country would be considered as being in a condition of war on March 12. Ghanchi18 April 7, 2020
Schools were locked down.
Self-quarantining, social distancing, and limiting social interactions were advised.
Several public areas were ordered to close.
Local municipal elections were postponed.
The National quarantining of the whole community was assumed to be the best strategy to curb the virus transmission.
The Schengen treaty zone was closed to non-EU citizens.
Germany Sensitive diagnostic assays were rapidly established in public health laboratories. Conrad et al.51 March 5, 2020
A massive contact probe around the first German patient with the virus was instantly commenced, with more than 700 samples.
People were requested to stay home. France 24 News52 March 17, 2020
Travel restrictions and border control measures were expanded for travelers from other EU countries. The Politico53 March 19, 2020
Gatherings of more than two individuals were prohibited. The Politico54 March 22, 2020
Some non-critical businesses underwent compulsory shutdown.
Social distancing policies were announced by the chancellor of Germany. The Guardian News55- April 5, 2020
Canada Performing a comprehensive health screening of returning travelers in 10 major airports. Government of Canada16 March 5, 2020
Control of the outbreak and the prevention of the future spread were focused on.
Emergency Operation Centre was established.
Canada has positively been influenced by the experience of the SARS outbreak (e.g., in the field of virtual care and diminishing exposure hazards). Webster56 March 21, 2020
As a part of the economic response plan in Canada, employers who were hugely affected by COVID-19 pandemic, have been financially supported. Government of Canada57 April 12, 2020
Singapore The country had increased pandemic readiness due to its experience in the outbreak of SARS in 2003. Lee et al.17 March 13, 2020
Multi-Ministry Task Force was established before the presence of the first COVID-19 case.
Employing complementary diagnostic methods and containment and surveillance measures to detect cases
A network of preparedness facilities was set up to manage infected cases.
Screening estimations, including temperature measures, were held for incoming travelers.
Social and community assessments were performed.
OR response measures were introduced, i.e.: Wong et al.58 March 4, 2020
An isolated OR was set up.
Workflow and processes were modified.
The staff was managed.
Clinical guidelines for anesthetic management were implemented.
ICU responses to the virus outbreak: Liew et al.59 March 9, 2020
A common strategy of containment was launched for healthcare settings.
All confirmed or suspected cases were isolated.
Solutions were introduced to address issues of critical care, including the control of infection, the flow of information among health personnel, psychological problems in healthcare workers and their exhaustion, progressive ICU services, and resuscitation response.
On January 2, 2020, all physicians were alarmed to detect any pneumonia case and a travel history to Wuhan in recent days. Wong et al.60 February 20, 2020
On January 3, 2020, temperature screening of the incoming travelers was started at airports.
Various preventive policies have been implemented to impede COVID-19 dissemination (e.g., quarantine order and stay-home notice). Singapore Government Agency Website61 March 25, 2020
Plenty of sources, including social media, websites, mobile applications, posters, and videos, as well as hotlines and chatbots, were delivered to the public. Singapore Government Agency Website62 April 10, 2020
South Korea Information gathering methods were used to monitor and manage COVID-19 cases and their contacts, using COVID-19 National Emergency Response Center63 February 18, 2020
Medical facility records
Card transactions
Patients were transferred to national quarantine stations or medical centers for isolation. Moran ki64 February 9, 2020
Mobilizing hospital beds for infected cases Sun Huh65 March 7, 2020
Using accommodation facilities (training institutes)
Releasing safety measures for healthcare workers and other people
Many public health physicians were ordered by the government to be under specialized training courses to treat COVID-19 cases.
The government hired volunteer health care workers and assigned emergency teams from the army to tackle the epidemic. Her66 April 3, 2020
Extensive monitoring, efficient patient triage, transparent information delivery, and utilization of information technologies were employed.
The government has developed more than 600 COVID-19 screening centers.
GPS records from patients’ mobile phones or records of their credit cards were used to create maps of their movements. The maps were subsequently sent to residents of the desired neighborhood or shown on the internet to alarm the people for precautions.
Employing screening strategies at the airports. Moradi & Vaezi67 April 3, 2020
Rapid investigation of cases.
Evidence-based and reality guided behavior.
The opening of schools was postponed from March 2 to April 6 by the Ministry of Education to diminish the virus transmission. Kim et al.21 April 6, 2020
United States Suspension of entry to the US Patel & Jernigan11 February 4, 2020
Executing forceful measures including screening of travelers arriving from china and case identification
Establishing a thorough regulatory system including setting up quarantine stations
Public health assessments
Detecting cases and contacts of persons infected with the virus Daniel B. Jernigan15 February 28, 2020
Evaluation, screening, and care of incoming travelers from zones with a considerable transference of the virus.
Social distancing strategies were promoted to aid in “flattening the curve” (i.e., decelerating the emergence of new cases). Stokes68 March 25, 2020
Travel was restricted, meetings and concerts were canceled, and colleges and universities began taking students off campus to online courses.
The medical schools fell into line, with additional motivating factors.
Telemedicine, specifically video consultation, was supported and developed to reduce spread hazards. Ohannessian et al.23 April 2, 2020
Australia The country released weekly epidemiology reports on COVID-19 outbreak and the status of Australia COVID-19 National Incident Room Surveillance Team6-10,69 February and March 2020
Denial of the entrance permission to people who have traveled to China
Active investigation of Australian cases
Announcing stricter travel restrictions
Extending the 14-day quarantine rule for all international passengers, irrespective of the country, as well as physical distancing policies.
Implementing powerful educational messaging for the public Kidd20 April 2, 2020
Closing the country borders
Shutting down non-essential businesses
Implementing protective measures and social distancing policies
Quarantining suspected or confirmed cases
Activating health emergency response plan
Initiating a primary care package by the government
Adopting Telehealth services (e.g., mental health, infection prevention and control).
RT-PCR: Reverse Transcription Polymerase Chain Reaction / OR: Operating Room / ICU: Intensive Care Unit / CCTV: Closed-circuit Television / GPS: Global Positioning System/ EU: European Union
Table1. Main control measures in the world categorized based on countries

According to the published articles, public health strategies and responses are divided into four main areas:

1) Monitoring: In this respect, countries investigate the whole or parts of the community by either using tele-monitoring strategies or broad investigation in airports or borders of the region. Approaches, such as the utilization of Global Positioning System/credit card records or the development of websites for self-monitoring or psychological consultation services, were also employed in some countries, specifically in South Korea and Singapore.

2) Public education: To provide community education, many governments attempted to offer transparent information about the virus. Additionally, information on preventive measures or proper practices in the community were delivered to the people through diverse sorts of media or messaging services.

3) Crowd controlling: Governments employed some policies to diminish gatherings. These approaches included social distancing, quarantining, street traffic controlling, school and university closures, postponing events, and shutting down some businesses.

4) Care facilities preparation: Constructing or preparing suitable care settings, including major hospitals with the highest degree of facilities, were other responses in some countries. Hospitals or shelters for caring suspected or confirmed cases at both stages of therapy and recovery were built or allocated. These facilities might subsequently reduce the death rate in these countries.

The mentioned control measures control measures in some countries could bring success strategies in coping with the current outbreak. However, other countries require to enact stricter laws or implement more practical policies. Based on the Worldometers website, 25 some countries could control the virus, and their total cases rate has remained steady after a specific date. Some other countries with a rising rate of total cases curbed their death rate, although their cases are still growing to a higher degree.


The world has encountered three outbreaks since 2002 with the epidemic of SARS-CoV, followed by MERS-CoV in 2012, and COVID-19 in 2019, which spread swiftly to several countries and threatened public health. 70 The immediate spread and its high transmission rate between people have caused global distress. 71 , 72

In South Korea, some methods for information collection were introduced for the screening and management of COVID-19 cases. By employing these techniques, precise information about the location and time of exposure and other details would be accessible to the general public. Since the release of a patient’s contacts violates the patient’s privacy, a protocol to protect this critical issue must be created. 63  Early and rapid responses to the outbreak as well as implementing preventive strategies, have helped South Korea to preclude community infection and limit it to some specified medical centers. By utilizing appropriate approaches, entrance of COVID-19 patients, and simultaneously, the dissemination of the virus across the country have been deterred. 67 Although South Korea was once one of the most infected countries outside China, the outbreak has reached a period of stability after stringent monitoring approaches and mass quarantine. 17 Based on the “Worldometers” statistics, the total cases in South Korea had been rising sharply until early March 2020, while since then, the rate has been experiencing a gradual increase. 25

Singapore has used a robust surveillance program to identify many cases and restrain them at a personal level. By early identification of cases by monitoring and intensive contact tracking among confirmed cases along with implementing border control policies, Singapore has managed to prevent the virus from spreading without substantial disturbances to daily routine life. 17 Additionally, Singapore had the experience of the 2003 SARS outbreak and performed well due to its readiness. Intensive Care Units (ICUs) of the country were fully prepared and responded swiftly to the virus outbreak. 17 , 58 , 59

Although in Australia, the number of confirmed cases is rising, the death rate in this country has remained relatively low. This might be the consequence of the country rapid response to the emerged crisis through control measures such as social distancing, public education, and the use of technological advancements. 20 Similar to Australia, Singapore has experienced a very low death rate, thanks to its early responses and control policies. 25

Iran is among countries that have launched a psychological assistance system for residents as well as establishing a self-monitoring website for suspected cases of COVID-19. 42 This country has made several attempts to combat the epidemic, but now it seems that it takes more cohesive, prompt, and effective interventions to halt the spread of this virus, specifically among the most susceptible population. 73 Additionally, adequate and stable economic resources and the effective utilization of them are required. 74

Social distancing and travel restrictions were among the key methods used by Japan government to confront the recent crisis. 12 , 49 This country has successfully controlled the virus outbreak with a comparatively low casualty rate. 25

According to the epidemic control experts of Canada, the experiences with the SARS outbreak could positively affect Canada’s response to the epidemic of COVID-19, specifically in the field of facility preparation. However, the increased burden in hospitals and care settings due to the growing number of new cases might remain a key challenge. 56

Given the accelerated proliferation of the disease and the need to offer urgent care treatment to an increasing number of patients, the current COVID-19 outbreak in Italy has imposed a tremendous pressure on the healthcare system. 38 Although the Italian health system was highly equipped, and the government responded rapidly to the outbreak, this country was not prepared enough to deal with the COVID-19 epidemic, and the number of cases is still rising. This situation has led to several challenges for the healthcare system all over this country. It seems that more appropriate measures of team working, proactive planning, and training can provide a better support in coping with this epidemic. 24 In Italy, data on the prevalence of the disease in asymptomatic individuals were deficient. Therefore, the actual prevalence and precise mortality rate were unclear. In this case, more apparent and comprehensive data are also required to help decision-making and increase consciousness among the public. 75

Although some countries such as Spain and France have implemented of suitable control strategies including massive lockdown to combat the epidemic, 18 , 46 more real-time screening of the transmission and mortality are required to be prioritized in these countries. 76 In Spain, the government’s late response to the outbreak was the leading cause of its failure in controlling the disease. In addition, due to the financial crisis in this country, the hospitals have been experiencing an austere decade. 77 In France, the underlying reasons might be different; the French citizens tended to follow the national lockdown policies less firmly than other nations. 78

At the beginning of the epidemic, China led the virus transmission rate with the fastest pace of the spread, while in the next few weeks, other countries took over China. 79 As mentioned above, Italy and Spain confronted a remarkable increase in the number of confirmed cases and deaths. As on March 19, 2020, it was reported that Italy overtook China with more than 3400 deaths from the virus 80 and at the time of writing, United States has the highest total cases compared to other countries. 25 In the United States, the comparison between New York and California would be an excellent illustration of a rapid response. California, unlike New York, has successfully managed to curb the virus from spreading. Disease prevention experts believe that the most significant distinction between these two regions is not a matter of population or location, but the time people began staying at home, and distinctions in their social distancing approach. In general, New York has experienced nine times more number of cases, seven times higher number of hospitalized patients, and fourteen times more fatalities than California. 81

Although China was the first infected country with once the highest rate of confirmed cases and mortality, looking at its present statistics, it can currently be categorized as a successful country in controlling the disease with strengthened strategies and public health response. 25 The community was also well-informed on COVID-19’s significance to conform with the national approaches of mask-wearing, hand-washing, social distancing, and temperature screening. Additionally, by retaining a firm containment policy, China is seeking to restore usual social and economic activities. 30 However, in the early days of the epidemic, there were some failures and negligence, the government avoided identifying the epidemic and undermined its seriousness in the initial days. 82

Regarding management and investigative strategies, there has still been a remarkable unfamiliarity in many countries. In this case, international cooperation would be beneficial in controlling the pandemic, 83 and by screening the situation deeply, further knowledge about the new virus would be gained, and nations can respond better. 84 The most known measures to control and prevent the disease include finding suspected cases and their contacts, blocking the transmission of the virus by isolation and personal protection as well as managing the infection sources. 85 There are also some prediction models in which experts forecasted the positive impact of these plans on controlling COVID-19 infectious transmission. 86 More efficient clinical management of the infected patients in addition to public health preparedness 1 and a prompt and accurate screening of the epidemic are needed in all countries in order to succeed in managing the spread of the infection. 87


According to the results from the management decisions of some governments on quarantining, social isolation, and flight suspensions, it is highly assured that these strategies would be the successful techniques to confront the present pandemic due to the severity and anonymity of COVID-19. In addition to those strategies, some countries have focused more on the utilization of robust case detection and screening approaches. All in all, governments should enact serviceable laws and put in place timely and strict measures to halt the disease spread and diminish its unintended deadly consequences.


  1. Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020; 76:71-6. Publisher Full Text | DOI | PubMed
  2. Battegay M, Kuehl R, Tschudin-Sutter S, Hirsch HH, Widmer AF, Neher RA. 2019-novel Coronavirus (2019-nCoV): estimating the case fatality rate - a word of caution. Swiss Med Wkly. 2020; 150:w20203. DOI | PubMed
  3. Haider N, Yavlinsky A, Simons D, Osman AY, Ntoumi F, Zumla A. Passengers’ destinations from China: low risk of Novel Coronavirus (2019-nCoV) transmission into Africa and South America. Epidemiol Infect. 2020; 148:e41. Publisher Full Text | DOI | PubMed
  4. Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol. 2020; 92:479-90. DOI | PubMed
  5. NCBI [Internet]. LitCovid. [cited 2020 12 April]. Available from:
  6. Team C-NIRS. COVID-19, Australia: Epidemiology Report 6 (Reporting week ending 19:00 AEDT 7 March 2020). Commun Dis Intell (2018). 2020; 44. DOI | PubMed
  7. Team C-NIRS. COVID-19, Australia: Epidemiology Report 5 (Reporting week ending 19:00 AEDT 29 February 2020). Commun Dis Intell (2018). 2020; 44. DOI | PubMed
  8. Team C-NIRS. COVID-19, Australia: Epidemiology Report 4 (Reporting week ending 19:00 AEDT 22 February 2020). Commun Dis Intell (2018). 2020; 44. DOI | PubMed
  9. Team C-NIRS. COVID-19, Australia: Epidemiology Report 3 (Reporting week ending 19:00 AEDT 15 February 2020). Commun Dis Intell (2018). 2020; 44. DOI | PubMed
  10. Team C-NIRS. COVID-19, Australia: Epidemiology Report 2 (Reporting week ending 19:00 AEDT 8 February 2020). Commun Dis Intell (2018). 2020; 44. DOI | PubMed
  11. Patel A, Jernigan DB, nCo VCDCRT. Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69:140-6. Publisher Full Text | DOI | PubMed
  12. Nishiura H, Kobayashi T, Yang Y, Hayashi K, Miyama T, Kinoshita R. The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights. J Clin Med. 2020; 9Publisher Full Text | DOI | PubMed
  13. Spina S, Marrazzo F, Migliari M, Stucchi R, Sforza A, Fumagalli R. The response of Milan’s Emergency Medical System to the COVID-19 outbreak in Italy. Lancet. 2020; 395:e49-e50. Publisher Full Text | DOI | PubMed
  14. Chen S, Yang J, Yang W, Wang C, Barnighausen T. COVID-19 control in China during mass population movements at New Year. Lancet. 2020; 395:764-6. DOI | PubMed
  15. Jernigan DB, Team CC-R. Update: Public Health Response to the Coronavirus Disease 2019 Outbreak - United States, February 24, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69:216-9. DOI | PubMed
  16. Government of Canada [Internet]. Coronavirus disease (COVID-19): Outbreak update. [cited 2020 15 March]. Available from:
  17. Lee VJ, Chiew CJ, Khong WX. Interrupting transmission of COVID-19: lessons from containment efforts in Singapore. J Travel Med. 2020. . Publisher Full Text | DOI | PubMed
  18. Ghanchi A. Adaptation of the National Plan for the Prevention and Fight Against Pandemic Influenza to the 2020 COVID-19 epidemic in France. Disaster Med Public Health Prep. 2020;1-9. DOI | PubMed
  19. Sani G, Janiri D, Di Nicola M, Janiri L, Ferretti S, Chieffo D. Mental health during and after the COVID-19 emergency in Italy. Psychiatry Clin Neurosci. 2020. . DOI | PubMed
  20. Kidd M. Australia’s primary care COVID-19 response. Aust J Gen Pract. 2020; 49DOI | PubMed
  21. Kim S, Kim YJ, Peck KR, Jung E. School Opening Delay Effect on Transmission Dynamics of Coronavirus Disease 2019 in Korea: Based on Mathematical Modeling and Simulation Study. J Korean Med Sci. 2020; 35:e143. Publisher Full Text | DOI | PubMed
  22. Davarpanah AH, Mahdavi A, Sabri A, Langroudi TF, Kahkouee S, Haseli S. Novel Screening and Triage Strategy in Iran During Deadly Coronavirus Disease 2019 (COVID-19) Epidemic: Value of Humanitarian Teleconsultation Service. J Am Coll Radiol. 2020. . Publisher Full Text | DOI | PubMed
  23. Ohannessian R, Duong TA, Odone A. Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action. JMIR Public Health Surveill. 2020; 6:e18810. Publisher Full Text | DOI | PubMed
  24. Sorbello M, El-Boghdadly K, Di Giacinto I, Cataldo R, Esposito C, Falcetta S. The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice. Anaesthesia. 2020. . DOI | PubMed
  25. Worldometers [Internet]. COVID-19 Coronavirus pandemic. [cited 2020 10 April]. Available from:
  26. Anzai A, Kobayashi T, Linton NM, Kinoshita R, Hayashi K, Suzuki A. Assessing the Impact of Reduced Travel on Exportation Dynamics of Novel Coronavirus Infection (COVID-19). J Clin Med. 2020; 9. Publisher Full Text | DOI | PubMed
  27. Chen W, Wang Q, Li YQ, Yu HL, Xia YY, Zhang ML. [Early containment strategies and core measures for prevention and control of novel coronavirus pneumonia in China]. Zhonghua Yu Fang Yi Xue Za Zhi. 2020; 54:1-6. DOI | PubMed
  28. Du Z, Wang L, Cauchemez S, Xu X, Wang X, Cowling BJ. Risk for Transportation of 2019 Novel Coronavirus Disease from Wuhan to Other Cities in China. Emerg Infect Dis. 2020; 26. DOI | PubMed
  29. Loeb J. China bans sale of wildlife following coronavirus. Vet Rec. 2020; 186:144-5. DOI | PubMed
  30. Zhang S, Wang Z, Chang R, Wang H, Xu C, Yu X. COVID-19 containment: China provides important lessons for global response. Front Med. 2020. . DOI | PubMed
  31. Cyranoski D. What China’s coronavirus response can teach the rest of the world. Nature. 2020; 579:479-80. DOI | PubMed
  32. Chen S, Zhang Z, Yang J, Wang J, Zhai X, Barnighausen T. Fangcang shelter hospitals: a novel concept for responding to public health emergencies. Lancet. 2020. . DOI | PubMed
  33. Ruan L, Wen M, Zeng Q, Chen C, Huang S, Yang S. New measures for COVID-19 response: a lesson from the Wenzhou experience. Clin Infect Dis. 2020. . DOI | PubMed
  34. Grasselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response. JAMA. 2020. . DOI | PubMed
  35. Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020. . DOI | PubMed
  36. Carenzo L, Costantini E, Greco M, Barra FL, Rendiniello V, Mainetti M. Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia. 2020. . DOI | PubMed
  37. Paterlini M. Lockdown in Italy: personal stories of doing science during the COVID-19 quarantine. Nature. 2020. . DOI | PubMed
  38. Guzzetta G, Poletti P, Ajelli M, Trentini F, Marziano V, Cereda D. Potential short-term outcome of an uncontrolled COVID-19 epidemic in Lombardy, Italy, February to March 2020. Euro Surveill. 2020; 25. Publisher Full Text | DOI | PubMed
  39. Ministry of Health and Medical Education [Internet]. New traffic restrictions. [cited 2020 15 March]. Available from: Persian.
  40. Abdi M. Coronavirus disease 2019 (COVID-19) outbreak in Iran: Actions and problems. Infect Control Hosp Epidemiol. 2020;1-2. Publisher Full Text | DOI | PubMed
  41. Seddighi H. Trust in humanitarian aid from the earthquake 2017 to COVID-19 in Iran: A policy analysis. Disaster Med Public Health Prep. 2020;1-9. DOI | PubMed
  42. Raeisi A, Tabrizi JS, Gouya MM. IR of Iran National Mobilization against COVID-19 Epidemic. Arch Iran Med. 2020; 23:216-9. DOI | PubMed
  43. Moradzadeh R. The challenges and considerations of community-based preparedness at the onset of COVID-19 outbreak in Iran, 2020. Epidemiol Infect. 2020;1-6. DOI | PubMed
  44. Social distancing policies in Iran [Internet]. Government of Iran. [cited 2020 4 April]. Available from: Persian.
  45. La Moncloa [Internet]. President of the Government calls for political and public unity to overcome coronavirus emergency. [cited 2020 18 March]. Available from:
  46. The Guardian [Internet]. Spain orders non-essential workers stay home for two weeks. [cited 2020 28 March]. Available from:
  47. Shirato K, Nao N, Katano H, Takayama I, Saito S, Kato F. Development of Genetic Diagnostic Methods for Novel Coronavirus 2019 (nCoV-2019) in Japan. Jpn J Infect Dis. 2020. . DOI | PubMed
  48. Sawano T, Ozaki A, Rodriguez-Morales AJ, Tanimoto T, Sah R. Limiting spread of COVID-19 from cruise ships - lessons to be learnt from Japan. QJM. 2020. . Publisher Full Text | DOI | PubMed
  49. The Guardian [Internet]. Japan declares state of emergency over coronavirus. [cited 2020 7 April]. Available from:
  50. Bernard Stoecklin S, Rolland P, Silue Y, Mailles A, Campese C, Simondon A. First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020. Euro Surveill. 2020; 25. Publisher Full Text | DOI | PubMed
  51. Konrad R, Eberle U, Dangel A, Treis B, Berger A, Bengs K. Rapid establishment of laboratory diagnostics for the novel coronavirus SARS-CoV-2 in Bavaria, Germany, February 2020. Euro Surveill. 2020; 25. Publisher Full Text | DOI | PubMed
  52. Franve 24 [Internet]. Merkel announces strict measures, tells Germans to stay home in virus fight. [cited 2020 17 March]. Available from:
  53. The Politico [Internet]. Germany expands border controls for EU travelers, minister says. [cited 2020 19 March]. Available from:
  54. The Politico [Internet]. Germany’s Merkel bans meetings of more than 2 people to slow coronavirus. [cited 2020 22 March]. Available from:
  55. The Guardian [Internet]. Germany’s devolved logic is helping it win the coronavirus race. [cited 2020 5 April]. Available from:
  56. Webster P. Canada and COVID-19: learning from SARS. Lancet. 2020; 395:936-7. DOI | PubMed
  57. Government of Canada [Internet]. Canada’s COVID-19 Economic Response Plan. [cited 2020 12 April]. Available from:
  58. Wong J, Goh QY, Tan Z, Lie SA, Tay YC, Ng SY. Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anaesth. 2020. . Publisher Full Text | DOI | PubMed
  59. Liew MF, Siow WT, MacLaren G, See KC. Preparing for COVID-19: early experience from an intensive care unit in Singapore. Crit Care. 2020; 24:83. Publisher Full Text | DOI | PubMed
  60. Wong JEL, Leo YS, Tan CC. COVID-19 in Singapore-Current Experience: Critical Global Issues That Require Attention and Action. JAMA. 2020. . DOI | PubMed
  61. Singapore Government Agency Website [Internet]. Everything you need to know about Quarantine Orders. [cited 2020 25 March]. Available from:
  62. Singapore Government Agency Website [Internet]. COVID-19 Resources. [cited 2020 10 April]. Available from:
  63. Covid-19 National Emergency Response Center E, Case Management Team KCfDC, Prevention. Contact Transmission of COVID-19 in South Korea: Novel Investigation Techniques for Tracing Contacts. Osong Public Health Res Perspect. 2020; 11:60-3. Publisher Full Text | DOI | PubMed
  64. Ki M, Task Force for -nCo V. Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea. Epidemiol Health. 2020; 42:e2020007. DOI | PubMed
  65. Huh S. How to train the health personnel for protecting themselves from novel coronavirus (COVID-19) infection during their patient or suspected case care. J Educ Eval Health Prof. 2020; 17:10. DOI | PubMed
  66. Her M. How is COVID-19 affecting South Korea? What is our current strategy?. Disaster Med Public Health Prep. 2020;1-7. DOI | PubMed
  67. Moradi H, Vaezi A. Lessons Learned From Korea: Covid-19 Pandemic. Infect Control Hosp Epidemiol. 2020;1-5. DOI | PubMed
  68. Stokes DC. Senior Medical Students in the COVID-19 Response: An Opportunity to Be Proactive. Acad Emerg Med. 2020; 27:343-5. DOI | PubMed
  69. Team C-NIRS. COVID-19, Australia: Epidemiology Report 8 (Reporting period from 19:00 AEDT 14 March to 23:59 AEDT 22 March 2020). Commun Dis Intell (2018). 2020; 44. DOI | PubMed
  70. Han Q, Lin Q, Jin S, You L. Coronavirus 2019-nCoV: A brief perspective from the front line. J Infect. 2020; 80:373-7. Publisher Full Text | DOI | PubMed
  71. Xu C, Luo X, Yu C, Cao S-J. The 2019-nCoV epidemic control strategies and future challenges of building healthy smart cities. Indoor and Built Environment. 2020;1420326X20910408. DOI
  72. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020; 382:970-1. Publisher Full Text | DOI | PubMed
  73. Raoofi A, Takian A, Akbari Sari A, Olyaeemanesh A, Haghighi H, Aarabi M. COVID-19 Pandemic and Comparative Health Policy Learning in Iran. Arch Iran Med. 2020; 23:220-34. DOI | PubMed
  74. Zandifar A, Badrfam R. Fighting COVID-19 in Iran; Economic Challenges Ahead. Arch Iran Med. 2020; 23:284. DOI | PubMed
  75. Lazzerini M, Putoto G. COVID-19 in Italy: momentous decisions and many uncertainties. Lancet Glob Health. 2020. . Publisher Full Text | DOI | PubMed
  76. Yuan J, Li M, Lv G, Lu ZK. Monitoring Transmissibility and Mortality of COVID-19 in Europe. Int J Infect Dis. 2020. . Publisher Full Text | DOI | PubMed
  77. The Guardian [Internet]. How did Spain get its coronavirus response so wrong? [cited 2020 12 April]. Available from:
  78. Reuters [Internet]. France’s coronavirus death rate accelerates, cases near 100,000. [cited 2020 7 April]. Available from:
  79. VOX [Internet]. Matthews D. 11 charts that explain the coronavirus pandemic: [cited 2020 18 March]. Available from:
  80. The Guardian [Internet]. Italy death toll overtakes China with 3,405 deaths from virus. [cited 2020 19 March]. Available from:
  81. NBC bay area [Internet]. Difference Between COVID-19 Cases in CA vs. NY Is Likely Sheer Luck: Experts. [cited 2020 8 April]. Available from:
  82. Bouey J. Strengthening China’s Public Health Response System: From SARS to COVID-19. Am J Public Health. 2020;e1-e2. DOI | PubMed
  83. Khot WY, Nadkar MY. The 2019 Novel Coronavirus Outbreak - A Global Threat. J Assoc Physicians India. 2020; 68:67-71. PubMed
  84. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020; 55:105924. Publisher Full Text | DOI | PubMed
  85. Boldog P, Tekeli T, Vizi Z, Denes A, Bartha FA, Rost G. Risk Assessment of Novel Coronavirus COVID-19 Outbreaks Outside China. J Clin Med. 2020; 9. Publisher Full Text | DOI | PubMed
  86. Washington Post [Internet]. Why outbreaks like coronavirus spread exponentially, and how to “flatten the curve”. [cited 2020 14 March]. Available from:
  87. Chen X, Yu B. First two months of the 2019 Coronavirus Disease (COVID-19) epidemic in China: real-time surveillance and evaluation with a second derivative model. Glob Health Res Policy. 2020; 5:7. Publisher Full Text | DOI | PubMed