The Impact of Strict Public Health Measures on COVID-19 Transmission in Developing Countries: The Case of Kuwait

Background: Many countries have succeeded in curbing the initial outbreak of COVID-19 by imposing strict public health control measures. However, little is known about the effectiveness of such control measures in curbing the outbreak in developing countries. In this study, we seek to assess the impact of various outbreak control measures in Kuwait to gain more insight into the outbreak progression and the associated healthcare burden. Methods: We use a SEIR mathematical model to simulate the first wave of the epidemic outbreak of COVID-19 in Kuwait with additional testing and hospitalization compartments. We calibrate our model by using a NBD observational framework for confirmed case and death counts. We simulate trajectories of model forecasts and assess the effectiveness of public health interventions by using maximum likelihood to estimate both the basic and effective reproduction numbers. Results: Our results indicate that the early strict control measures had the effect of delaying the intensity of the outbreak but were unsuccessful in reducing the effective reproduction number below 1. Forecasted model trajectories suggest a need to expand the healthcare system capacity to cope with the associated epidemic burden of such ineffectiveness. Conclusion: Strict public health interventions may not always lead to the same desired outcomes, particularly when population and demographic factors are not accounted for as in the case in some developing countries. Real-time dynamic modeling can provide an early assessment of the impact of such control measures as well as a forecasting tool to support outbreak surveillance and the associated healthcare expansion planning.