Insights into the developing countries’ inappropriate responses to COVID-19: A Randomised Controlled Trial analytical framework

The trade-off between the health and the economic stakes associated with tackling COVID-19 with or without lockdowns in developed countries is trickier in developing countries as, for them, both concern saving human lives. Therefore, the question of the appropriate policy between locking or not locking down should boil down to detect the one with the lower opportunity cost in terms of the expected number of deaths. Therefore, this paper had the major goal of assessing the appropriateness of lockdowns decided in most developing countries in response to the COVID-19 pandemic. As a method, it resorts to the Randomised Controlled Trial analytical framework taking DRC as a case study and the response to the Ebola epidemic as the counterfactual to that of the COVID-19 pandemic. Besides the introduction and the conclusion, first and last sections, the investigation is done and presented in five major sections.

The second section mainly indicates that DRC faces simultaneously many deadly endemics and epidemics and that has created a resource competition. The outbreak of a new dangerous epidemic, as COVID-19, diverts important national and international resources and attention from its predecessor and other endemics and hence indirectly takes lives which could be saved by the diverted resources and attention.

Considering the socio-economic precariousness in which the majority of the population lives in DRC and the unstable financial situation of corporates, the third section finds that putting people in lockdown without any financial or food support amounts pushing them to entirely spend the meagre capital they have in few days and gradually die from malnutrition and hunger.

Drawing on similarities between the 2018–2020 outbreak of Ebola and that of COVID-19, the fourth section shows that the trancing and isolating method used in response to the former is a good counterfactual of the lockdown used in response to the latter. The analysis of the possible sources of bias indicates that none of them is susceptible to bias the assessment towards an underestimation of the effectiveness of the lockdown. Some may bias the assessment toward an overestimation of its effectiveness. Consequently, a result suggesting ineffectiveness is robust to most of the possible biases but a result suggesting effectiveness is not.

Using the 2018–2020 outbreak of the Ebola epidemic as counterfactual, the fifth section shows that the COVID-19’s inter-regional transmissions with or without resorting to a lockdown and quarantines are not significantly different. Furthermore, with or without lockdowns and quarantines, intra-regional transmissions are high but controllable up to a full eradication.

The sixth section indicates that analysis is extendable to any country having, like DRC, the majority of its population under the age of a significant risk of getting complications and die in case of infection to the COVID-19 and facing, as in DRC, precarious economic and financial situations. The two conditions are met in most developing countries and not in developed countries.

As a conclusion, the study indicates that the lockdown has been an inappropriate response to COVID-19 in DRC: the number of lives we estimate it has saved is insignificant compared to that of lives we estimate it has taken just by deepening malnutrition and hunger and diverting resources and attention from other deadly epidemics and endemics. The core arguments and results are consistent with the situations in most developing countries but not with those of developed countries. Consequently, these lives we expect lockdowns to take concern mostly the poorer in poor countries. This is an alarming result as they may suffer and die more and longer during the post-COVID-19 economic crisis if they are not adequately rescued by domestic governments and the international community.

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