IDEAS home Printed from https://ideas.repec.org/a/eee/chieco/v93y2025ics1043951x25001452.html

Did early diagnostic confirmation save lives during the COVID-19 pandemic? Evidence from China

Author

Listed:
  • Chen, Simiao
  • Jin, Zhangfeng
  • Bärnighausen, Till
  • Bloom, David E.

Abstract

This paper investigates the impact of early diagnostic confirmation on the COVID-19 pandemic in a developing country. Using a dataset of the first laboratory-confirmed cases across Chinese cities and an instrumental variable strategy to address endogeneity, we show that reducing the time to publicly confirm the first case in a city by one day led to reductions of 9.4 % in COVID-19 prevalence and 12.7 % in mortality over the subsequent six months. The impact was more pronounced in cities farther from the COVID-19 epicenter, with lower migration exposure, more responsive public health systems, and lower health system capacity utilization. Enhanced social distancing and a less overstressed health system likely drove these effects. Our findings underscore the importance of allocating resources to improve diagnostic technologies; strengthening public health emergency response systems to test for, diagnose, and announce cases of infection; and acting swiftly when facing a potential outbreak.

Suggested Citation

  • Chen, Simiao & Jin, Zhangfeng & Bärnighausen, Till & Bloom, David E., 2025. "Did early diagnostic confirmation save lives during the COVID-19 pandemic? Evidence from China," China Economic Review, Elsevier, vol. 93(C).
    • Handle: RePEc:eee:chieco:v:93:y:2025:i:c:s1043951x25001452
    DOI: 10.1016/j.chieco.2025.102487
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1043951X25001452
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.chieco.2025.102487?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Sascha O. Becker & Ludger Woessmann, 2009. "Was Weber Wrong? A Human Capital Theory of Protestant Economic History," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 531-596.
    2. Fernando Alvarez & David Argente, 2020. "A Simple Planning Problem for COVID-19 Lockdown," Working Papers 2020-34, Becker Friedman Institute for Research In Economics.
    3. Yun Qiu & Xi Chen & Wei Shi, 2020. "Impacts of social and economic factors on the transmission of coronavirus disease 2019 (COVID-19) in China," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(4), pages 1127-1172, October.
    4. Daron Acemoglu & Victor Chernozhukov & Iván Werning & Michael D. Whinston, 2021. "Optimal Targeted Lockdowns in a Multigroup SIR Model," American Economic Review: Insights, American Economic Association, vol. 3(4), pages 487-502, December.
    5. Fang, Hanming & Wang, Long & Yang, Yang, 2020. "Human mobility restrictions and the spread of the Novel Coronavirus (2019-nCoV) in China," Journal of Public Economics, Elsevier, vol. 191(C).
    6. Jay J. Van Bavel & Katherine Baicker & Paulo S. Boggio & Valerio Capraro & Aleksandra Cichocka & Mina Cikara & Molly J. Crockett & Alia J. Crum & Karen M. Douglas & James N. Druckman & John Drury & Oe, 2020. "Using social and behavioural science to support COVID-19 pandemic response," Nature Human Behaviour, Nature, vol. 4(5), pages 460-471, May.
    7. Nathan Nunn & Leonard Wantchekon, 2011. "The Slave Trade and the Origins of Mistrust in Africa," American Economic Review, American Economic Association, vol. 101(7), pages 3221-3252, December.
    8. Daniel E. Ho & Zoe C. Ashwood & Cassandra Handan-Nader, 2019. "New Evidence on Information Disclosure through Restaurant Hygiene Grading," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 404-428, November.
    9. Daron Acemoglu & Victor Chernozhukov & Iván Werning & Michael D. Whinston, 2021. "Optimal Targeted Lockdowns in a Multigroup SIR Model," American Economic Review: Insights, American Economic Association, vol. 3(4), pages 487-502, December.
    10. Ginger Zhe Jin & Phillip Leslie, 2003. "The Effect of Information on Product Quality: Evidence from Restaurant Hygiene Grade Cards," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 118(2), pages 409-451.
    11. José Luis Montiel Olea & Carolin Pflueger, 2013. "A Robust Test for Weak Instruments," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 31(3), pages 358-369, July.
    12. Briscese, Guglielmo & Lacetera, Nicola & Macis, Mario & Tonin, Mirco, 2020. "Compliance with COVID-19 Social-Distancing Measures in Italy: The Role of Expectations and Duration," IZA Discussion Papers 13092, IZA Network @ LISER.
    13. repec:rza:wpaper:826 is not listed on IDEAS
    14. Ginger Zhe Jin & Phillip Leslie, 2019. "New Evidence on Information Disclosure through Restaurant Hygiene Grading: Reply," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 429-443, November.
    15. Martin Fiszbein & Yeonha Jung & Dietrich Vollrath, 2022. "Agrarian Origins of Individualism and Collectivism," NBER Working Papers 29643, National Bureau of Economic Research, Inc.
    16. Jérôme Adda, 2016. "Economic Activity and the Spread of Viral Diseases: Evidence from High Frequency Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(2), pages 891-941.
    17. Nakamura, Alice & Nakamura, Masao, 1981. "On the Relationships among Several Specification Error Tests Presented by Durbin, Wu, and Hausman," Econometrica, Econometric Society, vol. 49(6), pages 1583-1588, November.
    18. Andrey Simonov & Szymon Sacher & Jean-Pierre Dube & Shirsho Biswas, 2020. "The Persuasive Effect of Fox News: Non-Compliance with Social Distancing During the COVID-19 Pandemic," Working Papers 2020-67, Becker Friedman Institute for Research In Economics.
    19. Pierre Nouvellet & Tini Garske & Harriet L. Mills & Gemma Nedjati-Gilani & Wes Hinsley & Isobel M. Blake & Maria D. Van Kerkhove & Anne Cori & Ilaria Dorigatti & Thibaut Jombart & Steven Riley & Chris, 2015. "The role of rapid diagnostics in managing Ebola epidemics," Nature, Nature, vol. 528(7580), pages 109-116, December.
    20. James B. Ang, 2019. "Agricultural legacy and individualistic culture," Journal of Economic Growth, Springer, vol. 24(4), pages 397-425, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Chen, Simiao & Jin, Zhangfeng & Bloom, David E., 2020. "Act Early to Prevent Infections and Save Lives: Causal Impact of Diagnostic Efficiency on the COVID-19 Pandemic," IZA Discussion Papers 13749, IZA Network @ LISER.
    2. Victor Aguirregabiria & Jiaying Gu & Yao Luo & Pedro Mira, 2020. "A Dynamic Structural Model of Virus Diffusion and Network Production: A First Report," Working Papers wp2020_2014, CEMFI.
    3. Xiao Chen & Hanwei Huang & Jiandong Ju & Ruoyan Sun & Jialiang Zhang, 2022. "Endogenous cross-region human mobility and pandemics," CEP Discussion Papers dp1860, Centre for Economic Performance, LSE.
    4. Hakan Yilmazkuday, 2021. "Welfare costs of COVID‐19: Evidence from US counties," Journal of Regional Science, Wiley Blackwell, vol. 61(4), pages 826-848, September.
    5. Chernozhukov, Victor & Kasahara, Hiroyuki & Schrimpf, Paul, 2021. "Causal impact of masks, policies, behavior on early covid-19 pandemic in the U.S," Journal of Econometrics, Elsevier, vol. 220(1), pages 23-62.
    6. Leonardo Bursztyn & Aakaash Rao & Christopher Roth & David Yanagizawa-Drott, 2020. "Misinformation During a Pandemic," Working Papers 2020-44, Becker Friedman Institute for Research In Economics.
    7. Chen, Xiaoguang & Huang, Hanwei & Ju, Jiandong & Sun, Ruoyan & Zhang, Jialiang, 2024. "Endogenous mobility in pandemics: theory and evidence from the United States," LSE Research Online Documents on Economics 126830, London School of Economics and Political Science, LSE Library.
    8. Jacek Rothert & Ryan Brady & Michael Insler, 2020. "Local containment policies and country-wide spread of Covid-19 in the United States: an epidemiological analysis," GRAPE Working Papers 48, GRAPE Group for Research in Applied Economics.
    9. Mauro Caselli & Andrea Fracasso & Sergio Scicchitano, 2020. "From the lockdown to the new normal: An analysis of the limitations to individual mobility in Italy following the Covid-19 crisis," Discussion Paper series in Regional Science & Economic Geography 2020-07, Gran Sasso Science Institute, Social Sciences, revised Oct 2020.
    10. Krzysztof Zaremba, 2023. "Opening of hotels and ski facilities: Impact on mobility, spending, and Covid‐19 outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1148-1180, May.
    11. Li, Jingjing & Zhuang, Chu & Zou, Wei, 2024. "A tale of lockdown policies on the transmission of COVID-19 within and between Chinese cities: A study based on heterogeneous treatment effect," Economics & Human Biology, Elsevier, vol. 53(C).
    12. Jesus Fernandez-Villaverde & Charles I. Jones, 2020. "Macroeconomic Outcomes and COVID-19: A Progress Report," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 51(3 (Fall)), pages 111-166.
    13. Nicholas W. Papageorge & Matthew V. Zahn & Michèle Belot & Eline Broek-Altenburg & Syngjoo Choi & Julian C. Jamison & Egon Tripodi, 2021. "Socio-demographic factors associated with self-protecting behavior during the Covid-19 pandemic," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(2), pages 691-738, April.
    14. Jacek Rothert & Ryan Brady & Michael Insler, 2020. "The Fragmented United States of America: The impact of scattered lock-down policies on country-wide infections," Departmental Working Papers 65, United States Naval Academy Department of Economics.
    15. Difang Huang & Ying Liang & Boyao Wu & Yanyi Ye, 2024. "Estimating the Impact of Social Distance Policy in Mitigating COVID-19 Spread with Factor-Based Imputation Approach," Papers 2405.12180, arXiv.org.
    16. Yakubenko, Slava, 2021. "Home alone? Effect of weather-induced behaviour on spread of SARS-CoV-2 in Germany," Economics & Human Biology, Elsevier, vol. 42(C).
    17. Hakan Yilmazkuday, 2021. "Welfare Costs of Travel Reductions within the U.S. due to COVID-19," Working Papers 2114, Florida International University, Department of Economics.
    18. Kumar, Anand & Priya, Bhawna & Srivastava, Samir K., 2021. "Response to the COVID-19: Understanding implications of government lockdown policies," Journal of Policy Modeling, Elsevier, vol. 43(1), pages 76-94.
    19. Louis-Philippe Beland & Abel Brodeur & Taylor Wright, 2020. "COVID-19, Stay-at-Home Orders and Employment: Evidence from CPS Data," Carleton Economic Papers 20-04, Carleton University, Department of Economics, revised 19 May 2020.
    20. Nicola Fuchs-Schündeln & Dirk Krueger & André Kurmann & Etienne Lalé & Alexander Ludwig & Irina Popova, 2023. "The Fiscal and Welfare Effects of Policy Responses to the Covid-19 School Closures," IMF Economic Review, Palgrave Macmillan;International Monetary Fund, vol. 71(1), pages 35-98, March.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:chieco:v:93:y:2025:i:c:s1043951x25001452. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/chieco .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.