A Public Value Crisis Model Approach to COVID-19 Outbreak Control in the Dominican Republic

Q: What was the main purpose of PlanDuarte in Duarte Province?

PlanDuarte aimed to control the early severe COVID-19 outbreak by integrating public-private collaboration, epidemiological intelligence, and community engagement under a “Public Value Crisis Model.”

Q: How did the study measure the impact of the intervention?

The researchers used Interrupted Time Series Analysis with segmented regression (Newey-West standard errors) and compared Duarte Province with all other provinces using daily COVID-19 data from March to December 2020.

Q: What epidemiological improvements were associated with PlanDuarte?

After implementation, the post-intervention trend in daily cases decreased significantly in Duarte, and improvements aligned with increased testing, expanded hospital capacity, and strengthened intersectoral coordination.

Sep 30, 2026

Uploaded by Lucas Martin

COVID-19 exposed critical vulnerabilities in health systems worldwide, and the Dominican Republic faced an early, severe outbreak in Duarte Province requiring rapid action. The government launched the localized “Public Value Crisis Model” (PlanDuarte), combining public-private collaboration, epidemiological intelligence, and community engagement. Interrupted Time Series Analysis (March–December 2020) compared Duarte with other provinces. Results showed reduced epidemic growth after implementation alongside increased testing, expanded hospital capacity, and stronger coordination, indicating temporal association rather than definitive causality.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Objective

Methods

Results

Conclusion

Introduction

Review began 10/13/2025 Review ended 11/25/2025 Published 12/08/2025 © Copyright 2025 Baez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98766 Open Access Original Article A Public Value Crisis Model Approach to COVID- 19 Outbreak Control in the Dominican Republic Amado A. Baez 1, 2 , Robert Paulino 3, Carlos Ruiz-Matuk 3, Ingrid Ruiz 3 , Erick Sanchez 3 1. Research, Universidad Nacional Pedro Henríquez Ureña, Santo Domingo, DOM 2. Emergency Medicine, Augusta University Medical College of Georgia, Augusta, USA 3. Tropical Medicine Institute, La Universidad Iberoamericana (UNIBE), Santo Domingo, DOM Corresponding author: Amado A. Baez, [aabaezmd@gmail.com](aabaezmd@gmail.com) Abstract Background: COVID-19 exposed critical vulnerabilities in health systems worldwide. The Dominican Republic faced an early and severe outbreak in Duarte Province, necessitating rapid action. The government implemented a localized “Public Value Crisis Model,” known as \#PlanDuarte, integrating public-private collaboration, epidemiological intelligence, and community engagement. Objective: To evaluate whether \#PlanDuarte was associated with measurable epidemiological improvements using Interrupted Time Series Analysis (ITSA), and to examine how public value principles informed crisis governance. Methods: We analyzed daily COVID-19 data from March to December 2020 using segmented regression with Newey-West standard errors. Duarte Province (intervention site) was compared with all other provinces (non-intervention group) . Data sources included the Ministry of Public Health registry. We assessed changes in trends for daily new cases following the lockdown and the implementation of public value-driven actions. Results: Prior to the intervention, Duarte experienced a significant daily increase in cases (β1 = 0.88, p < 0.001) . Following implementation, the post-intervention trend decreased significantly (β3 = -1.63, p < 0.001), unlike the non-intervention provinces. Epidemiological improvements corresponded with increased testing, expanded hospital capacity, and strengthened intersectoral coordination. Conclusion: The intervention in Duarte Province was associated with reduced epidemic growth and strengthened system responsiveness. Rooted in public value theory, \#PlanDuarte illustrates how coordinated, community-empowering governance structures can improve crisis outcomes. Results reflect temporal association rather than definitive causality and underscore the need for context-sensitive governance in middle-income settings. Categories: Health Policy, Epidemiology/Public Health, Public Health Keywords: covid-19, dominican republic, health policy making, outbreak control, public value crisis model Introduction Emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) following a cluster of unexplained pneumonia in the city of Wuhan, China, in the late months of 2019 [1] provoked an unprecedented global health impact. Later, on January 30, 2020, the World Health Organization (WHO) declared the outbreak a public health emergency of international concern (PHEIC) and produced the first guidelines for country preparation and response plans, focused on detection, preparation, and rapid response to the outbreak [2] . These guidelines, along with the first sequences and laboratory assays, were delivered to all regional offices [2,3] . COVID-19 posed an unprecedented public health challenge for the Dominican Republic (DR), exposing gapsin surveillance, hospital capacity, interagency coordination, and community engagement. Duarte Province quickly became the country’s earliest epicenter, prompting the implementation of \#PlanDuarte, a targeted“Public Value Crisis Model” interventio

FAQs

What was the main purpose of PlanDuarte in Duarte Province?

PlanDuarte aimed to control the early severe COVID-19 outbreak by integrating public-private collaboration, epidemiological intelligence, and community engagement under a “Public Value Crisis Model.”

How did the study measure the impact of the intervention?

The researchers used Interrupted Time Series Analysis with segmented regression (Newey-West standard errors) and compared Duarte Province with all other provinces using daily COVID-19 data from March to December 2020.

What epidemiological improvements were associated with PlanDuarte?

After implementation, the post-intervention trend in daily cases decreased significantly in Duarte, and improvements aligned with increased testing, expanded hospital capacity, and strengthened intersectoral coordination.

Sep 30, 2026

Uploaded by Lucas Martin