Objectives: Better understanding of the dynamics of the COVID-19 (2019-novel coronavirus disease) pandemic to curb its spread is now a global imperative. While travel restrictions and control measures have been shown to limit the spread of the disease spread, the effectiveness of the enforcement of those measures should depend on the strength of the government. Whether, and how, the government plays a role in fighting the disease, however, has not been investigated. Here, we show that government management capacities are critical for the containment of the disease.

Setting: We conduct a statistical analysis based on cross-city comparisons within China. China has undergone almost the entire cycle of the anti-coronavirus campaign, which allows us to trace the full dynamics of the outbreak, with homogeneity in standards for statistics recording.

Participants: Not available.

Primary and secondary outcome measures: Outcome measures include city-specific COVID-19 case incidence and recoveries in China.

Results: The containment of COVID-19 depends on the effectiveness of the enforcement of control measures, which in turn depends on the local government’s management capacities. Specifically, government efficiency, capacity for law enforcement, and the transparency of laws and policies significantly reduce COVID-19 prevalence and increase the likelihood of recoveries. The organization size of the government, which is not closely related to its capacity for management, has a limited role.

Trial registration: Not available.