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

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.

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.

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.

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.

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.