Abstract
ABSTRACT Dynamic estimation of the reproduction number of COVID-19 is important for assessing the impact of public health measures on virus transmission. State and local decisions about whether to relax or strengthen mitigation measures are being made in part based on whether the reproduction number, Rt , falls below the self-sustaining value of 1. Employing branching point process models and COVID-19 data from Indiana as a case study, we show that estimates of the current value of Rt , and whether it is above or below 1, depend critically on choices about data selection and model specification and estimation. In particular, we find a range of Rt values from 0.47 to 1.20 as we vary the type of estimator and input dataset. We present methods for model comparison and evaluation and then discuss the policy implications of our findings.
Highlights
During the first months of 2020, nations responded to the COVID-19 pandemic by adopting a variety of public health interventions, including contact tracing, disease surveillance, and mandated social distancing (Pan et al 2020; Remuzzi and Remuzzi 2020; Walensky and del Rio 2020)
In the United States, direct public health authority is largely vested in states and localities, with local decision-makers playing a critical role in shaping public health responses and in deploying resources during times of crisis
The federal government, seeks to play a coordinating role through the Centers for Disease Control and Prevention (CDC), funds research through agencies such as the National Institutes of Health (NIH), and helps shape the regulatory environment through the Food and Drug Administration (FDA) and other agencies (Carpenter 2014; Sledge 2017; Gostin and Hodge 2020; Thomson and Nachlis 2020)
Summary
During the first months of 2020, nations responded to the COVID-19 pandemic by adopting a variety of public health interventions, including contact tracing, disease surveillance, and mandated social distancing (Pan et al 2020; Remuzzi and Remuzzi 2020; Walensky and del Rio 2020). The federal government, seeks to play a coordinating role through the Centers for Disease Control and Prevention (CDC), funds research through agencies such as the National Institutes of Health (NIH), and helps shape the regulatory environment through the Food and Drug Administration (FDA) and other agencies (Carpenter 2014; Sledge 2017; Gostin and Hodge 2020; Thomson and Nachlis 2020) While this system has the potential to be highly responsive and adaptive, it is prone to problems including divergent outcomes across political jurisdictions and difficulty coordinating responses to emergent events. In the absence of testing and of pharmaceutical interventions such as a vaccine or anti-viral therapies, social distancing measures (including shelter-in-place orders and mandated closure of nonessential businesses) emerged as the primary tool at the disposal of state and local decision-makers (Gostin and Wiley 2020)
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