Abstract
As the on-going severe acute respiratory syndrome coronavirus 2 pandemic, we aimed to understand whether economic reopening (EROP) significantly influenced coronavirus disease 2019 (COVID-19) incidence. COVID-19 data from Texas Health and Human Services between March and August 2020 were analysed. COVID-19 incidence rate (cases per 100 000 population) was compared to statewide for selected urban and rural counties. We used joinpoint regression analysis to identify changes in trends of COVID-19 incidence and interrupted time-series analyses for potential impact of state EROP orders on COVID-19 incidence. We found that the incidence rate increased to 145.1% (95% CI 8.4-454.5%) through 4th April, decreased by 15.5% (95% CI -24.4 -5.9%) between 5th April and 30th May, increased by 93.1% (95% CI 60.9-131.8%) between 31st May and 11th July and decreased by 13.2% (95% CI -22.2 -3.2%) after 12 July 2020. The study demonstrates the EROP policies significantly impacted trends in COVID-19 incidence rates and accounted for increases of 129.9 and 164.6 cases per 100 000 populations for the 24- or 17-week model, respectively, along with other county and state reopening ordinances. The incidence rate decreased sharply after 12th July considering the emphasis on a facemask or covering requirement in business and social settings.
Highlights
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an on-going pandemic
Available data on COVID-19 consisting of the total number of cases, recovered cases and dead cases for Smith County and other comparative counties were extracted from the websites of the Texas Health and Human Services (DSHS) COVID-19 Data [17] and standardised new confirmed COVID-19 cases to county population using the U.S Census Bureau data for Smith County with an estimated population of 232 751 persons based on U.S Census on 1 July 2019 [18]
The primary measure of interest was the incidence rate of the COVID-19 defined as number of COVID-19 cases per 100 000 person-week between 15 March 2020 and 29 August 2020 (24 weeks) with numerators defined by the number of new COVID-19 cases in the respective calendar weeks and denominators by the total population at risk in the corresponding week
Summary
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an on-going pandemic. The first COVID-19 case in the U.S was detected on 20 January 2020 in Washington State and was traced to Wuhan, China where initial cases were reported [1, 2]. COVID-19 cases have increased exponentially with human-to-human transmission mode in close unprotected contacts [2, 3]. In the U.S, approximately 6 million confirmed cases and more than 182 thousand deaths have been reported since the first U.S COVID-19 outbreak [4]. Non-pharmaceutical interventions such as early detection and quarantines, travel bans or movement management and restriction on public gatherings, have been reported as effective strategies to prevent or reduce COVID-19 transmission for ‘flatten the curve’ of the pandemic in the outbreak in China and other countries at risk globally [3, 5,6,7]
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