Abstract
The U.S. with only 4% of the world’s population, bears a disproportionate share of infections in the COVID-19 pandemic. To understand this puzzle, we investigate how mitigation strategies and compliance can work together (or in opposition) to reduce (or increase) the spread of COVID-19 infection. Building on the Oxford index, we create state-specific stringency indices tailored to U.S. conditions, to measure the degree of strictness of public mitigation measures. A modified time-varying SEIRD model, incorporating this Stringency Index as well as a Compliance Indicator is then estimated with daily data for a sample of 6 U.S. states: New York, New Hampshire, New Mexico, Colorado, Texas, and Arizona. We provide a simple visual policy tool to evaluate the various combinations of mitigation policies and compliance that can reduce the basic reproduction number to less than one, the acknowledged threshold in the epidemiological literature to control the pandemic. Understanding of this relationship by both the public and policy makers is key to controlling the pandemic. This tool has the potential to be used in a real-time, dynamic fashion for flexible policy options. Our methodology can be applied to other countries and has the potential to be extended to other epidemiological models as well. With this first step in attempting to quantify the factors that go into the “black box” of the transmission factor β, we hope that our work will stimulate further research in the dual role of mitigation policies and compliance.
Highlights
By July 31, 2020, the COVID-19 pandemic had resulted in 31.65 million infections and 971,711 deaths globally [1] with the U.S contributing 6.9 million cases, with 200,818 deaths
Our concern arose from the observation that states with similar community mitigation measures were experiencing very divergent trends in infection rates
In this paper we propose a simple modification to bring both mitigation policies and compliance into a standard epidemiological model and, in exploring their interaction, see the minimum levels of each that would lead each state studied to a point where the epidemic would die out
Summary
By July 31, 2020, the COVID-19 pandemic had resulted in 31.65 million infections and 971,711 deaths globally [1] with the U.S contributing 6.9 million cases, with 200,818 deaths. Though testing accelerated over the summer, on August 13, 2020, the U.S had an overall positivity rate (the percentage of tests conducted that are positive for COVID-19) of 7.5% [2], well above the upper bound recommended by the WHO (World Health Organization). Mitigation strategies and compliance in the COVID-19 fight is the U.S bearing such a disproportionate burden of infective cases when it has only 4.25% of the world’s population? On August 16, 2020, only 17 states had met the positivity recommendations [5]. The state disparities are a confusing mosaic of community mitigation strategies (with varying degrees of strictness) and diverse degrees of compliance by the public to such policies
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