Social Distancing Associations with COVID-19 Infection and Mortality Are Modified by Crowding and Socioeconomic Status.

Trang Vopham,Jaime E Hart,Gary Adamkiewicz,Matthew D Weaver

doi:10.3390/ijerph18094680

Abstract

The SARS-CoV-2 virus is a public health emergency. Social distancing is a key approach to slowing disease transmission. However, more evidence is needed on its efficacy, and little is known on the types of areas where it is more or less effective. We obtained county-level data on COVID-19 incidence and mortality during the first wave, smartphone-based average social distancing (0–5, where higher numbers indicate more social distancing), and census data on demographics and socioeconomic status. Using generalized linear mixed models with a Poisson distribution, we modeled associations between social distancing and COVID-19 incidence and mortality, and multiplicative interaction terms to assess effect modification. In multivariable models, each unit increase in social distancing was associated with a 26% decrease (p < 0.0001) in COVID-19 incidence and a 31% decrease (p < 0.0001) in COVID-19 mortality. Percent crowding, minority population, and median household income were all statistically significant effect modifiers. County-level increases in social distancing led to reductions in COVID-19 incidence and mortality but were most effective in counties with lower percentages of black residents, higher median household incomes, and with lower levels of household crowding.

Highlights

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus has emerged as a worldwide public health emergency
In multivariable-adjusted models, each unit increase in objective social distancing was associated with a 26% decrease in COVID-19 incidence and a 31%
In counties in the highest tertile of percent minority population (27.9–99.3%), increases in objective social distancing were not associated with COVID-19 incidence (IRR = 0.89; 95%CI: 0.77–1.04) or mortality (IRR = 0.98; 95%CI: 0.76–1.27)

Summary

Introduction

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus has emerged as a worldwide public health emergency. Social distancing remains one of the primary public health approaches to slowing disease transmission in the United. Through prohibiting social gatherings, closing non-essential business, and ordering people to stay at home—may reduce disease incidence [2,3], but it cannot be implemented without personal and economic consequences. In a study of 134 countries, lockdowns devised to increase social distancing were shown to reduce COVID-19 transmission. The same study observed proportional decreases in Google mobility metrics and COVID-19 transmission rates [4]. A study modeling the impacts of social distancing in the 25 counties in the United

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Discussion

Conclusion