Abstract
BackgroundThe novel coronavirus disease 2019 (COVID-19) sickened over 20 million residents in the United States (US) by January 2021. Our objective was to describe state variation in the effect of initial social distancing policies and non-essential business (NEB) closure on infection rates early in 2020.MethodsWe used an interrupted time series study design to estimate the total effect of all state social distancing orders, including NEB closure, shelter-in-place, and stay-at-home orders, on cumulative COVID-19 cases for each state. Data included the daily number of COVID-19 cases and deaths for all 50 states and Washington, DC from the New York Times database (January 21 to May 7, 2020). We predicted cumulative daily cases and deaths using a generalized linear model with a negative binomial distribution and a log link for two models.ResultsSocial distancing was associated with a 15.4% daily reduction (Relative Risk = 0.846; Confidence Interval [CI] = 0.832, 0.859) in COVID-19 cases. After 3 weeks, social distancing prevented nearly 33 million cases nationwide, with about half (16.5 million) of those prevented cases among residents of the Mid-Atlantic census division (New York, New Jersey, Pennsylvania). Eleven states prevented more than 10,000 cases per 100,000 residents within 3 weeks.ConclusionsThe effect of social distancing on the infection rate of COVID-19 in the US varied substantially across states, and effects were largest in states with highest community spread.
Highlights
The novel coronavirus disease 2019 (COVID-19) sickened over 20 million residents in the United States (US) by January 2021
We used an interrupted time series (ITS) quasiexperimental study design to evaluate the total effects of social distancing policies implemented between January 21 and May 7, 2020, using non-essential business (NEB) and public school closures as the key implementation markers [10]
States had an average of 1778.6 COVID-19 cases and 30.5 related deaths on the date of NEB closure
Summary
The novel coronavirus disease 2019 (COVID-19) sickened over 20 million residents in the United States (US) by January 2021. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic, which sickened over 20 million residents and caused over 370,000 deaths in the United States (US) by January 2021 [1, 2] This highly contagious, novel disease has a high case fatality rate in highrisk populations, and can cause severe morbidity and high healthcare resource use. Kaufman et al BMC Public Health (2021) 21:1239 schools and non-essential business (NEB) closure, and shelter in place or stay at home orders [4] These social distancing and mitigation policies changed behavior, reduced mobility and gathering, which reduced the opportunities for the virus to spread from person to person. The effectiveness of social distancing orders in mitigation community transmission has been well established [4, 6, 7]
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