Exploratory Study of Determinants of the Spread of COVID-19 before Shelter-in-Place Orders
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ABSTRACT:
SUBMITTER: Yoo C
PROVIDER: S-EPMC10149509 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
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Project description:State "shelter-in-place" (SIP) orders limited the spread of COVID-19 in the U.S. However, impacts may have varied by state, creating opportunities to learn from states where SIPs have been effective. Using a novel dataset of state-level SIP order enactment and county-level mobility data form Google, we use a stratified regression discontinuity study design to examine the effect of SIPs in all states that implemented them. We find that SIP orders reduced mobility nationally by 12 percentage points (95% CI: -13.1 to -10.9), however the effects varied substantially across states, from -35 percentage points to +11 percentage points. Larger reductions were observed in states with higher incomes, higher population density, lower Black resident share, and lower 2016 vote shares for Donald J. Trump. This suggests that optimal public policies during a pandemic will vary by state and there is unlikely to be a "one-size fits all" approach that works best.
| S-EPMC7775080 | biostudies-literature
Project description:One of the most common policy prescriptions to reduce the spread of COVID-19 has been to legally enforce social distancing through shelter-in-place orders (SIPOs). This study examines the role of localized urban SIPO policy in curbing COVID-19 cases. Specifically, we explore (i) the comparative effectiveness of county-level SIPOs in urbanized as compared to non-urbanized areas, (ii) the mechanisms through which SIPO adoption in urban counties yields COVID-related health benefits, and (iii) whether late adoption of a statewide SIPO yields health benefits beyond those achieved from early adopting counties. We exploit the unique laboratory of Texas, a state in which the early adoption of local SIPOs by densely populated counties covered almost two-thirds of the state's population prior to adoption of a statewide SIPO on April 2, 2020. Using an event study framework, we document that countywide SIPO adoption is associated with an 8 percent increase in the percent of residents who remain at home full-time and between a 13 to 19 percent decrease in foot-traffic at venues that may contribute to the spread of COVID-19 such as restaurants, bars, hotels, and entertainment venues. These social distancing effects are largest in urbanized and densely populated counties. Then, we find that in early adopting urban counties, COVID-19 case growth fell by 21 to 26 percentage points two-and-a-half weeks following adoption of a SIPO, a result robust to controls for county-level heterogeneity in COVID-19 outbreak timing, coronavirus testing, the age distribution, and political preferences. We find that approximately 90 percent of the curbed growth in COVID-19 cases in Texas came from the early adoption of SIPOs by urbanized counties, suggesting that the later statewide shelter-in-place mandate yielded relatively few health benefits.
| S-EPMC7647451 | biostudies-literature
Project description:This study explores the impact of Shelter-in-Place Orders (SIPOs) on health, with attention to heterogeneity in their impacts. First, using daily state-level social distancing data, we document that adoption of a SIPO was associated with a 9%-10% increase in the rate at which state residents remained in their homes full-time. Using daily state-level coronavirus case data, we find that approximately 3 weeks following the adoption of a SIPO, cumulative COVID-19 cases fell by approximately 53.5%. However, this average effect masks important heterogeneity across states-early adopters and high population density states appear to reap larger benefits from their SIPOs. (JEL H75, I12, I18).
| S-EPMC7436765 | biostudies-literature
Project description:Background/objectivesPhysical distancing during the COVID-19 pandemic may have unintended, detrimental effects on social isolation and loneliness among older adults. Our objectives were to investigate (1) experiences of social isolation and loneliness during shelter-in-place orders, and (2) unmet health needs related to changes in social interactions.DesignMixed-methods longitudinal phone-based survey administered every 2 weeks.SettingTwo community sites and an academic geriatrics outpatient clinical practice.ParticipantsA total of 151 community-dwelling older adults.MeasurementsWe measured social isolation using a six-item modified Duke Social Support Index, social interaction subscale, that included assessments of video-based and Internet-based socializing. Measures of loneliness included self-reported worsened loneliness due to the COVID-19 pandemic and loneliness severity based on the three-item University of California, Los Angeles (UCLA) Loneliness Scale. Participants were invited to share open-ended comments about their social experiences.ResultsParticipants were on average aged 75 years (standard deviation = 10), 50% had hearing or vision impairment, 64% lived alone, and 26% had difficulty bathing. Participants reported social isolation in 40% of interviews, 76% reported minimal video-based socializing, and 42% minimal Internet-based socializing. Socially isolated participants reported difficulty finding help with functional needs including bathing (20% vs 55%; P = .04). More than half (54%) of the participants reported worsened loneliness due to COVID-19 that was associated with worsened depression (62% vs 9%; P < .001) and anxiety (57% vs 9%; P < .001). Rates of loneliness improved on average by time since shelter-in-place orders (4-6 weeks: 46% vs 13-15 weeks: 27%; P = .009), however, loneliness persisted or worsened for a subgroup of participants. Open-ended responses revealed challenges faced by the subgroup experiencing persistent loneliness including poor emotional coping and discomfort with new technologies.ConclusionMany older adults are adjusting to COVID-19 restrictions since the start of shelter-in-place orders. Additional steps are critically needed to address the psychological suffering and unmet medical needs of those with persistent loneliness or barriers to technology-based social interaction.
| S-EPMC7536935 | biostudies-literature
Project description:BackgroundPolicies implemented to slow transmission of COVID-19 are expected to have disrupted delivery of routine health services, including tuberculosis (TB) care.MethodsWe analyzed daily counts of drug-susceptible (DS)-TB case notifications from all health facilities affiliated with the Philippines National TB Program (NTP) before and after implementation of community quarantine (January 1-December 31, 2020). Using an interrupted time series design, we assessed the immediate and sustained effects of community quarantine on TB case reporting. Using 2019 WHO estimates of national TB incidence, treatment, and mortality rates for the Philippines, we modeled excess mortality from TB, assuming a national decline in TB case reporting were extended for 12 months, followed by a return to pre-community quarantine trends.ResultsThe analysis included 192,918 DS-TB case notifications from 2,986 facilities located in 113 provinces and highly urbanized cities across 17 regions and covered 49 observations days before and 174 days after community quarantine implementation. We found an significant drop and steeper decline in daily TB case notifications after the implementation of community quarantine, resulting in 44.6% (95% CI 38.3-50.1) fewer daily TB case notifications 60 days after implementation of community quarantine. During 2020, DS-TB case notifications never returned to pre-quarantine levels. Assuming a 12-month disruption of TB case reporting, we estimate there will be 56.3% increase in TB-related deaths in the Philippines.ConclusionModified delivery of TB prevention and care should be prioritized alongside efforts to combat COVID-19.
| S-EPMC8519831 | biostudies-literature
Project description:ImportancePublic health initiatives that include shelter-in-place orders are expensive and unpopular. Demonstrating the success of these initiatives is essential to justify their systemic or individual cost.ObjectiveTo examine the association of a shelter-in-place order with lower rates of seasonal respiratory viral activity.Design, setting, and participantsThis cohort study with interrupted time series analysis obtained monthly counts of respiratory virus testing results at UC Davis Health from August 1, 2014, to July 31, 2020. Patients of all ages underwent testing conducted by the laboratory at UC Davis Health, a referral center for a 65 000-square-mile area that includes 33 counties and more than 6 million Northern California residents.ExposuresA statewide shelter-in-place order was instituted on March 19, 2020, restricting residents to their homes except for traveling for essential activities. Large social gatherings were prohibited, schools were closed, and nonessential personnel worked remotely. Those who had to leave their homes were mandated to wear face masks, engage in frequent handwashing, and maintain physical distancing.Main outcomes and measuresPositivity rates of common respiratory viruses within the community served by UC Davis Health.ResultsA total of 46 128 tests for viral respiratory pathogens over a 6-year period were included in the analysis. For the postexposure period (March 25-July 31), approximately 168 positive test results occurred for the studied organisms in the 2020 virus year, a positivity rate of 9.88 positive results per 100 tests that was much lower than the positivity rate of 29.90 positive results per 100 tests observed for this date range in the previous 5 virus years. In contrast, the positivity rates were similar for the preexposure time frame (August 1-March 24) in the 2020 virus year and for the same time periods in the 5 previous years (30.40 vs 33.68 positive results per 100 tests). In the regression analyses, statistically significant decreases in viral activity were observed in the postexposure period for influenza (93% decrease; incidence rate ratio [IRR], 0.07; 95% CI, 0.02-0.33) and for rhinovirus or enterovirus (81% decrease; IRR, 0.19; 95% CI, 0.09-0.39) infections. Lower rates of postexposure viral activity were seen for respiratory syncytial virus, parainfluenzavirus, coronaviruses, and adenoviruses; however, these associations were not statistically significant.Conclusions and relevanceUsing interrupted time series analysis of testing for viral respiratory pathogens, this study found that statistically significant lower rates of common community respiratory viruses appeared to be associated with a shelter-in-place order during the coronavirus disease 2019 pandemic.
| S-EPMC7835714 | biostudies-literature
Project description:Psychosocial health can influence the development and experience of several chronic diseases, and has been negatively affected for many individuals amid the COVID-19 global pandemic. To understand the impact of contemplative practices on emotional and mental health during COVID-19, the Stanford WELL for Life Study (US component), incorporated a series of additional surveys into its ongoing study. A total of 1,097 participants residing in California who responded to at least one of three COVID-19 surveys were included in this analysis. Linear and generalized mixed-effects regression models were used to investigate relationships between individual contemplative practice behaviors (CPB) (embodied observing meditation, non-reactive mindfulness meditation, self-compassion cultivation, cultivation of compassion for others) and four psychosocial outcomes measured in the original WELL questionnaire (resilience, dealing with stress, positive emotions, and negative emotions). In addition, the associations between CPB and depression, distress, and compliance with local Shelter-In-Place orders were also investigated. Participants who engaged in any contemplative practice reported significantly more resilience and positive emotions, dealing better with stress, lower distress, and were less likely to report an experience with depression in the last week. Similar findings held when CPB was modeled as a continuous variable. Significant interactions between the duration of the SIP and CPB were also observed for resilience and SIP compliance outcomes, indicating that steeper declines were observed among participants with little or no CPB across the study period. Further investigation into the potential protective benefits of CPB during times of major disruption and uncertainty is warranted.
| S-EPMC8220389 | biostudies-literature
Project description:IntroductionThe first COVID-19 cases occurred in the US in January of 2020, leading to the implementation of shelter in place. This study seeks to define the impact of shelter in place on the epidemiology of pediatric trauma.MethodsWe examined pediatric trauma admissions at 5 Level 1 and 1 Level 2 US pediatric trauma centers between January 1 and June 30, 2017-2020. Demographic and injury data were compared between pre- and post-shelter in place patient cohorts.ResultsA total of 8772 pediatric trauma activations were reviewed. There was a 13% decrease in trauma volume in 2020, with a nadir at 16 days following implementation of shelter in place. Injury severity scores were higher in the post-shelter in place cohort. The incidence of nonmotorized vehicle accidents and gunshot wounds increased in the post-shelter in place cohort.ConclusionWe found an overall decrease in pediatric trauma volume following shelter in place. However, injuries tended to be more severe. Our findings help inform targeted injury prevention campaigns during future pandemics.
| S-EPMC8275016 | biostudies-literature
Project description:We estimate the effects of shelter-in-place (SIP) orders during the first wave of the COVID-19 pandemic. We do not find detectable effects of these policies on disease spread or deaths. We find small but measurable effects on mobility that dissipate over time. And we find small, delayed effects on unemployment. We conduct additional analyses that separately assess the effects of expanding versus withdrawing SIP orders and test whether there are spillover effects in other states. Our results are consistent with prior studies showing that SIP orders have accounted for a relatively small share of the mobility trends and economic disruptions associated with the pandemic. We reanalyze two prior studies purporting to show that SIP orders caused large reductions in disease prevalence, and show that those results are not reliable. Our results do not imply that social distancing behavior by individuals, as distinct from SIP policy, is ineffective.
| S-EPMC8053946 | biostudies-literature
Project description:Ultra-processed food (UPF) consumption poses a potential risk to public health and may be related to shelter-in-place orders. This study utilized the level of food processing as a lens by which to examine the relationships between diet, weight change, and lifestyle changes (including cooking, snacking, and sedentary activity) that occurred during regional shelter-in-place orders. This study used a cross-sectional, retrospective survey (n = 589) to assess baseline demographics, changes in lifestyle behaviors using a Likert scale, and changes in dietary behaviors using a modified food frequency questionnaire from mid-March to May 2020; data were collected in the California Bay Area from August to October 2020. Foods were categorized by level of processing (minimally processed, processed, and ultra-processed) using the NOVA scale. Stepwise multiple linear regression and univariate linear regression models were used to determine the associations between these factors. Increased snacking was positively associated with a change in the percent of the calories derived from UPF and weight gain (β = 1.0, p < 0.001; β = 0.8 kg, p < 0.001) and negatively associated with the share of MPF calories consumed (β = -0.9, p < 0.001). These relationships have public health implications as interventions designed around decreased snacking may positively impact diet and weight management and thereby mitigate negative health outcomes.
| S-EPMC8619493 | biostudies-literature