Dataset Information

The effect of social distance measures on COVID-19 epidemics in Europe: an interrupted time series analysis.

ABSTRACT: Following the introduction of unprecedented "stay-at-home" national policies, the COVID-19 pandemic recently started declining in Europe. Our research aims were to characterize the changepoint in the flow of the COVID-19 epidemic in each European country and to evaluate the association of the level of social distancing with the observed decline in the national epidemics. Interrupted time series analyses were conducted in 28 European countries. Social distance index was calculated based on Google Community Mobility Reports. Changepoints were estimated by threshold regression, national findings were analyzed by Poisson regression, and the effect of social distancing in mixed effects Poisson regression model. Our findings identified the most probable changepoints in 28 European countries. Before changepoint, incidence of new COVID-19 cases grew by 24% per day on average. From the changepoint, this growth rate was reduced to 0.9%, 0.3% increase, and to 0.7% and 1.7% decrease by increasing social distancing quartiles. The beneficial effect of higher social distance quartiles (i.e., turning the increase into decline) was statistically significant for the fourth quartile. Notably, many countries in lower quartiles also achieved a flat epidemic curve. In these countries, other plausible COVID-19 containment measures could contribute to controlling the first wave of the disease. The association of social distance quartiles with viral spread could also be hindered by local bottlenecks in infection control. Our results allow for moderate optimism related to the gradual lifting of social distance measures in the general population, and call for specific attention to the protection of focal micro-societies enriching high-risk elderly subjects, including nursing homes and chronic care facilities.

SUBMITTER: Voko Z

PROVIDER: S-EPMC7288252 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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The effect of social distance measures on COVID-19 epidemics in Europe: an interrupted time series analysis.

Vokó Zoltán Z Pitter János György JG

GeroScience 20200611 4

Following the introduction of unprecedented "stay-at-home" national policies, the COVID-19 pandemic recently started declining in Europe. Our research aims were to characterize the changepoint in the flow of the COVID-19 epidemic in each European country and to evaluate the association of the level of social distancing with the observed decline in the national epidemics. Interrupted time series analyses were conducted in 28 European countries. Social distance index was calculated based on Google ...[more]

PMID: 32529592

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Project description:BackgroundInterrupted time series (ITS) analysis is a time series regression model that aims to evaluate the effect of an intervention on an outcome of interest. ITS analysis is a quasi-experimental study design instrumental in situations where natural experiments occur, gaining popularity, particularly due to the Covid-19 pandemic. However, challenges, including the lack of a control group, have impeded the quantification of the effect size in ITS. The current paper proposes a method and develops a user-friendly R package to quantify the effect size of an ITS regression model for continuous and count outcomes, with or without seasonal adjustment.ResultsThe effect size presented in this work, together with its corresponding 95% confidence interval (CI) and P-value, is based on the ITS model-based fitted values and the predicted counterfactual (the exposed period had the intervention not occurred) values. A user-friendly R package to fit an ITS and estimate the effect size was developed and accompanies this paper. To illustrate, we implemented a nation population-based ITS study from January 2001 to May 2021 covering the all-cause mortality of Israel (n = 9,350 thousand) to quantify the effect size of Covid-19 exposure on mortality rates. In the period unexposed to the Covid-19 pandemic, the mortality rate decreased over time and was expected to continue decreasing had Covid-19 not occurred. In contrast, the period exposed to the Covid-19 pandemic was associated with an increased all-cause mortality rate (relative risk = 1.11, 95% CI = 1.04, 1.18, P < 0.001).ConclusionFor the first time, the effect size in ITS: was quantified, can be estimated by end-users with an R package we developed, and was demonstrated with data showing an increase in mortality following the Covid-19 pandemic. ITS effect size reporting can assist public health policy makers in assessing the magnitude of the entire intervention effect using a single, readily understood measure.

Project description:Time series are a critical component of ecological analysis, used to track changes in biotic and abiotic variables. Information can be extracted from the properties of time series for tasks such as classification (e.g., assigning species to individual bird calls); clustering (e.g., clustering similar responses in population dynamics to abrupt changes in the environment or management interventions); prediction (e.g., accuracy of model predictions to original time series data); and anomaly detection (e.g., detecting possible catastrophic events from population time series). These common tasks in ecological research all rely on the notion of (dis-) similarity, which can be determined using distance measures. A plethora of distance measures have been described, predominantly in the computer and information sciences, but many have not been introduced to ecologists. Furthermore, little is known about how to select appropriate distance measures for time-series-related tasks. Therefore, many potential applications remain unexplored. Here, we describe 16 properties of distance measures that are likely to be of importance to a variety of ecological questions involving time series. We then test 42 distance measures for each property and use the results to develop an objective method to select appropriate distance measures for any task and ecological dataset. We demonstrate our selection method by applying it to a set of real-world data on breeding bird populations in the UK and discuss other potential applications for distance measures, along with associated technical issues common in ecology. Our real-world population trends exhibit a common challenge for time series comparisons: a high level of stochasticity. We demonstrate two different ways of overcoming this challenge, first by selecting distance measures with properties that make them well suited to comparing noisy time series and second by applying a smoothing algorithm before selecting appropriate distance measures. In both cases, the distance measures chosen through our selection method are not only fit-for-purpose but are consistent in their rankings of the population trends. The results of our study should lead to an improved understanding of, and greater scope for, the use of distance measures for comparing ecological time series and help us answer new ecological questions.

Dataset Information

The effect of social distance measures on COVID-19 epidemics in Europe: an interrupted time series analysis.

Publications

The effect of social distance measures on COVID-19 epidemics in Europe: an interrupted time series analysis.

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