State-level needs for social distancing and contact tracing to contain COVID-19 in the United States.
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ABSTRACT:
SUBMITTER: Chiu WA
PROVIDER: S-EPMC7572893 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Social distancing measures have been implemented in the United States (US) since March 2020, to mitigate the spread of SARS-CoV-2, the causative agent of COVID-19. However, by mid-May most states began relaxing these measures to support the resumption of economic activity, even as disease incidence continued to increase in many states. To evaluate the impact of relaxing social distancing restrictions on COVID-19 dynamics and control in the US, we developed a transmission dynamic model and calibrated it to US state-level COVID-19 cases and deaths from March to June 20th, 2020, using Bayesian methods. We used this model to evaluate the impact of reopening, social distancing, testing, contact tracing, and case isolation on the COVID-19 epidemic in each state. We found that using stay-at-home orders, most states were able to curtail their COVID-19 epidemic curve by reducing and achieving an effective reproductive number below 1. But by June 20th, 2020, only 19 states and the District of Columbia were on track to curtail their epidemic curve with a 75% confidence, at current levels of reopening. Of the remaining 31 states, 24 may have to double their current testing and/or contact tracing rate to curtail their epidemic curve, and seven need to further restrict social contact by 25% in addition to doubling their testing and contact tracing rates. When social distancing restrictions are being eased, greater state-level testing and contact tracing capacity remains paramount for mitigating the risk of large-scale increases in cases and deaths.
| S-EPMC7362894 | biostudies-literature
Project description:BackgroundSocial distancing and public policy have been crucial for minimizing the spread of SARS-CoV-2 in the United States. Publicly available, county-level time series data on mobility are derived from individual devices with global positioning systems, providing a variety of indices of social distancing behavior per day. Such indices allow a fine-grained approach to modeling public behavior during the pandemic. Previous studies of social distancing and policy have not accounted for the occurrence of pre-policy social distancing and other dynamics reflected in the long-term trajectories of public mobility data.ObjectiveWe propose a differential equation state-space model of county-level social distancing that accounts for distancing behavior leading up to the first official policies, equilibrium dynamics reflected in the long-term trajectories of mobility, and the specific impacts of four kinds of policy. The model is fit to each US county individually, producing a nationwide data set of novel estimated mobility indices.MethodsA differential equation model was fit to three indicators of mobility for each of 3054 counties, with T=100 occasions per county of the following: distance traveled, visitations to key sites, and the log number of interpersonal encounters. The indicators were highly correlated and assumed to share common underlying latent trajectory, dynamics, and responses to policy. Maximum likelihood estimation with the Kalman-Bucy filter was used to estimate the model parameters. Bivariate distributional plots and descriptive statistics were used to examine the resulting county-level parameter estimates. The association of chronology with policy impact was also considered.ResultsMobility dynamics show moderate correlations with two census covariates: population density (Spearman r ranging from 0.11 to 0.31) and median household income (Spearman r ranging from -0.03 to 0.39). Stay-at-home order effects were negatively correlated with both (r=-0.37 and r=-0.38, respectively), while the effects of the ban on all gatherings were positively correlated with both (r=0.51, r=0.39). Chronological ordering of policies was a moderate to strong determinant of their effect per county (Spearman r ranging from -0.12 to -0.56), with earlier policies accounting for most of the change in mobility, and later policies having little or no additional effect.ConclusionsChronological ordering, population density, and median household income were all associated with policy impact. The stay-at-home order and the ban on gatherings had the largest impacts on mobility on average. The model is implemented in a graphical online app for exploring county-level statistics and running counterfactual simulations. Future studies can incorporate the model-derived indices of social distancing and policy impacts as important social determinants of COVID-19 health outcomes.
| S-EPMC7759510 | biostudies-literature
Project description:In order to reduce the spread of SARS-CoV-2, much of the US was placed under social distancing guidelines during March 2020. We characterized risk perceptions and adherence to social distancing recommendations in March 2020 among US adults aged 18+ in an online survey with age and gender quotas to match the general US population (N = 713). We used multivariable logistic and linear regression to estimate associations between age (by generational cohort) and these outcomes. The median perceived risk of infection with COVID-19 within the next month was 32%, and 65% of individuals were practicing more social distancing than before the outbreak. Baby Boomers had lower perceived risk than Millennials (-10.6%, 95% CI: -16.2%, -5.0%), yet were more frequently social distancing (OR = 1.64; 95% CI: 1.05, 2.56). Public health outreach should focus on raising compliance with social distancing recommendations, especially among high risk groups. Efforts to address risk perceptions alone may be inadequate.
| S-EPMC7485770 | biostudies-literature
Project description:Eliminating disparities in the burden of COVID-19 requires equitable access to control measures across socio-economic groups. Limited research on socio-economic differences in mobility hampers our ability to understand whether inequalities in social distancing are occurring during the SARS-CoV-2 pandemic. To assess how mobility patterns have varied across the United States during the COVID-19 pandemic, and identify associations with socio-economic factors of populations. We used anonymized mobility data from tens of millions of devices to measure the speed and depth of social distancing at the county level between February and May 2020. Using linear mixed models, we assessed the associations between social distancing and socio-economic variables, including the proportion of people below the poverty level, the proportion of Black people, the proportion of essential workers, and the population density. We find that the speed, depth, and duration of social distancing in the United States is heterogeneous. We particularly show that social distancing is slower and less intense in counties with higher proportions of people below the poverty level and essential workers; and in contrast, that social distancing is intense in counties with higher population densities and larger Black populations. Socio-economic inequalities appear to be associated with the levels of adoption of social distancing, potentially resulting in wide-ranging differences in the impact of COVID-19 in communities across the United States. This is likely to amplify existing health disparities, and needs to be addressed to ensure the success of ongoing pandemic mitigation efforts.
| S-EPMC7668753 | biostudies-literature
Project description:IntroductionMost countries are dependent on nonpharmaceutical public health interventions such as social distancing, contact tracing, and case isolation to mitigate COVID-19 spread until medicines or vaccines widely available. Minimal research has been performed on the independent and combined impact of each of these interventions based on empirical case data.MethodsWe obtained data from all confirmed COVID-19 cases from January 7th to February 22nd 2020 in Zhejiang Province, China, to fit an age-stratified compartmental model using human contact information before and during the outbreak. The effectiveness of social distancing, contact tracing, and case isolation was studied and compared in simulation. We also simulated a two-phase reopening scenario to assess whether various strategies combining nonpharmaceutical interventions are likely to achieve population-level control of a second-wave epidemic.ResultsOur study sample included 1,218 symptomatic cases with COVID-19, of which 664 had no inter-province travel history. Results suggest that 36.5 % (95 % CI, 12.8-57.1) of contacts were quarantined, and approximately five days (95 % CI, 2.2-11.0) were needed to detect and isolate a case. As contact networks would increase after societal and economic reopening, avoiding a second wave without strengthening nonpharmaceutical interventions compared to the first wave it would be exceedingly difficult.ConclusionsContinuous attention and further improvement of nonpharmaceutical interventions are needed in second-wave prevention. Specifically, contact tracing merits further attention.
| S-EPMC8275486 | biostudies-literature
Project description:Currently, no federal policies exist in the United States regarding private wells; this authority is devolved to states. This study inventoried state-level policies governing private wells in the United States in order to identify the topics addressed by each state, division of responsibilities across state agencies, and geographic differences in policy comprehensiveness. From May to August 2016, two independent reviewers conducted an online search followed by directly contacting state agencies (98% response) to identify all state-level policies in the United States that directly reference private wells. The search, updated in April 2018, confirmed the existing water policy list and identified 23 additional policies. Policies were then coded according to nine not-mutually-exclusive classifications. The results indicate that all states had at least one policy addressing private well drilling or construction. Significant geographic differences exist in maintenance-related policies. In conclusion, although drilling and construction safety are addressed by each state, some policy domains are addressed inconsistently across states, and other policy domains are absent in most states.
| S-EPMC6656387 | biostudies-literature
Project description:As of 1st June 2020, the US Centres for Disease Control and Prevention reported 104,232 confirmed or probable COVID-19-related deaths in the US. This was more than twice the number of deaths reported in the next most severely impacted country. We jointly model the US epidemic at the state-level, using publicly available death data within a Bayesian hierarchical semi-mechanistic framework. For each state, we estimate the number of individuals that have been infected, the number of individuals that are currently infectious and the time-varying reproduction number (the average number of secondary infections caused by an infected person). We use changes in mobility to capture the impact that non-pharmaceutical interventions and other behaviour changes have on the rate of transmission of SARS-CoV-2. We estimate that Rt was only below one in 23 states on 1st June. We also estimate that 3.7% [3.4%-4.0%] of the total population of the US had been infected, with wide variation between states, and approximately 0.01% of the population was infectious. We demonstrate good 3 week model forecasts of deaths with low error and good coverage of our credible intervals.
| S-EPMC7712910 | biostudies-literature
Project description:The new coronavirus disease 2019 (COVID-19) has required the implementation of severe mobility restrictions and social distancing measures worldwide. While these measures have been proven effective in abating the epidemic in several countries, it is important to estimate the effectiveness of testing and tracing strategies to avoid a potential second wave of the COVID-19 epidemic. We integrate highly detailed (anonymized, privacy-enhanced) mobility data from mobile devices, with census and demographic data to build a detailed agent-based model to describe the transmission dynamics of SARS-CoV-2 in the Boston metropolitan area. We find that enforcing strict social distancing followed by a policy based on a robust level of testing, contact-tracing and household quarantine, could keep the disease at a level that does not exceed the capacity of the health care system. Assuming the identification of 50% of the symptomatic infections, and the tracing of 40% of their contacts and households, which corresponds to about 9% of individuals quarantined, the ensuing reduction in transmission allows the reopening of economic activities while attaining a manageable impact on the health care system. Our results show that a response system based on enhanced testing and contact tracing can play a major role in relaxing social distancing interventions in the absence of herd immunity against SARS-CoV-2.
| S-EPMC7273304 | biostudies-literature
Project description:BackgroundSocial distancing-when people limit close contact with others outside their household-is a primary intervention available to combat the COVID-19 pandemic. The importance of social distancing is unlikely to change until effective treatments or vaccines become widely available. However, relatively little is known about how best to promote social distancing. Applying knowledge from social and behavioral research on conventional health behaviors (e.g., smoking, physical activity) to support public health efforts and research on social distancing is promising, but empirical evidence supporting this approach is needed.PurposeWe examined whether one type of social distancing behavior-reduced movement outside the home-was associated with conventional health behaviors.MethodWe examined the association between GPS-derived movement behavior in 2,858 counties in USA from March 1 to April 7, 2020 and the prevalence of county-level indicators influenced by residents' conventional health behaviors.ResultsChanges in movement were associated with conventional health behaviors, and the magnitude of these associations were similar to the associations among the conventional health behaviors. Counties with healthier behaviors-particularly less obesity and greater physical activity-evidenced greater reduction in movement outside the home during the initial phases of the pandemic in the USA.ConclusionsSocial distancing, in the form of reduced movement outside the home, is associated with conventional health behaviors. Existing scientific literature on health behavior and health behavior change can be more confidently used to promote social distancing behaviors during the COVID-19 pandemic.
| S-EPMC7337613 | biostudies-literature
Project description:Recent research has suggested that the social distancing mandates introduced in the United States during the main waves of the 1918–20 influenza pandemic caused an increase in suicide rates. However, that finding relies on poor-quality, temporally mismatched data and has signs of omitted variable bias. Similarly, a long-standing finding that American suicide rates in 1918–20 were also boosted by the influenza mortality of the time has gone unquestioned in the literature, despite the original research admitting its risk of ecological fallacy. Using higher-powered mortality data, I cast doubt on both findings by analyzing the experiences of the pandemic in 43 of the largest American cities of the time. In line with some populations’ experiences of COVID-19, I report tentative evidence that social distancing mandates during the 1918–20 pandemic may have been associated with decreased suicide rates. Larger, cross-national investigations of the effects of historical pandemics and social distancing mandates on mental health and suicide are needed. Highlights • 1918–19 ‘lockdowns’ in US cities did not correlate with elevated suicide rates.• US cities with higher influenza mortality also did not have higher suicide rates.• Both of these findings contradict previous, weaker analyses.• Limited evidence suggests that social distancing may have decreased suicide rates.
| S-EPMC8551840 | biostudies-literature