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Evaluating the effects of shelter-in-place policies during the COVID-19 pandemic.

ABSTRACT: 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.

SUBMITTER: Berry CR

PROVIDER: S-EPMC8053946 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Epidemiology of pediatric trauma during the COVID-19 pandemic shelter in place.

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

Effect of shelter-in-place on emergency department radiology volumes during the COVID-19 pandemic.

Project description:PURPOSE:The coronavirus disease 2019 (COVID-19) pandemic has led to significant disruptions in the healthcare system including surges of infected patients exceeding local capacity, closures of primary care offices, and delays of non-emergent medical care. Government-initiated measures to decrease healthcare utilization (i.e., "flattening the curve") have included shelter-in-place mandates and social distancing, which have taken effect across most of the USA. We evaluate the immediate impact of the Public Health Messaging and shelter-in-place mandates on Emergency Department (ED) demand for radiology services. METHODS:We analyzed ED radiology volumes from the five University of California health systems during a 2-week time period following the shelter-in-place mandate and compared those volumes with March 2019 and early April 2019 volumes. RESULTS:ED radiology volumes declined from the 2019 baseline by 32 to 40% (p < 0.001) across the five health systems with a total decrease in volumes across all 5 systems by 35% (p < 0.001). Stratifying by subspecialty, the smallest declines were seen in non-trauma thoracic imaging, which decreased 18% (p value < 0.001), while all other non-trauma studies decreased by 48% (p < 0.001). CONCLUSION:Total ED radiology demand may be a marker for public adherence to shelter-in-place mandates, though ED chest radiology demand may increase with an increase in COVID-19 cases.

| S-EPMC7273127 | biostudies-literature

Impact of shelter-in-place orders on TB case notifications and mortality in the Philippines during the COVID-19 pandemic.

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

Effectiveness of COVID-19 shelter-in-place orders varied by state.

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

Effects of easing shelter-in-place restrictions and the lingering COVID-19 pandemic on orthopaedic trauma at a community level 2 trauma center.

Project description:ObjectivesEvaluate the effect of easing "shelter-in-place" restrictions and coronavirus-2019 (COVID-19) cases on orthopaedic trauma encounters (OTEs) at a community level II trauma center.MethodsA retrospective analysis was conducted of OTEs from March-June of 2016 to 2020. Injuries were classified by high or low severity. Admission and surgical intervention rates were also compared year to year. Data were statistically analyzed and compared with external data for traffic counts near the hospital and COVID-19 cases in Michigan as well as a timeline for enacting and easing of shelter-in-place orders in the state of Michigan.ResultsThere was no difference in the number of OTEs May to June, 2020 compared with the average of those same months 2016 to 2019. March to June, 2020 showed no change in proportion of injury severity, admissions, or surgical interventions when compared with the average of March-June, 2016 to 2019, although the overall quantity of each was decreased in March and April. A significant negative correlation was found between the daily number of COVID-19 cases in Michigan and OTEs.ConclusionsThe quantity of OTEs normalized to pre-COVID-19 levels in May and June of 2020 compared with 2016 to 2019 despite a previously documented 45.1% drop in March and April. A negative correlation was noted between the number of reported Michigan COVID-19 cases and volume of OTEs. There were no significant changes noted to admission rates or rates of surgical intervention on OTEs throughout the time period studied.

| S-EPMC8568387 | biostudies-literature

Physical activity and mental health during the COVID-19 pandemic among individuals with amputation

Project description: Not available

| S-BSST1055 | biostudies-other

Delayed Colorectal Cancer Care During Coronavirus Disease (COVID-19) Pandemic (DECOR-19)

Project description:To understand and analyse the global impact of COVID-19 on outpatient services, inpatient care, elective surgery, and perioperative colorectal cancer care, a DElayed COloRectal cancer surgery (DECOR-19) survey was conducted in collaboration with numerous international colorectal societies with the objective of obtaining several learning points from the impact of the COVID-19 outbreak on our colorectal cancer patients which will assist us in the ongoing management of our colorectal cancer patients and to provide us safe oncological pathways for future outbreaks.

| 2346925 | ecrin-mdr-crc

Body Weight Changes During Pandemic-Related Shelter-in-Place in a Longitudinal Cohort Study.

Project description: Not available

| S-EPMC7985720 | biostudies-literature

Effects of Emergency Care-related Health Policies during the COVID-19 Pandemic in Korea: a Quasi-Experimental Study.

Project description:BackgroundThe purpose of this study was to review the nationwide emergency care-related health policies during the coronavirus disease 2019 (COVID-19) pandemic disaster in Korea and to analyze the effects of the policies on the safety of patients who visit emergency departments (EDs) during this period.MethodsThis study is a quasi-experiment study. The study population was patients who visited all 402 EDs in Korea between December 31, 2019 and May 13, 2020, using the National Emergency Department Information System (NEDIS) database. The study period was classified into 5 phases according to the level of national crisis warning of infectious disease and the implementation of emergency care-related health policies, and all study phases were 27 days. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay (LOS) in the ED during the COVID-19 outbreak.ResultsThe number of ED visits during the study period was 2,636,341, and the in-hospital mortality rate was 1.4%. The number of ED visits decreased from 803,160 in phase 1 to 496,619 in phase 5 during the study period. For in-hospital mortality, the adjusted odds ratio (OR) (95% confidence interval) was 0.77 (0.74-0.79) in phase 5 compared to phase 3. Additionally, by subgroup, the ORs were 0.69 (0.57-0.83) for the patients with acute myocardial infarction and 0.76 (0.67-0.87) for severe trauma in phase 5 compared to phase 3. The ED LOS increased while the number of ED visits decreased as the COVID-19 pandemic progressed, and the ED LOS declined after policy implementation (beta coefficient: -5.3 [-6.5 to -4.2] minutes in phase 5 compared to phase 3).ConclusionImplementing appropriate emergency care policies in the COVID-19 pandemic would have contributed to improving the safety of all emergency patients and reducing in-hospital mortality by preventing excessive deaths.

| S-EPMC8076843 | biostudies-literature

Aging in Place During a Pandemic: Neighborhood Engagement and Environments Since the COVID-19 Pandemic Onset.

Project description:Background and objectivesThe COVID-19 pandemic may fundamentally change neighborhood environments and ways of aging in place. This research aimed to investigate perceptions of and engagement in neighborhoods since the pandemic onset among aging Americans.Research design and methodsData were from the COVID-19 Coping Study, a longitudinal cohort study of health and wellbeing of US adults aged ≥55 years during the COVID-19 pandemic. In the present analysis, we conducted a qualitative thematic analysis of responses to an open-ended survey question about how respondents felt that COVID-19 has impacted their neighborhood and relationships with neighbors. The survey data were collected June-September 2020 and analyzed for a random stratified sub-sample of 1,000 study participants. Sampling quotas for age, gender, race/ethnicity, and education aimed to match the US population aged ≥55 (average age: 67.7 years).ResultsWe identified four overarching themes: altered neighborly social interactions, support levels, and community environments; and no observed changes. Geographic factors that impacted neighborhood engagement included age structure, sociopolitical diversity, urbanicity/rurality, and walkability; while individual factors included age, race/ethnicity, socioeconomic status, political orientation, health status, duration of residence, lifestyle, and personality.Discussion and implicationsThe results highlight resilience among aging adults and their neighbors, sources of individual and community vulnerability, and opportunities to strengthen social infrastructure to support aging in place since the pandemic onset.

| S-EPMC8767892 | biostudies-literature

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