Dataset Information

State-Level Stay-at-Home Orders and Objectively Measured Movement in the United States During the COVID-19 Pandemic.

ABSTRACT:

Objective

Social distancing has been one of the primary interventions used to slow the spread of COVID-19 during the ongoing pandemic. Although statewide stay-at-home orders in the United States received a large degree of media and political attention, relatively little peer-reviewed research has examined the impacts of such orders on social distancing behaviors.

Method

This study used daily GPS-derived movement from 2858 counties in the United States from March 1 to May 7, 2020, to test the degree to which changes in state-level stay-at-home orders were associated with movement outside the home.

Results

From early March to early April, people in counties with state-level stay-at-home orders decreased their movement significantly more than counties without state-level stay-at-home orders; 3.1% more people stayed within 1 mile of home, and 1.6% fewer vehicle miles were driven per day. From early April to early May, people in counties within states that ended their stay-at-home orders increased their movement significantly more than counties in states whose stay-at-home orders remained in place; 1.2% fewer people remained within 1 mile of home, and 6.2% more vehicle miles were driven per day. The magnitude of changes associated with state-level stay-at-home orders was many times smaller than the total changes in movement across all counties over the same periods.

Conclusions

Stay-at-home orders were associated with greater social distancing but accounted for only part of this behavioral change. Research on behavior change would be useful to determine additional interventions that could support social distancing during the COVID-19 pandemic.

SUBMITTER: Bourassa KJ

PROVIDER: S-EPMC8238409 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Publications

State-Level Stay-at-Home Orders and Objectively Measured Movement in the United States During the COVID-19 Pandemic.

Bourassa Kyle J KJ

Psychosomatic medicine 20210501 4

<h4>Objective</h4>Social distancing has been one of the primary interventions used to slow the spread of COVID-19 during the ongoing pandemic. Although statewide stay-at-home orders in the United States received a large degree of media and political attention, relatively little peer-reviewed research has examined the impacts of such orders on social distancing behaviors.<h4>Method</h4>This study used daily GPS-derived movement from 2858 counties in the United States from March 1 to May 7, 2020, ...[more]

PMID: 33395214

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Project description:ImportanceTo cope with the continuing coronavirus disease 2019 (COVID-19) pandemic, state and local officials need information on the effectiveness of policies aimed at curbing disease spread, as well as state-specific characteristics, like the racial mix, associated with increased risks related to the disease.ObjectiveTo investigate whether state-imposed stay-at-home orders (SAHOs) and the proportion of African American population in a state were associated with the state-level COVID-19 cases.Design, setting, and participantsThis cross-sectional study used daily, state-level data on COVID-19 cases, tests, and fatalities from the COVID Tracking Project. Data from March 1 to May 4, 2020, for all states (except Washington state) as well as the District of Columbia were used.ExposuresThe key exposure variables were state-level SAHO (1 if in place, 0 otherwise), and proportion of state population who are African American.Main outcomes and measuresThe primary outcome was daily cumulative COVID-19 case rates. A secondary outcome was subsequent COVID-19 fatality rates, derived using mean cumulative fatality rates 21 to 28 days after each date. Multivariate regression models were estimated.ResultsThe final sample included 3023 pooled state- and day-level observations. The mean (SD) cumulative positive case rate was 103.186 (200.067) cases per 100 000 state population, the mean (SD) cumulative test rate was 744.23 (894.944) tests per 100 000 state population, and the mean (SD) subsequent cumulative fatality rate was 12.923 (21.737) deaths per 100 000 state population. There was a negative association of SAHOs with cumulative case rates (β = -1.166; 95% CI, -1.484 to -0.847; P < .001) and subsequent fatality rates (β = -0.204; 95% CI, -0.294 to -0.113; P < .001). Estimation analyses indicated that expected cumulative case rates would have been more than 200% higher and fatality rates approximately 22% higher if there were no SAHOs, as compared with SAHOs fully in place. A higher proportion of African American population was associated with higher case rates (β = 0.045; 95% CI, 0.014 to 0.077; P = .001) and fatality rates (β = 0.068; 95% CI, 0.044 to 0.091; P < .001).Conclusions and relevanceIn this cross-sectional study, SAHOs were associated with reductions in COVID-19 case rates. These findings could help inform policy makers to address the continued COVID-19 pandemic in the US. The proportion of African American population was positively associated with COVID-19 case rates, and this state-level finding adds to evidence from existing ecological studies using county-level data on racial disparities in COVID-19 infection rates and underlines the urgency of better understanding and addressing these disparities.

Project description:ObjectiveWe examined the association between stay-at-home order implementation and the incidence of COVID-19 infections and deaths in rural versus urban counties of the United States.DesignWe used an interrupted time-series analysis using a mixed effects zero-inflated Poisson model with random intercept by county and standardised by population to examine the associations between stay-at-home orders and county-level counts of daily new COVID-19 cases and deaths in rural versus urban counties between 22 January 2020 and 10 June 2020. We secondarily examined the association between stay-at-home orders and mobility in rural versus urban counties using Google Community Mobility Reports.InterventionsIssuance of stay-at-home orders.Primary and secondary outcome measuresCo-primary outcomes were COVID-19 daily incidence of cases (14-day lagged) and mortality (26-day lagged). Secondary outcome was mobility.ResultsStay-at-home orders were implemented later (median 30 March 2020 vs 28 March 2020) and were shorter in duration (median 35 vs 54 days) in rural compared with urban counties. Indoor mobility was, on average, 2.6%-6.9% higher in rural than urban counties both during and after stay-at-home orders. Compared with the baseline (pre-stay-at-home) period, the number of new COVID-19 cases increased under stay-at-home by incidence risk ratio (IRR) 1.60 (95% CI, 1.57 to 1.64) in rural and 1.36 (95% CI, 1.30 to 1.42) in urban counties, while the number of new COVID-19 deaths increased by IRR 14.21 (95% CI, 11.02 to 18.34) in rural and IRR 2.93 in urban counties (95% CI, 1.82 to 4.73). For each day under stay-at-home orders, the number of new cases changed by a factor of 0.982 (95% CI, 0.981 to 0.982) in rural and 0.952 (95% CI, 0.951 to 0.953) in urban counties compared with prior to stay-at-home, while number of new deaths changed by a factor of 0.977 (95% CI, 0.976 to 0.977) in rural counties and 0.935 (95% CI, 0.933 to 0.936) in urban counties. Each day after stay-at-home orders expired, the number of new cases changed by a factor of 0.995 (95% CI, 0.994 to 0.995) in rural and 0.997 (95% CI, 0.995 to 0.999) in urban counties compared with prior to stay-at-home, while number of new deaths changed by a factor of 0.969 (95% CI, 0.968 to 0.970) in rural counties and 0.928 (95% CI, 0.926 to 0.929) in urban counties.ConclusionStay-at-home orders decreased mobility, slowed the spread of COVID-19 and mitigated COVID-19 mortality, but did so less effectively in rural than in urban counties. This necessitates a critical re-evaluation of how stay-at-home orders are designed, communicated and implemented in rural areas.

Project description:BackgroundThe coronavirus disease (COVID-19) has led to dramatic changes worldwide in people's everyday lives. To combat the pandemic, many governments have implemented social distancing, quarantine, and stay-at-home orders. There is limited research on the impact of such extreme measures on mental health.ObjectiveThe goal of this study was to examine whether stay-at-home orders produced differential changes in mental health symptoms using internet search queries on a national scale.MethodsIn the United States, individual states vary in their adoption of measures to reduce the spread of COVID-19; as of March 23, 2020, 11 of the 50 states had issued stay-at-home orders. The staggered rollout of stay-at-home measures across the United States allows us to investigate whether these measures impact mental health by exploring variations in mental health search queries across the states. This paper examines the changes in mental health search queries on Google between March 16-23, 2020, across each state and Washington, DC. Specifically, this paper examines differential changes in mental health searches based on patterns of search activity following issuance of stay-at-home orders in these states compared to all other states. The participants were all the people who searched mental health terms in Google between March 16-23. Between March 16-23, 11 states underwent stay-at-home orders to prevent the transmission of COVID-19. Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation.ResultsAnalyzing over 10 million search queries using generalized additive mixed models, the results suggested that the implementation of stay-at-home orders are associated with a significant flattening of the curve for searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances, with the most prominent flattening associated with suicidal ideation and anxiety.ConclusionsThese results suggest that, despite decreased social contact, mental health search queries increased rapidly prior to the issuance of stay-at-home orders, and these changes dissipated following the announcement and enactment of these orders. Although more research is needed to examine sustained effects, these results suggest mental health symptoms were associated with an immediate leveling off following the issuance of stay-at-home orders.

Project description:BackgroundAt the beginning of the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) of unprecedented scope and duration were implemented to limit community spread of COVID-19. There remains limited evidence about how these measures impacted the lived experience of affected communities. This study captured the early impacts and coping strategies implemented in King County, Washington, one of the first U.S. communities impacted by COVID-19.MethodsWe conducted a cross-sectional web-based survey of 793 English- and Spanish-speaking adult King County residents from March 18, 2020 -May 30, 2020, using voluntary response sampling. The survey included close- and open-ended questions on participant demographics, wellbeing, protective actions, and COVID-19-related concerns, including a freeform narrative response to describe the pandemic's individual-, family- and community-level impacts and associated coping strategies. Descriptive statistics were used to analyze close-ended questions, and qualitative content analysis methods were used to analyze free-form narrative responses.ResultsThe median age of participants was 45 years old, and 74% were female, 82% were White, and 6% were Hispanic/Latinx; 474 (60%) provided a qualitative narrative. Quantitative findings demonstrated that higher percentages of participants engaged in most types of COVID-19 protective behaviors after the stay-at-home order was implemented and schools and community spaces were closed, relative to before, and that participants tended to report greater concern about the pandemic's physical health or healthcare access impacts than the financial or social impacts. Qualitative data analysis described employment or financial impacts (56%) and vitality coping strategies (65%), intended to support health or positive functioning.ConclusionsThis study documented early impacts of the COVID-19 pandemic and the NPIs implemented in response, as well as strategies employed to cope with those impacts, which can inform early-stage policy formation and intervention strategies to mitigate the negative impacts. Future research should explore the endurance and evolution of the early impacts and coping strategies throughout the multiyear pandemic.

Dataset Information

State-Level Stay-at-Home Orders and Objectively Measured Movement in the United States During the COVID-19 Pandemic.

Objective

Method

Results

Conclusions

Publications

State-Level Stay-at-Home Orders and Objectively Measured Movement in the United States During the COVID-19 Pandemic.

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