scholarly journals Social Media as an Early Proxy for Social Distancing Indicated by the COVID-19 Reproduction Number: Observational Study (Preprint)

2020 ◽  
Author(s):  
Joseph Younis ◽  
Harvy Freitag ◽  
Jeremy S Ruthberg ◽  
Jonathan P Romanes ◽  
Craig Nielsen ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Observational Study ◽  
Social Mobility ◽  
Reproduction Number ◽  
The United States ◽  
Google Trends ◽  
Basic Reproductive Number ◽  
Social Distancing ◽  
Google Search

BACKGROUND  The magnitude and time course of the COVID-19 epidemic in the United States depends on early interventions to reduce the basic reproductive number to below 1. It is imperative, then, to develop methods to actively assess where quarantine measures such as social distancing may be deficient and suppress those potential resurgence nodes as early as possible. OBJECTIVE We ask if social media is an early indicator of public social distancing measures in the United States by investigating its correlation with the time-varying reproduction number (R<sub>t</sub>) as compared to social mobility estimates reported from Google and Apple Maps. METHODS  In this observational study, the estimated R<sub>t</sub> was obtained for the period between March 5 and April 5, 2020, using the EpiEstim package. Social media activity was assessed using queries of “social distancing” or “#socialdistancing” on Google Trends, Instagram, and Twitter, with social mobility assessed using Apple and Google Maps data. Cross-correlations were performed between R<sub>t</sub> and social media activity or mobility for the United States. We used Pearson correlations and the coefficient of determination (ρ) with significance set to <i>P</i>&lt;.05. RESULTS Negative correlations were found between Google search interest for “social distancing” and R<sub>t</sub> in the United States (<i>P</i>&lt;.001), and between search interest and state-specific R<sub>t</sub> for 9 states with the highest COVID-19 cases (<i>P</i>&lt;.001); most states experienced a delay varying between 3-8 days before reaching significance. A negative correlation was seen at a 4-day delay from the start of the Instagram hashtag “#socialdistancing” and at 6 days for Twitter (<i>P</i>&lt;.001). Significant correlations between R<sub>t</sub> and social media manifest earlier in time compared to social mobility measures from Google and Apple Maps, with peaks at –6 and –4 days. Meanwhile, changes in social mobility correlated best with R<sub>t</sub> at –2 days and +1 day for workplace and grocery/pharmacy, respectively. CONCLUSIONS Our study demonstrates the potential use of Google Trends, Instagram, and Twitter as epidemiological tools in the assessment of social distancing measures in the United States during the early course of the COVID-19 pandemic. Their correlation and earlier rise and peak in correlative strength with R<sub>t</sub> when compared to social mobility may provide proactive insight into whether social distancing efforts are sufficiently enacted. Whether this proves valuable in the creation of more accurate assessments of the early epidemic course is uncertain due to limitations. These limitations include the use of a biased sample that is internet literate with internet access, which may covary with socioeconomic status, education, geography, and age, and the use of subtotal social media mentions of social distancing. Future studies should focus on investigating how social media reactions change during the course of the epidemic, as well as the conversion of social media behavior to actual physical behavior.

scholarly journals Social Media as an Early Proxy for Social Distancing Indicated by the COVID-19 Reproduction Number: Observational Study

10.2196/21340 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e21340 ◽  
Author(s):  
Joseph Younis ◽  
Harvy Freitag ◽  
Jeremy S Ruthberg ◽  
Jonathan P Romanes ◽  
Craig Nielsen ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Observational Study ◽  
Social Mobility ◽  
Reproduction Number ◽  
The United States ◽  
Google Trends ◽  
Basic Reproductive Number ◽  
Social Distancing ◽  
Google Search

Background  The magnitude and time course of the COVID-19 epidemic in the United States depends on early interventions to reduce the basic reproductive number to below 1. It is imperative, then, to develop methods to actively assess where quarantine measures such as social distancing may be deficient and suppress those potential resurgence nodes as early as possible. Objective We ask if social media is an early indicator of public social distancing measures in the United States by investigating its correlation with the time-varying reproduction number (Rt) as compared to social mobility estimates reported from Google and Apple Maps. Methods  In this observational study, the estimated Rt was obtained for the period between March 5 and April 5, 2020, using the EpiEstim package. Social media activity was assessed using queries of “social distancing” or “#socialdistancing” on Google Trends, Instagram, and Twitter, with social mobility assessed using Apple and Google Maps data. Cross-correlations were performed between Rt and social media activity or mobility for the United States. We used Pearson correlations and the coefficient of determination (ρ) with significance set to P<.05. Results Negative correlations were found between Google search interest for “social distancing” and Rt in the United States (P<.001), and between search interest and state-specific Rt for 9 states with the highest COVID-19 cases (P<.001); most states experienced a delay varying between 3-8 days before reaching significance. A negative correlation was seen at a 4-day delay from the start of the Instagram hashtag “#socialdistancing” and at 6 days for Twitter (P<.001). Significant correlations between Rt and social media manifest earlier in time compared to social mobility measures from Google and Apple Maps, with peaks at –6 and –4 days. Meanwhile, changes in social mobility correlated best with Rt at –2 days and +1 day for workplace and grocery/pharmacy, respectively. Conclusions Our study demonstrates the potential use of Google Trends, Instagram, and Twitter as epidemiological tools in the assessment of social distancing measures in the United States during the early course of the COVID-19 pandemic. Their correlation and earlier rise and peak in correlative strength with Rt when compared to social mobility may provide proactive insight into whether social distancing efforts are sufficiently enacted. Whether this proves valuable in the creation of more accurate assessments of the early epidemic course is uncertain due to limitations. These limitations include the use of a biased sample that is internet literate with internet access, which may covary with socioeconomic status, education, geography, and age, and the use of subtotal social media mentions of social distancing. Future studies should focus on investigating how social media reactions change during the course of the epidemic, as well as the conversion of social media behavior to actual physical behavior.

scholarly journals The Twitter Social Mobility Index: Measuring Social Distancing Practices With Geolocated Tweets (Preprint)

2020 ◽  
Author(s):  
Paiheng Xu ◽  
Mark Dredze ◽  
David A Broniatowski
Keyword(s):  
United States ◽  
South Carolina ◽  
Social Mobility ◽  
State Level ◽  
The United States ◽  
Mobility Index ◽  
Social Distancing ◽  
Mobility Data ◽  
Response Planning ◽  
Twitter Data

BACKGROUND Social distancing is an important component of the response to the COVID-19 pandemic. Minimizing social interactions and travel reduces the rate at which the infection spreads and “flattens the curve” so that the medical system is better equipped to treat infected individuals. However, it remains unclear how the public will respond to these policies as the pandemic continues. OBJECTIVE The aim of this study is to present the Twitter Social Mobility Index, a measure of social distancing and travel derived from Twitter data. We used public geolocated Twitter data to measure how much users travel in a given week. METHODS We collected 469,669,925 tweets geotagged in the United States from January 1, 2019, to April 27, 2020. We analyzed the aggregated mobility variance of a total of 3,768,959 Twitter users at the city and state level from the start of the COVID-19 pandemic. RESULTS We found a large reduction (61.83%) in travel in the United States after the implementation of social distancing policies. However, the variance by state was high, ranging from 38.54% to 76.80%. The eight states that had not issued statewide social distancing orders as of the start of April ranked poorly in terms of travel reduction: Arkansas (45), Iowa (37), Nebraska (35), North Dakota (22), South Carolina (38), South Dakota (46), Oklahoma (50), Utah (14), and Wyoming (53). We are presenting our findings on the internet and will continue to update our analysis during the pandemic. CONCLUSIONS We observed larger travel reductions in states that were early adopters of social distancing policies and smaller changes in states without such policies. The results were also consistent with those based on other mobility data to a certain extent. Therefore, geolocated tweets are an effective way to track social distancing practices using a public resource, and this tracking may be useful as part of ongoing pandemic response planning.

scholarly journals Threat, Coping, and Social Distance Adherence During COVID-19: Cross-Continental Comparison Using an Online Cross-Sectional Survey

10.2196/23019 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e23019
Author(s):  
Abrar Al-Hasan ◽  
Jiban Khuntia ◽  
Dobin Yim
Keyword(s):  
United States ◽  
Social Media ◽  
South Korea ◽  
Information Source ◽  
The United States ◽  
Seemingly Unrelated Regression ◽  
Social Distancing ◽  
Unrelated Regression ◽  
And Coping ◽  
Appraisal Processes

Background Social distancing is an effective preventative policy for COVID-19 that is enforced by governments worldwide. However, significant variations are observed in adherence to social distancing across individuals and countries. Due to the lack of treatment, rapid spread, and prevalence of COVID-19, panic and fear associated with the disease causes great stress. Subsequent effects will be a variation around the coping and mitigation strategies for different individuals following different paths to manage the situation. Objective This study aims to explore how threat and coping appraisal processes work as mechanisms between information and citizens’ adherence to COVID-19–related recommendations (ie, how the information sources and social media influence threat and coping appraisal processes with COVID-19 and how the threat and coping appraisal processes influence adherence to policy guidelines). In addition, this study aims to explore how citizens in three different countries (the United States, Kuwait, and South Korea), randomly sampled, are effectively using the mechanisms. Methods Randomly sampled online survey data collected by a global firm in May 2020 from 162 citizens of the United States, 185 of Kuwait, and 71 of South Korea were analyzed, resulting in a total sample size of 418. A seemingly unrelated regression model, controlling for several counterfactuals, was used for analysis. The study’s focal estimated effects were compared across the three countries using the weighted distance between the parameter estimates. Results The seemingly unrelated regression model estimation results suggested that, overall, the intensity of information source use for the COVID-19 pandemic positively influenced the threat appraisal for the disease (P<.001). Furthermore, the intensity of social media use for the COVID-19 pandemic positively influenced the coping appraisal for the disease (P<.001). Higher COVID-19 threat appraisal had a positive effect on social distancing adherence (P<.001). Higher COVID-19 coping appraisal had a positive effect on social distancing adherence (P<.001). Higher intensity of COVID-19 knowledge positively influenced social distancing adherence (P<.001). There were country-level variations. Broadly, we found that the United States had better results than South Korea and Kuwait in leveraging the information to threat and coping appraisal to the adherence process, indicating that individuals in countries like the United States and South Korea may be more pragmatic to appraise the situation before making any decisions. Conclusions This study’s findings suggest that the mediation of threat and coping strategies are essential, in varying effects, to shape the information and social media strategies for adherence outcomes. Accordingly, coordinating public service announcements along with information source outlets such as mainstream media (eg, TV and newspaper) as well as social media (eg, Facebook and Twitter) to inform citizens and, at the same time, deliver balanced messages about the threat and coping appraisal is critical in implementing a staggered social distancing and sheltering strategy.

Public Health Implications of Google Searches for Sunscreen, Sunburn, Skin Cancer, and Melanoma in the United States

2018 ◽  
Vol 33 (4) ◽  
pp. 611-615 ◽  
Author(s):  
Zachary H. Hopkins ◽  
Aaron M. Secrest
Keyword(s):  
Public Health ◽  
United States ◽  
Skin Cancer ◽  
Search Engine ◽  
State Level ◽  
The United States ◽  
Google Trends ◽  
Search Term ◽  
Melanoma Incidence ◽  
Google Search

Purpose: Google Trends (GT) offers insights into public interests and behaviors and holds potential for guiding public health campaigns. We evaluated trends in US searches for sunscreen, sunburn, skin cancer, and melanoma and their relationships with melanoma outcomes. Design: Google Trends was queried for US search volumes from 2004 to 2017. Time-matched search term data were correlated with melanoma outcomes data from Surveillance Epidemiology and End Results Program and United States Cancer Statistics databases (2004-2014 and 2010-2014, respectively). Setting: Users of the Google search engine in the United States. Participants: Google search engine users in the United States. This represents approximately 65% of the population. Measures: Search volumes, melanoma outcomes. Analysis: Pearson correlations between search term volumes, time, and national melanoma outcomes. Spearman correlations between state-level search data and melanoma outcomes. Results: The terms “sunscreen,” “sunburn,” “skin cancer,” and “melanoma” were all highly correlated ( P < .001), with sunscreen and sunburn having the greatest correlation ( r = 0.95). Sunscreen/sunburn searches have increased over time, but skin cancer/melanoma searches have decreased ( P < .05). Nationally, sunscreen, sunburn, and skin cancer were significantly correlated with melanoma incidence. At the state level, only sunscreen and melanoma searches were significantly correlated with melanoma incidence. Conclusions: We conclude that online skin cancer prevention campaigns should focus on the search terms “sunburn” and “sunscreen,” given the decreasing online searches for skin cancer and melanoma. This is reinforced by the finding that sunscreen searches are higher in areas with higher melanoma incidence.

scholarly journals The Causality Inference of Public Interest in Restaurants and Bars on Daily COVID-19 Cases in the United States: Google Trends Analysis

10.2196/22880 ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. e22880
Author(s):  
Milad Asgari Mehrabadi ◽  
Nikil Dutt ◽  
Amir M Rahmani
Keyword(s):  
United States ◽  
Granger Causality ◽  
Public Interest ◽  
Granger Causality Test ◽  
The United States ◽  
Google Trends ◽  
Causality Test ◽  
Us States ◽  
Search Queries ◽  
Google Search

Background The COVID-19 pandemic has affected virtually every region in the world. At the time of this study, the number of daily new cases in the United States was greater than that in any other country, and the trend was increasing in most states. Google Trends provides data regarding public interest in various topics during different periods. Analyzing these trends using data mining methods may provide useful insights and observations regarding the COVID-19 outbreak. Objective The objective of this study is to consider the predictive ability of different search terms not directly related to COVID-19 with regard to the increase of daily cases in the United States. In particular, we are concerned with searches related to dine-in restaurants and bars. Data were obtained from the Google Trends application programming interface and the COVID-19 Tracking Project. Methods To test the causation of one time series on another, we used the Granger causality test. We considered the causation of two different search query trends related to dine-in restaurants and bars on daily positive cases in the US states and territories with the 10 highest and 10 lowest numbers of daily new cases of COVID-19. In addition, we used Pearson correlations to measure the linear relationships between different trends. Results Our results showed that for states and territories with higher numbers of daily cases, the historical trends in search queries related to bars and restaurants, which mainly occurred after reopening, significantly affected the number of daily new cases on average. California, for example, showed the most searches for restaurants on June 7, 2020; this affected the number of new cases within two weeks after the peak, with a P value of .004 for the Granger causality test. Conclusions Although a limited number of search queries were considered, Google search trends for restaurants and bars showed a significant effect on daily new cases in US states and territories with higher numbers of daily new cases. We showed that these influential search trends can be used to provide additional information for prediction tasks regarding new cases in each region. These predictions can help health care leaders manage and control the impact of the COVID-19 outbreak on society and prepare for its outcomes.

scholarly journals The Association of Social Distancing, Population Density, and Temperature with the SARS-CoV-2 Instantaneous Reproduction Number in Counties Across the United States

2020 ◽  
Author(s):  
David Rubin ◽  
Jing Huang ◽  
Brian T. Fisher ◽  
Antonio Gasparrini ◽  
Vicky Tam ◽  
...  
Keyword(s):  
United States ◽  
Population Density ◽  
Reproduction Number ◽  
Multivariable Analysis ◽  
The United States ◽  
Fatality Rate ◽  
Social Distancing ◽  
Specific Factors ◽  
Lower Population ◽  
Lower Population Density

AbstractImportanceThe Covid-19 pandemic has been marked by considerable heterogeneity in outbreaks across the United States. Local factors that may be associated with variation in SARS-CoV-2 transmission have not been well studied.ObjectiveTo examine the association of county-level factors with variation in the SARS-CoV-2 reproduction number over time.DesignObservational studySetting211 counties in 46 states and the District of Columbia between February 25, 2020 and April 23, 2020.ParticipantsResidents within the counties (55% of the US population)ExposuresSocial distancing as measured by percent change in visits to non-essential businesses, population density, lagged daily wet bulb temperatures.Main Outcomes and MeasuresThe instantaneous reproduction number (Rt) which is the estimated number of cases generated by one case at a given time during the pandemic.ResultsMedian case incidence was 1185 cases and fatality rate was 43.7 deaths per 100,000 people for the top decile of 21 counties, nearly ten times the incidence and fatality rate in the lowest density quartile. Average Rt in the first two weeks was 5.7 (SD 2.5) in the top decile, compared to 3.1 (SD 1.2) in the lowest quartile. In multivariable analysis, a 50% decrease in visits to non-essential businesses was associated with a 57% decrease in Rt (95% confidence interval, 56% to 58%). Cumulative temperature effects over 4 to 10 days prior to case incidence were nonlinear; relative Rt decreased as temperatures warmed above 32°F to 53°F, which was the point of minimum Rt, then increased between 53°F and 66°F, at which point Rt began to decrease. At 55°F, and with a 70% reduction in visits to non-essential business, 96% of counties were estimated to fall below a threshold Rt of 1.0, including 86% of counties among the top density decile and 98% of counties in the lowest density quartile.Conclusions and RelevanceSocial distancing, lower population density, and temperate weather change were associated with a decreased SARS-Co-V-2 Rt in counties across the United States. These relationships can inform selective public policy planning in communities during the SARS-CoV-2 pandemic.Key PointsQuestionHow is the instantaneous reproduction number (Rt) of SARS-CoV-2 influenced by local area effects of social distancing, wet bulb temperature, and population density in counties across the United States?FindingsSocial distancing, temperate weather, and lower population density were associated with a decrease in Rt. Of these county-specific factors, social distancing appeared to be the most significant in reducing SARS-CoV-2 transmission.MeaningRt varies significantly across counties. The relationship between Rt and county-specific factors can inform policies to reduce SARS-CoV-2 transmission in selective and heterogeneous communities.

scholarly journals Influence of Health Beliefs on Adherence to COVID-19 Preventative Practices: International, Social Media–Based Survey Study (Preprint)

2020 ◽  
Author(s):  
Julianna C Hsing ◽  
Jasmin Ma ◽  
Alejandra Barrero-Castillero ◽  
Shilpa G Jani ◽  
Uma Palam Pulendran ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Logistic Regression ◽  
Hong Kong ◽  
Health Beliefs ◽  
Self Efficacy ◽  
The United States ◽  
Perceived Severity ◽  
Social Distancing ◽  
United States Mexico

BACKGROUND Health behavior is influenced by culture and social context. However, there are limited data evaluating the scope of these influences on COVID-19 response. OBJECTIVE This study aimed to compare handwashing and social distancing practices in different countries and evaluate practice predictors using the health belief model (HBM). METHODS From April 11 to May 1, 2020, we conducted an online, cross-sectional survey disseminated internationally via social media. Participants were adults aged 18 years or older from four different countries: the United States, Mexico, Hong Kong (China), and Taiwan. Primary outcomes were self-reported handwashing and social distancing practices during COVID-19. Predictors included constructs of the HBM: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Associations of these constructs with behavioral outcomes were assessed by multivariable logistic regression. RESULTS We analyzed a total of 71,851 participants, with 3070 from the United States, 3946 from Mexico, 1201 from Hong Kong (China), and 63,634 from Taiwan. Of these countries, respondents from the United States adhered to the most social distancing practices (χ<sup>2</sup><sub>3</sub>=2169.7, <i>P</i>&lt;.001), while respondents from Taiwan performed the most handwashing (χ<sup>2</sup><sub>3</sub>=309.8, <i>P</i>&lt;.001). Multivariable logistic regression analyses indicated that self-efficacy was a positive predictor for handwashing (odds ratio [OR]<sub>United States</sub> 1.58, 95% CI 1.21-2.07; OR<sub>Mexico</sub> 1.5, 95% CI 1.21-1.96; OR<sub>Hong Kong</sub> 2.48, 95% CI 1.80-3.44; OR<sub>Taiwan</sub> 2.30, 95% CI 2.21-2.39) and social distancing practices (OR<sub>United States</sub> 1.77, 95% CI 1.24-2.49; OR<sub>Mexico</sub> 1.77, 95% CI 1.40-2.25; OR<sub>Hong Kong</sub> 3.25, 95% CI 2.32-4.62; OR<sub>Taiwan</sub> 2.58, 95% CI 2.47-2.68) in all countries. Handwashing was positively associated with perceived susceptibility in Mexico, Hong Kong, and Taiwan, while social distancing was positively associated with perceived severity in the United States, Mexico, and Taiwan. CONCLUSIONS Social media recruitment strategies can be used to reach a large audience during a pandemic. Self-efficacy was the strongest predictor for handwashing and social distancing. Policies that address relevant health beliefs can facilitate adoption of necessary actions for preventing COVID-19. Our findings may be explained by the timing of government policies, the number of cases reported in each country, individual beliefs, and cultural context.

scholarly journals Citizens’ Adherence to COVID-19 Mitigation Recommendations by the Government: A 3-Country Comparative Evaluation Using Web-Based Cross-Sectional Survey Data

10.2196/20634 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e20634 ◽  
Author(s):  
Abrar Al-Hasan ◽  
Dobin Yim ◽  
Jiban Khuntia
Keyword(s):  
United States ◽  
Social Media ◽  
South Korea ◽  
Comparative Evaluation ◽  
Information Sources ◽  
The United States ◽  
Ordered Probit ◽  
Web Based ◽  
Social Distancing ◽  
The Government

Background Social distancing is an effective preventative policy for the coronavirus disease (COVID-19) that is enforced by governments worldwide. However, significant variations are observed in following the policy across individuals and countries. Arguably, differences in citizens’ adherence actions will be influenced by their perceptions about government’s plans and the information available to guide their behaviors—more so in the digital age in the realm of mass influence of social media on citizens. Insights into the underlying factors and dynamics involved with citizens’ adherence process will inform the policy makers to follow appropriate communication and messaging approaches to influence citizens’ willingness to adhere to the recommendations. Objective The aim of this study is a comparative evaluation of citizens’ adherence process to COVID-19–relevant recommendations by the government. The focus is on how three different countries’ (United States, Kuwait, and South Korea) citizens, randomly sampled, respond to governments’ pandemic guidance efforts. We draw insights into two categories of perceived government roles in managing the pandemic: (1) citizens’ perceptions of government’s role in responding to the pandemic and (2) citizens’ perceptions of government’s business reopening efforts. Undoubtedly, the internet and social media have burgeoned, with differing effects on shaping individuals’ views and assessments of the COVID-19 situation; we argue and test for the effects of information sources, social media use, and knowledge on the adherence actions. Methods We randomly sampled web-based survey data collected by a global firm in May 2020 from citizens of the United States, Kuwait, and South Korea. A nonlinear ordered probit regression, controlling for several counterfactuals, was used for analysis. The focal estimated effects of the study were compared across countries using the weighted distance between the parameter estimates. Results The total sample size was 482 respondents, of which 207 (43%) lived in the United States, 181 (38%) lived in Kuwait, and 94 (20%) lived in South Korea. The ordered probit estimation results suggest that overall, perception of government response efforts positively influenced self-adherence (P<.001) and others’ adherence (P<.001) to social distancing and sheltering. Perception of government business reopening efforts positively influenced others’ adherence (P<.001). A higher intensity of general health information source for COVID-19 had a positive effect on self-adherence (P=.003). A higher intensity of social media source use for COVID-19 positively influenced others’ adherence (P=.002). A higher intensity of knowledge on COVID-19 positively influenced self-adherence (P=.008) and negatively influenced others’ adherence (P<.001). There were country-level variations—broadly, the United States and Kuwait had better effects than South Korea. Conclusions As the COVID-19 global pandemic continues to grow and governmental restrictions are ongoing, it is critical to understand people’s frustration to reduce panic and promote social distancing to facilitate the control of the pandemic. This study finds that the government plays a central role in terms of adherence to restrictions. Governments need to enhance their efforts on publicizing information on the pandemic, as well as employ strategies for improved communication management to citizens through social media as well as mainstream information sources.

scholarly journals Coronavirus Disease 2019 (COVID-19) Transmission in the United States Before Versus After Relaxation of Statewide Social Distancing Measures

2020 ◽  
Author(s):  
Alexander C Tsai ◽  
Guy Harling ◽  
Zahra Reynolds ◽  
Rebecca F Gilbert ◽  
Mark J Siedner
Keyword(s):  
United States ◽  
State Government ◽  
Disease Burden ◽  
Reproduction Number ◽  
District Of Columbia ◽  
The United States ◽  
Third Party ◽  
Social Distancing ◽  
Significant Reversal ◽  
The Mean

Abstract Background Weeks after issuing social distancing orders to suppress severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and reduce growth in cases of severe coronavirus disease 2019 (COVID-19), all US states and the District of Columbia partially or fully relaxed these measures. Methods We identified all statewide social distancing measures that were implemented and/or relaxed in the United States between 10 March and 15 July 2020, triangulating data from state government and third-party sources. Using segmented linear regression, we estimated the extent to which relaxation of social distancing affected epidemic control, as indicated by the time-varying, state-specific effective reproduction number (Rt). Results In the 8 weeks prior to relaxation, mean Rt declined by 0.012 units per day (95% confidence interval [CI], −.013 to −.012), and 46/51 jurisdictions achieved Rt &lt; 1.0 by the date of relaxation. After relaxation of social distancing, Rt reversed course and began increasing by 0.007 units per day (95% CI, .006–.007), reaching a mean Rt of 1.16. Eight weeks later, the mean Rt was 1.16 and only 9/51 jurisdictions were maintaining an Rt &lt; 1.0. Parallel models showed similar reversals in the growth of COVID-19 cases and deaths. Indicators often used to motivate relaxation at the time of relaxation (eg, test positivity rate &lt;5%) predicted greater postrelaxation epidemic growth. Conclusions We detected an immediate and significant reversal in SARS-CoV-2 epidemic suppression after relaxation of social distancing measures across the United States. Premature relaxation of social distancing measures undermined the country’s ability to control the disease burden associated with COVID-19.

Sign in / Sign up

Export Citation Format

Share Document