Objective: The proposed symposium will be organized around four objectives: (1) present the methods and results of a content analysis of 1,470 state governmental documents that identified 9 types of nonpharmaceutical mitigation interventions and the timing at which states enacted each of these strategies; (2) present findings of a determinant study to explore factors associated with timing of enacting social distancing interventions; (3) present findings of an impact study that links the timing of each mitigation order to various case counts of Covid-19; and (4) discuss the implications of this study, particularly the removal of social distancing interventions in the absence of effective pharmaceutical interventions that may carry high risk for a relapse.
Methods: Content analysis, Cox proportional hazards model, multiple-event survival model correcting for clustering effect, and a random-effect spatial error panel model were employed in the analysis.
Results: Results show that Covid-19 prevalence rate, population size, unemployment, proportion of uninsured, poverty, level of economic development, proportion of minority people, and public health infrastructure are the key determinants affecting the initiation of mitigation interventions. Three mitigation strategies (non-essential business closure, large gathering bans, and restaurant/bar limitations) showed positive impacts on reducing cumulative cases, new cases, and death rates across states.
Conclusions: Our exploratory findings suggest that at least three mitigation strategies were having an effect at that time. Because there is no preventive vaccine and because there are few potentially effective treatments, recent reductions in new cases and deaths must be due, in large part, to the social interventions delivered by states. The removal of these social interventions in the absence of effective pharmaceutical interventions carries high risk for a relapse.