Session: Social Distancing Interventions in the COVID-19 Pandemic in the United States: An Exploratory Investigation of the Determinants and Impacts of Alternative Mitigation Strategies (Society for Social Work and Research 25th Annual Conference - Social Work Science for Social Change)

Background: To date, major Covid-19 disease indicators have not shown a uniform downward trajectory across states and municipalities in the United States. The unprecedented implementation of social distancing and other mitigation strategies is associated with a large number of job losses and is projected to cost at least 2 trillion U.S. dollars. Policy makers are facing a tough decision: How to balance between economic and public health interests? Which strategies should be undertaken at which time points in order to maximize utility functions? This symposium was organized to present an exploratory investigation on the determinants and impacts of U.S. mitigation strategies used in the first 5 weeks of the pandemic.

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.