Identifying the Evolving Types and Timelines of COVID-19 Social Distancing Measures: A Content Analysis

Backgrounds and Purpose: Since the pandemic began in 2020, the state governments issued differing social distancing measures aiming at reducing the spread of COVID-19. Limited research has focused on understanding the variation in and dynamic development of social distancing policies. The main research question in this study is to explore major social distancing measures that state governments issued, lifted, and reissued from the declaration of national emergency (3/13/2020) to the moment when major vaccination efforts from Biden administration had not yet been initiated (1/5/2021).

Methods: Qualitative content analysis was employed to analyze large quantities of executive orders from state government websites. After systematically reviewing 3,703 governmental documents issued by state governors, two independent researchers coded six mitigation strategies using strict definitions for each category.

Results: Six social distancing interventions were categorized as shown below incorporating exact timeframe (date and hour) and its uneven, changeable progress, including its enactment, rescindment, reenactment, and re-lifting.
1) Stay-at-home order: Orders issued by governors to require residents to stay at home except for essential activities. Its rescindment refers to orders that clearly state the expiration or ending point of stay-at-home orders. Stay-at-home advisory: Orders issued by governors that advise or suggest residents to stay at home except for essential activities, often adopted by those states which issued a first round of stay-at-home orders and lifted them later. These can be viewed as the less forceful version of stay-at-home order. 2) Public school closure: Orders regarding formal closure of all public K-12 schools until reopening, defined by when the first school district in a state started either fully in-person classes or hybrid-model classes. 3) Restaurant/bar limits: Orders requiring the closure of on-premises food and drink consumption and only allowing delivery, drive-through and carry-out options. Its rescindment refers to orders that allowed dining-in services at restaurants. Dining-in services closure: Orders requesting the closure of dining-in restaurant services, often issued in a state which hoped to put a second round of limitations on restaurants opening. Note: The policies for restaurants and bars are different. We here captured the time of lifting and reclosure of dining-in service for restaurants. 4) Large gathering ban of more than 10 people. Orders defined by a prohibition of public gatherings with greater than 10 people, the time when they lifted the order, and the time when they reenacted the gathering ban. 5) Non-essential business closure: Orders compelling the closure of all non-essential business, excluding non-essential retail business closure orders. The rescindment refers to the time when states started to reopen personal care services, including salons, barber shops, spas, and tattoo parlors. 6) Face covering requirement: Orders requiring all residents to wear face coverings in public settings.

Conclusion and Implications: Six major policy interventions regarding promoting social distancing and their changing processes were identified from existing governmental documents through the content analysis. Further research using these categories is needed to understand the determinants and impact of enacting, lifting, and reissuing social distancing interventions to inform public health best practices and policy making.