SARS-CoV-2 Transmission Potential and Policy Changes in South Carolina, February 2020 – January 2021
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Abstract
Introduction
We aimed to examine how public health policies influenced the dynamics of COVID-19 time-varying reproductive number ( R t ) in South Carolina from February 26, 2020 to January 1, 2021.
Methods
COVID-19 case series (March 6, 2020 - January 10, 2021) were shifted by 9 days to approximate the infection date. We analyzed the effects of state and county policies on R t using EpiEstim. We performed linear regression to evaluate if per-capita cumulative case count varies across counties with different population size.
Results
R t shifted from 2-3 in March to <1 during April and May. R t rose over the summer and stayed between 1.4 and 0.7. The introduction of statewide mask mandates was associated with a decline in R t (−15.3%; 95% CrI, -13.6%, -16.8%), and school re-opening, an increase by 12.3% (95% CrI, 10.1%, 14.4%). Less densely populated counties had higher attack rate (p<0.0001).
Conclusion
The R t dynamics over time indicated that public health interventions substantially slowed COVID-19 transmission in South Carolina, while their relaxation may have promoted further transmission. Policies encouraging people to stay home, such as closing non-essential businesses, were associated with R t reduction, while policies that encouraged more movement, such as re-opening schools, were associated with R t increase.
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SciScore for 10.1101/2021.09.25.21263798: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations: There are a number of limitations in this study. First, this analysis was based on aggregate data reported by the surveillance system of COVID-19 in South Carolina. The data was arranged by date of report. Even though we shifted the date backward by 9 days to approximate the date of infection, this remained an estimation. Second, date of report is affected by holidays, on which days cases were not reported. Third, the …
SciScore for 10.1101/2021.09.25.21263798: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Limitations: There are a number of limitations in this study. First, this analysis was based on aggregate data reported by the surveillance system of COVID-19 in South Carolina. The data was arranged by date of report. Even though we shifted the date backward by 9 days to approximate the date of infection, this remained an estimation. Second, date of report is affected by holidays, on which days cases were not reported. Third, the effects of viral variants on transmission potential44 cannot be shown in this study. The first two cases of the Beta (B.1.351) variant in the U.S. were detected in South Carolina after the study period ended,46 so this may not be a severe limitation. Fourth, while re-opening of schools was staggered by grade in South Carolina, we lumped the re-openings together as we chose the first date of the re-opening as the date of policy change. However, for the county-level policy change analysis, we had specific school re-opening dates for all nine selected counties (Figures 2 and 3). And finally, we do not examine the impact of vaccinations on the transmission potential in South Carolina; however, our data was right-censored on January 10th, 2021, by which point there were minimal numbers of people fully vaccinated. Although we examined the impact of policy mandates, we did not examine the extent to which these policies were adhered on the ground. Behavioral variation in some places might impact the effectiveness of policies. However, as we attempted to exa...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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