Non-Pharmaceutical Interventions and COVID-19 Burden in the United States
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
Background
Non-pharmaceutical interventions (NPIs) are mitigation strategies used to reduce the spread of transmissible diseases. The relative effectiveness of specific NPIs remains uncertain.
Methods
We used state-level Coronavirus disease 2019 (COVID-19) case and mortality data between January 19, 2020 and March 7, 2021 to model NPI policy effectiveness. Empirically derived breakpoints in case and mortality velocities were used to identify periods of stable, decreasing, or increasing COVID-19 burden. The associations between NPI adoption and subsequent decreases in case or death velocities were estimated using generalized linear models accounting for weekly variability shared across states. State-level NPI policies included: stay at home order, indoor public gathering ban (mild >10 or severe ≤10), indoor restaurant dining ban, and public mask mandate.
Results
28,602,830 cases and 511,899 deaths were recorded. The odds of a decrease in COVID-19 case velocity were significantly elevated for stay at home (OR 2.02, 95% CI 1.63-2.52), indoor dining ban (OR 1.62, 95% CI 1.25-2.10), public mask mandate (OR 2.18, 95% CI 1.47-3.23), and severe gathering ban (OR 1.68, 95% CI 1.31-2.16). In mutually adjusted models, odds remained elevated for stay at home (AOR 1.47, 95% CI 1.04-2.07) and public mask mandate (AOR = 2.27, 95% CI 1.51-3.41). Stay at home (OR 2.00, 95% CI 1.53-2.62; AOR 1.89, 95% CI 1.25-2.87) was also associated with greater likelihood of decrease in death velocity in unadjusted and adjusted models.
Conclusions
NPIs employed in the U.S. during the COVID-19 pandemic, most significantly stay at home orders, were associated with decreased COVID-19 burden.
Article activity feed
-
SciScore for 10.1101/2021.09.26.21264142: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Given sample size limitations, limited variation in some policy adoption, and temporal variation in the progression of COVID-19 to death, we are limited in our ability to attribute deviations in daily death counts to specific policy actions. An additional consideration is that NPIs associated with decreasing case velocities but not …
SciScore for 10.1101/2021.09.26.21264142: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Given sample size limitations, limited variation in some policy adoption, and temporal variation in the progression of COVID-19 to death, we are limited in our ability to attribute deviations in daily death counts to specific policy actions. An additional consideration is that NPIs associated with decreasing case velocities but not associated with decreasing subsequent deaths may signal that case decreases occurred disproportionally among younger individuals with less risk for COVID-19 mortality. This may be particularly true for public mask mandates, which were significantly associated with decreased case but not mortality burden in adjusted models. Our modeling approach allowed us to evaluate the merits of various NPIs concomitantly in a time-dependent fashion. Prior NPI studies have generally focused on pandemic influenza and relied on expert opinion or modeling rather than real-world data.7,9,15,30,31 In fact, the most recent Pandemic Influenza Plan by the U.S. Department of Health and Human Services described study of NPIs in the status of a data collection phase.15 Some retrospective data regarding NPIs and viral pandemics has been published. An analysis of U.S. cities found an association between increased duration of NPIs and total mortality reduction.30 Auger et al13 found school closures were associated with decreased COVID-19 incidence and mortality but adjustment for other NPIs was not included. Bendavid et al32 reported, in an international comparison of 10 count...
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.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
-
-