Evaluation of the U.S. governors' decision when to issue stay‐at‐home orders

  1. Benjamin Djulbegovic
  2. David J. Weiss
  3. Iztok Hozo

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Abstract

Rationale, aims and objectives

In the United States, the reluctance of the federal government to impose a national stay‐at‐home policy in wake of COVID‐19 pandemic has left the decision of how to achieve social distancing to individual state governors. We hypothesized that in the absence of formal guidelines, the decision to close a state reflects the classic Weber‐Fechner law of psychophysics – the amount by which a stimulus (such as number of cases or deaths) must increase in order to be noticed as a fraction of the intensity of that stimulus.

Methods

On 12 April 2020, we downloaded data from the New York Times database from all 50 states and the District of Columbia; by that time all but 7 states had issued the stay‐at‐home orders. We fitted the Weber‐Fechner logarithmic function by regressing the log 2 of cases and deaths, respectively, against the daily counts. We also conducted Cox regression analysis to determine if the probability of issuing the stay‐at‐home order increases proportionally as the number of cases or deaths increases.

Results

We found that the decision to issue the state‐at‐home order reflects the Weber‐Fechner law. Both the number of infections ( P = <.0001; R 2 = .79) and deaths ( P < .0001; R 2 = .63) were significantly associated with the decision to issue the stay‐at‐home orders. The results indicate that for each doubling of infections or deaths, an additional four to six states will issue stay‐at‐home orders. Cox regression showed that when the number of deaths reached 256 and the number of infected people were over 16 000 the probability of issuing “stay‐at‐home” order was close to 100%. We found no difference in decision‐making according to the political affiliation; the results remain unchanged on 16 July 2 020.

Conclusions

when there are not clearly articulated rules to follow, decision‐makers resort to simple heuristics, in this case one consistent with the Weber‐Fechner law.

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  1. Version published to 10.1111/jep.13458
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    SciScore for 10.1101/2020.05.14.20093633: (What is this?)

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    Table 1: Rigor

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    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyses were done in STATA statistical software.9 Patient and public involvement: This analysis is based on publicly available, individual data.
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    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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.

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  3. Version published to 10.1101/2020.05.14.20093633v1 on medRxiv