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Register a new userEstimating the treatment effect of the juvenile stay-at-home order on SARS-CoV-2 infection spread in Saline County, Arkansas
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Sharmodeep Bhattacharyya
Publication date
2020
fields
Mathematical Statistics
and research's language is
English
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We investigate the treatment effect of the juvenile stay-at-home order (JSAHO) adopted in Saline County, Arkansas, from April 6 to May 7, in mitigating the growth of SARS-CoV-2 infection rates. To estimate the counterfactual control outcome for Saline County, we apply Difference-in-Differences and Synthetic Control design methodologies. Both approaches show that stay-at-home order (SAHO) significantly reduced the growth rate of the infections in Saline County during the period the policy was in effect, contrary to some of the findings in the literature that cast doubt on the general causal impact of SAHO with narrower scopes.
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Accurately estimating the effectiveness of stay-at-home orders (SHOs) on reducing social contact and disease spread is crucial for mitigating pandemics. Leveraging individual-level location data for 10 million smartphones, we observe that by April 30th---when nine in ten Americans were under a SHO---daily movement had fallen 70% from pre-COVID levels. One-quarter of this decline is causally attributable to SHOs, with wide demographic differences in compliance, most notably by political affiliation. Likely Trump voters reduce movement by 9% following a local SHO, compared to a 21% reduction among their Clinton-voting neighbors, who face similar exposure risks and identical government orders. Linking social distancing behavior with an epidemic model, we estimate that reductions in movement have causally reduced SARS-CoV-2 transmission rates by 49%.
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Near real-time monitoring of outbreak transmission dynamics and evaluation of public health interventions are critical for interrupting the spread of the novel coronavirus (SARS-CoV-2) and mitigating morbidity and mortality caused by coronavirus disease (COVID-19). Formulating a regional mechanistic model of SARS-CoV-2 transmission dynamics and frequently estimating parameters of this model using streaming surveillance data offers one way to accomplish data-driven decision making. For example, to detect an increase in new SARS-CoV-2 infections due to relaxation of previously implemented mitigation measures one can monitor estimates of the basic and effective reproductive numbers. However, parameter estimation can be imprecise, and sometimes even impossible, because surveillance data are noisy and not informative about all aspects of the mechanistic model, even for reasonably parsimonious epidemic models. To overcome this obstacle, at least partially, we propose a Bayesian modeling framework that integrates multiple surveillance data streams. Our model uses both COVID-19 incidence and mortality time series to estimate our model parameters. Importantly, our data generating model for incidence data takes into account changes in the total number of tests performed. We apply our Bayesian data integration method to COVID-19 surveillance data collected in Orange County, California. Our results suggest that California Department of Public Health stay-at-home order, issued on March 19, 2020, lowered the SARS-CoV-2 effective reproductive number $R_{e}$ in Orange County below 1.0, which means that the order was successful in suppressing SARS-CoV-2 infections. However, subsequent re-opening steps took place when thousands of infectious individuals remained in Orange County, so $R_{e}$ increased to approximately 1.0 by mid-June and above 1.0 by mid-July.
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