Differences in rapid increases in county-level COVID-19 incidence by implementation of statewide closures and mask mandates - United States, June 1-September 30, 2020

BACKGROUND AND OBJECTIVE

Community mitigation strategies could help reduce COVID-19 incidence, but there are few studies that explore associations nationally and by urbanicity. In a national county-level analysis, we examined the probability of being identified as a county with rapidly increasing COVID-19 incidence (rapid riser identification) during the summer of 2020 by implementation of mitigation policies prior to the summer, overall and by urbanicity.

METHODS

We analyzed county-level data on rapid riser identification during June 1-September 30, 2020 and statewide closures and statewide mask mandates starting March 19 (obtained from state government websites). Poisson regression models with robust standard error estimation were used to examine differences in the probability of rapid riser identification by implementation of mitigation policies (P-value< .05); associations were adjusted for county population size.

RESULTS

Counties in states that closed for 0-59 days were more likely to become a rapid riser county than those that closed for >59 days, particularly in nonmetropolitan areas. The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening (adjusted prevalence ratio = 0.57; 95% confidence intervals = 0.51-0.63); when stratified by urbanicity, associations were more pronounced in nonmetropolitan areas.

CONCLUSIONS

These results underscore the potential value of community mitigation strategies in limiting the COVID-19 spread, especially in nonmetropolitan areas.

Social distancing policies in 22 African countries during the COVID-19 pandemic: a desk review

Introduction

on January 30, 2020, the World Health Organization declared the novel coronavirus outbreak a Public Health Emergency of International Concern. As of October 5, 2020, there were over 34.8 million reported cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and more than 1 million reported deaths from coronavirus disease 2019 (COVID-19), globally. Non-pharmaceutical interventions, such as social distancing policies, hand hygiene, and mask use, are key public health measures to control COVID-19. In response to, or in some cases even before, the first wave of SARS-CoV-2 infections were reported in their countries, policy makers across Africa issued various social distancing policies.

Methods

we describe social distancing policies issued from March 1 to April 24, 2020 in 22 Anglophone countries of sub-Saharan Africa. We reviewed policies identified online.

Results

though all 22 countries closed schools and banned gatherings, they took a variety of approaches to sizes of gatherings banned and to stay-at-home orders, with 13 countries issuing national stay-at-home orders, four issuing subnational stay-at-home orders, and five not issuing stay-at-home orders. Enforcement provisions varied by country, as did funeral and health care exceptions.

Conclusion

movement restrictions, business restrictions, and school closures can have substantial negative impacts on economies, education, nutrition, and routine health care. Yet easing or lifting of COVID-19 social distancing policies can lead to increased transmission. Our review documents a wide variety of policy alternatives used in Africa and can inform future adjustments as countries ease, lift, and reapply measures in response to their evolving epidemics.

Social distancing policies in 22 African countries during the COVID-19 pandemic: a desk review

Introduction

on January 30, 2020, the World Health Organization declared the novel coronavirus outbreak a Public Health Emergency of International Concern. As of October 5, 2020, there were over 34.8 million reported cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and more than 1 million reported deaths from coronavirus disease 2019 (COVID-19), globally. Non-pharmaceutical interventions, such as social distancing policies, hand hygiene, and mask use, are key public health measures to control COVID-19. In response to, or in some cases even before, the first wave of SARS-CoV-2 infections were reported in their countries, policy makers across Africa issued various social distancing policies.

Methods

we describe social distancing policies issued from March 1 to April 24, 2020 in 22 Anglophone countries of sub-Saharan Africa. We reviewed policies identified online.

Results

though all 22 countries closed schools and banned gatherings, they took a variety of approaches to sizes of gatherings banned and to stay-at-home orders, with 13 countries issuing national stay-at-home orders, four issuing subnational stay-at-home orders, and five not issuing stay-at-home orders. Enforcement provisions varied by country, as did funeral and health care exceptions.

Conclusion

movement restrictions, business restrictions, and school closures can have substantial negative impacts on economies, education, nutrition, and routine health care. Yet easing or lifting of COVID-19 social distancing policies can lead to increased transmission. Our review documents a wide variety of policy alternatives used in Africa and can inform future adjustments as countries ease, lift, and reapply measures in response to their evolving epidemics.