Impacts of introducing and lifting nonpharmaceutical interventions on COVID-19 daily growth rate and compliance in the United States

Proc Natl Acad Sci U S A. 2021 Mar 23;118(12):e2021359118. doi: 10.1073/pnas.2021359118.

Abstract

We evaluate the impacts of implementing and lifting nonpharmaceutical interventions (NPIs) in US counties on the daily growth rate of COVID-19 cases and compliance, measured through the percentage of devices staying home, and evaluate whether introducing and lifting NPIs protecting selective populations is an effective strategy. We use difference-in-differences methods, leveraging on daily county-level data and exploit the staggered introduction and lifting of policies across counties over time. We also assess heterogenous impacts due to counties' population characteristics, namely ethnicity and household income. Results show that introducing NPIs led to a reduction in cases through the percentage of devices staying home. When counties lifted NPIs, they benefited from reduced mobility outside of the home during the lockdown, but only for a short period. In the long term, counties experienced diminished health and mobility gains accrued from previously implemented policies. Notably, we find heterogenous impacts due to population characteristics implying that measures can mitigate the disproportionate burden of COVID-19 on marginalized populations and find that selectively targeting populations may not be effective.

Keywords: COVID-19; compliance; lockdown measures; nonpharmaceutical interventions; public policy.

MeSH terms

  • COVID-19 / economics
  • COVID-19 / epidemiology*
  • COVID-19 / prevention & control
  • COVID-19 / transmission*
  • Communicable Disease Control / methods*
  • Communicable Disease Control / statistics & numerical data
  • Guideline Adherence / statistics & numerical data
  • Health Policy / economics
  • Health Policy / trends
  • Humans
  • Pandemics
  • Physical Distancing
  • SARS-CoV-2 / isolation & purification
  • Socioeconomic Factors
  • United States / epidemiology