https://orcid.org/0000-0002-4624-5615
Abstract
Purpose
Evaluate the correlation between statutory social distancing interventions and Covid-19 mortality independently in both the United States and Europe. The study is presented as a potential methodology to evaluate the effectiveness of statutory social distancing policy.
Patients and Methods
Twenty-seven states in the United States and, separately, 12 European countries were selected which had clearly defined and dated establishment of statewide or national mandates for social distancing measures from the Institute for Health Metrics and Evaluation (IHME) data. Mandated social distancing measures considered in this study include: School closures, Prohibition on mass gatherings, business closures, stay at home orders, severe travel restrictions, and closure of non-essential businesses. The state/country Covid-19 peak mortality rate (PMR) was defined as the initial averaged normalized maximum during which social distancing mandates were in effect. Mandate-days were defined as the total days legislative mandates were in place to the PMR.
Results
The normalized peak mortality rate in the US and in Europe did not demonstrate a statistically significant correlation to the total mandate days (R-squared=0.053, p=0.246, R-squared=2.4E-06, p=0.996). A significant correlation was found between normalized mortality rate and state/country population density (R-squared=0.524, p=0.00002,R-squared=0.397, p=0.0281).
Discussion
The analysis appears to suggest no mandate effective reduction in Covid-19 mortality rate to its defined initial peak when interpreting their mean-effect. A strong correlation to population density suggests human interaction frequency does affect the peak mortality rate.
Abbreviations
FDA, Food and Drug Administration; CFR, Code of Federal Regulations; IHME, Institute of Health Metrics and Evaluation; GLME, General Linear Mixed-Effects; PMR, Peak-mortality-rate due to Covid-19 as calculated using Equation 1; MAP, Mortality-at-peak due to Covid-19, standardized by state total population as reported in referenced IHME data.
Data Sharing Statement
Depersonalized data made available for download on IHME Websites can be used, shared, modified or built upon by non-commercial users via the Creative Commons Attribution-NonCommercial 4.0 International License. https://creativecommons.org/licenses/by-nc/4.0/Data available Institute for Health Metrics and Evaluation (IHME) http://www.healthdata.org/covid accessed on June 17, 2020 and July 19, 2020.
Preprint version published: Medrxiv 2020; DOI: 10.1101/2020.08.26.20182758.
Ethics Approval and Consent to Participate
This clinical study was conducted in accordance with the ethical principles contained within Declaration of Helsinki, Protection of Human Volunteers (21 CFR 50), Institutional Review Boards (21 CFR 56), and Obligations of Clinical Investigators (21 CFR 812). No IRB was required with the use of depersonalized public data.
Consent for Publication
Not Applicable. Depersonalized data made available for download on IHME Websites can be used, shared, modified or built upon by non-commercial users via the Creative Commons Attribution-NonCommercial 4.0 International License. https://creativecommons.org/licenses/by-nc/4.0/
Author Contributions
All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.