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Background The Coronavirus Disease 2019 (COVID-19) pandemic warranted a myriad of government-ordered business closures across the USA in efforts to mitigate the spread of the virus. This study aims to discover the implications of government-enforced health policies of reopening public businesses amidst the pandemic and its effect on county-level infection rates. Methods Eighty-three US counties (n = 83) that reported at least 20 000 cases as of 4 November 2020 were selected for this study. The dates when businesses (restaurants, bars, retail, gyms, salons/barbers and public schools) partially and fully reopened, as well as infection rates on the 1st and 14th days following each businesses’ reopening, were recorded. Regression analysis was conducted to deduce potential associations between the 14-day change in infection rate and mask usage frequency, median household income, population density and social distancing. Results On average, infection rates rose significantly as businesses reopened. The average 14-day change in infection rate was higher for fully reopened businesses (infection rate = +0.100) compared to partially reopened businesses (infection rate = +0.0454). The P-value of the two distributions was 0.001692, indicating statistical significance (P < 0.01). Conclusion This research provides insight into the transmission of COVID-19 and promotes evidence-driven policymaking for disease prevention and community health.

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Introduction: Coronavirus disease 2019 (COVID-19) disparities among vulnerable populations are a paramount concern that extends to COVID-19 vaccine administration. We aim to better characterize the scope of vaccine inequity in California by comparing the Social Vulnerability Index (SVI) of California counties and respective vaccination rates, modeling the growth rate and anticipated maximum proportion of individuals vaccinated by SVI group. Methods: Overall SVI, its four themes, and 9228 data points of daily vaccination numbers across all 58 California counties were used to model, overall and by theme, growth velocity of proportion of population vaccinated and the expected maximum proportion of individuals (at least 1 dose of Pfizer-BioNTech, Moderna, or Johnson & Johnson/Janssen) that will be vaccinated for each theme. Results: Overall high vulnerability counties in California have lower vaccine coverage velocity compared to low and moderate vulnerability counties. The largest disparity in coverage velocity between low and highly vulnerable counties was observed in Theme 3 (minority status & language). However, our model showed that highly vulnerable counties based on Theme 3 are expected to eventually achieve a higher proportion of vaccinated individuals compared to low vulnerable counterparts if current trajectories continue. Counties in the overall low vulnerability category are estimated to achieve a higher proportion of vaccinated individuals when compared to high and moderate vulnerable counties, assuming current trajectories. The largest disparity in asymptotic proportion vaccinated between high and low vulnerable counties was observed in Theme 2 (household composition & disability). Conclusion: This study provides insight into the problem of COVID-19 vaccine disparity across California which can be used to help promote equity during the current pandemic as well as guide the allocation of future vaccines such as COVID-19 booster shots.