In the week before Hurricane Katrina's landfall in August 2005, emergency management officials in Jefferson County (Birmingham), Alabama, began to make plans for the potential influx of evacuees from the Gulf Coast. No pharmacy component to the plan was in place at that time. The Jefferson County Department of Health (JCDH) discovered that local pharmacies and hospital emergency departments were dealing with significant requests for medication refills. JCDH, in cooperation with a local school of pharmacy, developed a plan for addressing the unforeseen need for routine prescription refills by evacuees. This article discusses this novel pharmacy plan and lessons learned from the event, and may serve as a model for other municipalities and/or states interested in preparing a pharmacy response to future natural disasters.
Background
Social distancing have been widely used to mitigate community spread of SARS-CoV-2. We sought to quantify the impact of COVID-19 social distancing policies across 27 European counties in spring 2020 on population mobility and the subsequent trajectory of disease.
Methods
We obtained data on national social distancing policies from the Oxford COVID-19 Government Response Tracker and aggregated and anonymized mobility data from Google. We used a pre-post comparison and two linear mixed-effects models to first assess the relationship between implementation of national policies and observed changes in mobility, and then to assess the relationship between changes in mobility and rates of COVID-19 infections in subsequent weeks.
Results
Compared to a pre-COVID baseline, Spain saw the largest decrease in aggregate population mobility (~70%), as measured by the time spent away from residence, while Sweden saw the smallest decrease (~20%). The largest declines in mobility were associated with mandatory stay-at-home orders, followed by mandatory workplace closures, school closures, and non-mandatory workplace closures. While mandatory shelter-in-place orders were associated with 16.7% less mobility (95% CI: -23.7% to -9.7%), non-mandatory orders were only associated with an 8.4% decrease (95% CI: -14.9% to -1.8%). Large-gathering bans were associated with the smallest change in mobility compared with other policy types. Changes in mobility were in turn associated with changes in COVID-19 case growth. For example, a 10% decrease in time spent away from places of residence was associated with 11.8% (95% CI: 3.8%, 19.1%) fewer new COVID-19 cases.
Discussion
This comprehensive evaluation across Europe suggests that mandatory stay-at-home orders and workplace closures had the largest impacts on population mobility and subsequent COVID-19 cases at the onset of the pandemic. With a better understanding of policies’ relative performance, countries can more effectively invest in, and target, early nonpharmacological interventions.
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