Social distancing measures, with varying degrees of restriction, have been imposed around the world in order to stem the spread of COVID-19. In this work we analyze the effect of current social distancing measures in the United States. We quantify the reduction in doubling rate, by state, that is associated with social distancing. We find that social distancing is associated with a statistically-significant reduction in the doubling rate for all but three states. At the same time, we do not find significant evidence that social distancing has resulted in a reduction in the number of daily confirmed cases. Instead, social distancing has merely stabilized the spread of the disease. We provide an illustration of our findings for each state, including point estimates of the effective reproduction number, R, both with and without social distancing. We also discuss the policy implications of our findings.

Social distancing measures have been imposed across the US in order to stem the spread of COVID‐19. We quantify the reduction in doubling rate, by state, that is associated with this intervention. Using the earlier of K‐12 school closures and restaurant closures, by state, to define the start of the intervention, and considering daily confirmed cases through April 23rd, 2020, we find that social distancing is associated with a statistically‐significant (p < 0.01) reduction in the doubling rate for all states except for Nebraska, North Dakota, and South Dakota, when controlling for false discovery, with the doubling rate averaged across the states falling from 0.302 (0.285, 0.320) days ‐1 to 0.010 (‐0.007, 0.028) days ‐1 . However, we do not find that social distancing has made the spread subcritical. Instead, social distancing has merely stabilized the spread of the disease. We provide an illustration of our findings for each state, including estimates of the effective reproduction number, R , both with and without social distancing. We also discuss the policy implications of our findings.

REPORTE DE CASO / CASE REPORT Neumomediastino y neumopericardio espontáneo en paciente con COVID-19; reporte de caso RESUMEN I n t r o d u c c i ó n : E l n e u m o m e d i a s t i n o y neumopericardio espontáneo en pacientes con COVID-19 pueden presentarse de manera inusual, y causar una evolución clínica tórpida. Presentamos el primer reporte clínico del Paraguay de una paciente con neumomediastino y neumopericardio asociado a neumonía por COVID-19.Presentación del caso: Una mujer de 39 años, con neumonía por COVID-19, presentó disnea y dolor de tórax persistente e intenso qu perduraban hasta tres semanas después de inicio de infección. Al día veinte y seis de su evolución, la evaluación retrospectiva de los controles tomográficos torácicos mostró presencia de aire en mediastino y en saco pericárdico. Se instauró un tratamiento médico conservador y sintomático con buena respuesta y evolución favorable. Conclusión: El neumomediastino y neumopericardio espontáneo puede ser causa de síntomas persistentes después del periodo agudo de la COVID-19. Se cree que la ruptura de la pared alveolar permitiría que el aire discurra a través de vaina peribroncovascular hacia los espacios anatómicos. Aunque infrecuentes, se debe tomar en consideración estas entidades en el espectro diagnóstico de síndromes dolorosos, para los cuales los estudios de imágenes torácicas prestan una ayuda excepcional.

This paper studies the impact of knowledge specialization on earnings losses following displacement. We develop a novel measure of the specialization of human capital, based on how concentrated the knowledge used in an occupation is. Combining our measure with individual labor histories from the NLSY 79-97 and Norway’s LEED, we show that workers with more specialized human capital suffer larger earnings losses following exogenous displacement. A one standard deviation increase in pre-displacement knowledge specialization increases the earnings losses post-displacement by 3 to 4 pp per year in the US, and by 1.5 to 2 pp per year in Norway. In the US, the negative effect of higher pre-displacement knowledge specialization on post-displacement earnings is driven by the negative impact of knowledge specialization on well-paid outside opportunities. By contrast, this association between outside opportunities and knowledge specialization plays no role in post-displacement earnings losses in Norway, where the negative effect of specialization is in part explained by its association with the routine content and the offshoring probability of the occupation.

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