Association of state social distancing restrictions with nursing home COVID-19 and non-COVID-19 outcomes

Y, Li; Cheng, Zijing; Cai, Xiujun; Y, Mao; Temkin‐Greener, Helena

doi:10.1101/2021.02.08.21251382

Cited by 3 publications

References 36 publications

(75 reference statements)

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Were COVID-19 lockdowns worth it? A meta-analysis

Herby,

Jonung,

Hanke

2024

Public Choice

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Following the onset of the COVID-19 pandemic, an unprecedented use of mandatory lockdowns—defined as the imposition of at least one compulsory, non-pharmaceutical intervention—took place. We conduct a meta-analysis to determine the effect of these lockdowns on COVID-19 mortality. Our meta-analysis finds that lockdowns in the spring of 2020 had a relatively small effect on COVID-19 mortality and is consistent with the view that voluntary changes in behavior, such as social distancing, played an important role in mitigating the pandemic. Given the enormous economic costs associated with lockdowns and our findings of the relatively small health benefits, the efficacy of lockdowns during the COVID-19 pandemic is called into question.

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Were COVID-19 lockdowns worth it? A meta-analysis

Herby,

Jonung,

Hanke

2024

Public Choice

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A Systematic Literature Review and Meta-Analysis of the Effects of Lockdowns on COVID-19 Mortality II

Herby,

Jonung,

Hanke

2023

Preprint

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The purpose of this systematic review and meta-analysis is to determine the effect of lockdowns on COVID-19 mortality based on available empirical evidence. Lockdowns are defined as the imposition of at least one compulsory, non-pharmaceutical intervention (NPI). We employ a systematic search and screening procedure in which 19,646 studies are identified that could potentially address the purpose of our study. After three levels of screening, 32 studies qualified. Of those, estimates from 22 studies could be converted to standardized measures for inclusion in the meta-analysis. They are separated into three groups: lockdown stringency index studies, shelter-in-place-order (SIPO) studies, and specific NPI studies. Stringency index studies find that the average lockdown in Europe and the United States in the spring of 2020 only reduced COVID-19 mortality by 3.2%. This translates into approximately 6,000 avoided deaths in Europe and 4,000 in the United States. SIPOs were also relatively ineffective in the spring of 2020, only reducing COVID-19 mortality by 2.0%. This translates into approximately 4,000 avoided deaths in Europe and 3,000 in the United States. Based on specific NPIs, we estimate that the average lockdown in Europe and the United States in the spring of 2020 reduced COVID-19 mortality by 10.7%. This translates into approximately 23,000 avoided deaths in Europe and 16,000 in the United States. In comparison, there are approximately 72,000 flu deaths in Europe and 38,000 flu deaths in the United States each year. When checked for potential biases, our results are robust. Our results are also supported by the natural experiments we have been able to identify. The results of our meta-analysis support the conclusion that lockdowns in the spring of 2020 had little to no effect on COVID-19 mortality. This result is consistent with the view that voluntary changes in behavior, such as social distancing, did play an important role in mitigating the pandemic.

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County-Level Social Determinants of Health and COVID-19 in Nursing Homes, United States, June 1, 2020–January 31, 2021

et al. 2021

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Objectives Nursing homes are a primary setting of COVID-19 transmission and death, but research has primarily focused only on factors within nursing homes. We investigated the relationship between US nursing home–associated COVID-19 infection rates and county-level and nursing home attributes. Methods We constructed panel data from the Centers for Medicare & Medicaid Services (CMS) minimum dataset, CMS nursing home data, 2010 US Census data, 5-year (2012-2016) American Community Survey estimates, and county COVID-19 infection rates. We analyzed COVID-19 data from June 1, 2020, through January 31, 2021, during 7 five-week periods. We used a maximum likelihood estimator, including an autoregressive term, to estimate effects and changes over time. We performed 3 model forms (basic, partial, and full) for analysis. Results Nursing homes with nursing (0.005) and staff (0.002) shortages had high COVID-19 infection rates, and locally owned (−0.007) or state-owned (−0.025) and nonprofit (–0.011) agencies had lower COVID-19 infection rates than privately owned agencies. County-level COVID-19 infection rates corresponded with COVID-19 infection rates in nursing homes. Racial and ethnic minority groups had high nursing home–associated COVID-19 infection rates early in the study. High median annual personal income (−0.002) at the county level correlated with lower nursing home–associated COVID-19 infection rates. Conclusions Communities with low rates of nursing home infections had access to more resources (eg, financial resources, staffing) and likely had better mitigation efforts in place earlier in the pandemic than nursing homes that had access to few resources and poor mitigation efforts. Future research should address the social and structural determinants of health that are leaving racial and ethnic minority populations and institutions such as nursing homes vulnerable during times of crises.

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Association of state social distancing restrictions with nursing home COVID-19 and non-COVID-19 outcomes

Cited by 3 publications

References 36 publications

Were COVID-19 lockdowns worth it? A meta-analysis

Were COVID-19 lockdowns worth it? A meta-analysis

A Systematic Literature Review and Meta-Analysis of the Effects of Lockdowns on COVID-19 Mortality II

County-Level Social Determinants of Health and COVID-19 in Nursing Homes, United States, June 1, 2020–January 31, 2021

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