Purpose: The United States has the highest number of confirmed COVID-19 cases in the world to date, with over 94,000 COVID-19-related deaths. The true risk of a COVID-19 resurgence as states prepare to reopen businesses is unknown. This paper aims to classify businesses by their risk of transmission and provide a method to measure traffic and risk at businesses as states reopen in order to quantify the relationship between the density of potential super-spreader businesses and COVID-19
cases.
Methods: We constructed a COVID-19 Business Transmission Risk Index based upon the frequency and duration of visits and square footage of businesses pre-pandemic in 2019 in 8 states (Massachusetts, Rhode Island, Connecticut, New Hampshire, Vermont, Maine, New York, and California). We used this index to classify businesses as potential super-spreaders. Then, we analyzed the association between the density of
super-spreader businesses in a county and the rate of COVID-19 cases. We performed significance testing using a negative binomial regression. The main outcome of interest is the cumulative number of COVID-19 cases each week.
Results: We developed an index to monitor traffic and quantify potential risk at businesses and found a positive association between the density of potential superspreader businesses and COVID-19 cases. A 1 percentage point increase in the density of super-spreader businesses is associated with 5% higher COVID-19 cases, all else
equal.
Conclusion: Higher densities of potential super-spreader businesses are associated with higher rates of COVID-19 cases. This may have important implications for how states reopen potential super-spreader businesses. Our main contribution is an index that provides a way for policymakers to monitor traffic and potential risk at
businesses as states reopen.