Did the Timing of State Mandated Lockdown Affect the Spread of COVID-19 Infection? A County-level Ecological Study in the United States

Abstract

Previous pandemics have demonstrated that several demographic, geographic, and socioeconomic factors may play a role in increased infection risk. During this current coronavirus disease 2019 (COVID-19) pandemic, our aim was to examine the association of timing of lockdown at the county level and aforementioned risk factors with daily case rate (DCR) in the United States. Methods:A cross-sectional study using publicly available data was performed including Americans with COVID-19 infection as of May 24, 2020. The United States counties with >100 000 population and >50 cases per 100 000 people were included. The independent variable was the days required from the declaration of lockdown to reach the target case rate (50/100 000 cases) while the dependent (outcome) variable was the DCR per 100 000 on the day of statistical calculation (May 24, 2020) after adjusting for multiple confounding socio-demographic, geographic, and health-related factors. Each independent factor was correlated with outcome variables and assessed for collinearity with each other. Subsequently, all factors with significant association to the outcome variable were included in multiple linear regression models using stepwise method. Models with best R 2 value from the multiple regression were chosen. Results:The timing of mandated lockdown order had the most significant association on the DCR per 100 000 after adjusting for multiple socio-demographic, geographic and health-related factors. Additional factors with significant association with increased DCR include rate of uninsured and unemployment. Conclusions:The timing of lockdown order was significantly associated with the spread of COVID-19 at the county level in the United States.

Predisposing, Enabling, and Reinforcing Factors of COVID-19 Prevention Behavior in Indonesia: A Mixed-methods Study

“…Thus, the lockdown policy was suboptimal. The timing of the lockdown orders was significantly associated with the spread of COVID-19 after adjusting for various socio-demographic, geographic, and health-related factors [ 33 ]. Over time, many policies have been issued by the government to prevent the spread.…”

Assessing the Impacts of COVID-19 and Social Isolation on Mental Health in the United States of America

“…Culminating in the rise of self-reported stress levels and depressive symptoms [10]. What’s interesting to take into account is how many countries were implementing swift lockdown measures to mitigate the spread of COVID-19 [14]. In contrast, the United States of America (USA) opted for individual states to choose their lockdown policies.…”

“…This made it difficult for individuals to determine what sources were correct and what information applied to the specific lockdown restriction they were in depending on their state. Timing of when a state enacted a mask mandate had a significant association with the spread of COVID-19 [14]. Recent research has suggested that state-level policy differences may be associated with different outcomes concerning the COVID-19 pandemic [37].…”

Understanding mental health trends during COVID-19 pandemic in the United States using network analysis

“…However, the federal government at this time opted for a hands-off approach to COVID-19 and allowed individual states to decide on the best ways to limit the spread of this deadly disease [1]. This variation in leadership led to differing outcomes in terms of the spread of COVID-19 [26]. These mandates to protect the public ranged from school and work closures to stay-at-home orders, all of which can have important effects on several aspects of an individual’s life.…”