Local Decision Making for Implementing Social Distancing in Response to Outbreaks

Abstract

Objectives: Social distancing is the practice of restricting contact among persons to prevent the spread of infection. This study sought to (1) identify key features of preparedness and the primary concerns of local public health officials in deciding to implement social distancing measures and (2) determine whether any particular factor could explain the widespread variation among health departments in responses to past outbreaks. Methods:We conducted an online survey of health departments in the United States in 2015 to understand factors influencing health departments' decision making when choosing whether to implement social distancing measures. We paired survey results with data on area population demographic characteristics and analyzed them with a focus on broad trends.Results: Of 600 health departments contacted, 150 (25%) responded. Of these 150 health departments, 63 (42%) indicated that they had implemented social distancing in the past 10 years. Only 10 (7%) health departments had a line-item budget for isolation or quarantine. The most common concern about social distancing was public health impact (n ¼ 62, 41%). Concerns about law, politics, finances, vulnerable populations, and sociocultural issues were each identified by 7% to 10% of health departments. We were unable to clearly predict which factors would influence these decisions.Conclusions: Variations in the decision to implement social distancing are likely the result of differences in organizational authority and resources and in the primary concerns about implementing social distancing. Research and current social distancing guidelines for health departments should address these factors.

Does Density Aggravate the COVID-19 Pandemic?

“…Social distancing can be implemented by governments at the local and state levels through one or a combination of interventions, including the closure of schools, bars, restaurants, and any social or sporting events; sick leave; work-from-home policies; splitting shifts to reduce workplace interactions; sheltering in place; and travel/trade bans (Chu et al, 2017). These interventions are critical to stopping the disease's outbreak, but quick and efficient actions by local, state, and federal governments at early stages before the epidemic gets out of control are even more critical (Katz et al, 2019). This is another source of spatial variation of the disease spread because state and local governments across the United States take different actions at different times, which could make a difference in disease outcomes.…”

Effect of the social distancing measures on the spread of COVID-19 in 10 highly infected countries

“…Danny Ibarra-Vega has developed a mathematical model with the systems dynamics methodology to evaluate the effectiveness of the quarantines or lockdowns on the reduction in community contacts for a population scale of 100,000 (Ibarra-Vega, 2020). Katz et al have sought to identify the key features of preparedness and the primary concerns of local public health officials in deciding to implement social distancing measures for the case of The U.S. (Katz et al, 2019). Jarvis et al have evaluated the effectiveness of the physical distancing measures on the transmission of COVID-19 in The U.K. (Jarvis et al, 2020).…”

Factors impacting social distancing measures for preventing coronavirus disease 2019 [COVID-19]: A systematic review

“…The search results are summarised in Figure 1. In total, 1235 citations were identi ed, of which 16 were found to be relevant [39,40,[41][42][43][44][45][46][47][48][49][50][51][52][53][54] excluded 68 studies.…”

“…Studies reported that quarantine, and school and border closure have been the most effective means of suppressing transmission [40,43]. The commonest factors associated with SDM success are support on governmental measures for social distancing and isolation by avoiding crowds, closure of public places, hand hygiene, and individuals' adherence to country-speci c mitigation measures [45,48]. Most participants felt that guidance on social distancing and isolation had been generally unclear, although some described how it had "become clearer".…”