College openings in the United States increase mobility and COVID-19 incidence.

School and college reopening-closure policies are considered one of the most promising non-pharmaceutical interventions for mitigating infectious diseases. Nonetheless, the effectiveness of these policies is still debated, largely due to the lack of empirical evidence on behavior during implementation. We examined U.S. college reopenings' association with changes in human mobility within campuses and in COVID-19 incidence in the counties of the campuses over a twenty-week period around college reopenings in the Fall of 2020. We used an integrative framework, with a difference-in-differences design comparing areas with a college campus, before and after reopening, to areas without a campus and a Bayesian approach to estimate the daily reproductive number (Rt). We found that college reopenings were associated with increased campus mobility, and increased COVID-19 incidence by 4.9 cases per 100,000 (95% confidence interval [CI]: 2.9-6.9), or a 37% increase relative to the pre-period mean. This reflected our estimate of increased transmission locally after reopening. A greater increase in county COVID-19 incidence resulted from campuses that drew students from counties with high COVID-19 incidence in the weeks before reopening (χ2(2) = 8.9, p = 0.012) and those with a greater share of college students, relative to population (χ2(2) = 98.83, p < 0.001). Even by Fall of 2022, large shares of populations remained unvaccinated, increasing the relevance of understanding non-pharmaceutical decisions over an extended period of a pandemic. Our study sheds light on movement and social mixing patterns during the closure-reopening of colleges during a public health threat, and offers strategic instruments for benefit-cost analyses of school reopening/closure policies.

Tracking Public and Private Responses to the COVID-19 Epidemic: Evidence from State and Local Government Actions

This paper examines the determinants of social distancing during the COVID-19 epidemic. We classify state and local government actions, and we study multiple proxies for social distancing based on data from smart devices. Mobility fell substantially in all states, even ones that have not adopted major distancing mandates. There is little evidence, for example, that stay-at-home mandates induced distancing. In contrast, early and information-focused actions have had bigger effects. Event studies show that first case announcements, emergency declarations, and school closures reduced mobility by 1-5% after 5 days and 7-45% after 20 days. Between March 1 and April 11, average time spent at home grew from 9.1 hours to 13.9 hours. We find, for example, that without state emergency declarations, event study estimates imply that hours at home would have been 11.3 hours in April, suggesting that 55% of the growth comes from emergency declarations and 45% comes from secular (non-policy) trends. State and local government actions induced changes in mobility on top of a large response across all states to the prevailing knowledge of public health risks. Early state policies conveyed information about the epidemic, suggesting that even the policy response mainly operates through a voluntary channel.

Paid sick-leave and physical mobility: Evidence from the United States during a pandemic

We study the effects of a massive temporary U.S. paid sick leave (PSL) mandate that became effective April 1st, 2020 on self-quarantining, proxied by physical mobility behaviors gleaned from cellular devices. Such behaviors are critical for containment of infectious diseases. The national PSL policy was implemented in response to the COVID-19 global pandemic and mandated two weeks of fully compensated paid leave. We study the impact of this policy using difference-in-differences methods, leveraging pre-policy county-level differences in the share of ‘nonessential’ workers likely eligible for paid sick leave benefits. We find robust evidence that the policy increased the average number of hours at home and reduced the share of the individuals likely at work. Comparing the county with the lowest to highest policy exposure, we find that the average hours per day not at home, and at work decreased by 8.9% and 6.9% post-policy.

Mandated and Voluntary Social Distancing During The COVID-19 Epidemic: A Review

For much of 2020, the COVID-19 epidemic upended social and economic life globally. In an effort to reduce COVID-19 risks in the U.S., state and local governments issued many recommendations and regulations to induce social distancing, adding to voluntary reductions in interpersonal contact. The responses to the epidemic helped contain spread, but also lead to high unintended societal costs. In the summer months, states took steps to revive the economy and lift social distancing regulations. However, as many epidemiologists expected, the scale of the epidemic has expanded very rapidly in the fall. In the week of October 14, the US generated around 57,000 new COVID-19 cases and 700 deaths each day. By November 15, the country was generating about 151,000 new cases and 1,200 deaths per day. These rapid increases in cases and deaths raise concerns about the capacity of local healthcare systems around the country. State governments are once again facing difficult choices about whether and how to use policies to address the spread of the virus. The incoming Biden-Harris administration faces an important challenge in trying to manage the epidemic as well as a large scale vaccination campaign. Although the epidemic is less than a year old, it has generated a huge volume of research by economists, epidemiologists, and others. This body of work may help inform policy decisions facing society in the coming months. In this paper, we make five broad contributions. First, we provide a concise review of economic and social science research on mobility patterns, labor market outcomes, consumer behavior, and population health during the first phase of the epidemic. Second, we sketch a simple microeconomic model that may be useful considering the determinants of social distancing and the role of different policy instruments in promoting distancing. Third, we present a simple typology of the policies that were used at the state and county levels during the closure and re-opening phases of the epidemic in the U.S.. Fourth, we review a collection of new data sources that have played an important role in monitoring and analyzing population behavior this year. Fifth, we present results from event study regressions that try to disentangle private vs. policy-induced changes in mobility patterns during the early part of the epidemic.

Is the Cure Worse than the Problem Itself? Immediate Labor Market Effects of COVID-19 Case Rates and School Closures in the U.S

The relationship between population health and measures of economic well-being and economic activity is a long standing topic in health economics (Preston, 1975;Cutler, Deaton, and Lleras-Muney, 2006;Ruhm, 2000). The conceptual issues in analyzing the complicated link between health and economic well-being are central to understanding the implications of the COVID-19 epidemic in the United States The public health shock of the epidemic has direct economic impacts, but the mitigation policies governments are using to control the spread of the virus may also damage economic activity. We estimate how state job market conditions respond to state COVID-19 infections and school closures, which are the earliest of the major mitigation policies. Mitigation policies and local epidemiological conditions explain some of the variation in unemployment patterns. However, the historically unprecedented increase in new UI claims during the weeks of March 15-21 and March 22-28 was largely across-the-board and occurred in all states. This suggests most of the economic disruption was driven by the health shock itself. Put differently, it appears that the labor market slowdown was due primarily to a nationwide response to evolving epidemiological conditions and that individual state policies and own epidemiologic situations have had a comparatively modest effect.

Is Healthcare Employment Resilient and “Recession Proof”?

Conventional wisdom often holds that the healthcare sector fares better than other sectors during economic downturns. However, little research has examined the relationship between local economic conditions and healthcare employment. Understanding how the healthcare sector responds to economic conditions is important for policy makers seeking to ensure an adequate supply of healthcare workers, as well as for those directing displaced workers into new jobs. We examine the impact of macroeconomic conditions on both the healthcare labor market and the pipeline of healthcare workers receiving healthcare degrees during a pre-COVID time period, 2005-2017. Our results indicate that the healthcare sector is stable across past business cycles. If anything, when areas experience more severe local economic downturns, healthcare employment increases. Much remains unknown about the adjustments and lasting impacts for the healthcare sector associated with the COVID era. Our study represents an important backdrop as policy makers consider ways to sustain the healthcare sector during economic and public health turbulence.

Impacts of State Reopening Policy on Human Mobility

This study quantifies the effect of state reopening policies on daily mobility, travel, and mixing behavior during the COVID-19 pandemic. We harness cell device signal data to examine the effects of the timing and pace of reopening plans in different states. We quantify the increase in mobility patterns during the reopening phase by a broad range of cell-device-based metrics. Soon (four days) after reopening, we observe a 6% to 8% mobility increase. In addition, we find that temperature and precipitation are strongly associated with increased mobility across counties. The mobility measures that reflect visits to a greater variety of locations responds the most to reopening policies, while total time in vs. outside the house remains unchanged. The largest increases in mobility occur in states that were late adopters of closure measures, suggesting that closure policies may have represented more of a binding constraint in those states. Together, these four observations provide an assessment of the extent to which people in the U.S. are resuming movement and physical proximity as the COVID-19 pandemic continues.

The Great Unequalizer: Initial Health Effects of COVID-19 in the United States

We measure inequities from the COVID-19 pandemic on mortality and hospitalizations in the United States during the early months of the outbreak. We discuss challenges in measuring health outcomes and health inequality, some of which are specific to COVID-19 and others that complicate attribution during most large health shocks. As in past epidemics, pre-existing biological and social vulnerabilities profoundly influenced the distribution of disease. In addition to the elderly, Hispanic, Black and Native American communities were disproportionately affected by the virus, particularly when assessed using the years of potential life lost metric. For example, Hispanic and Black Americans in 2020 saw 39.5 and 25 percent increases in excess mortality relative to trend, compared to a less than 15 percent increase for Whites;we find losses in potential years of life three to four times larger among Hispanic and Black compared to White Americans. Individual-level data from a commercially insured population show that otherwise similar Black and Hispanic enrollees were hospitalized due to COVID-19 at a higher rate than White enrollees. We provide a conceptual framework and initial empirical analysis which seek to shed light on contributors to pandemic-related health inequality, and suggest areas for future research.

Effects of State COVID-19 Closure Policy on NON-COVID-19 Health Care Utilization

The U.S. health care system has experienced great pressure since early March 2020 as it pivoted to providing necessary care for COVID-19 patients. But there are signs that non-COVID-19 care use declined during this time period. We examine near real time data from a nationwide electronic healthcare records system that covers over 35 million patients to provide new evidence of how non-COVID-19 acute care and preventive/primary care have been affected during the epidemic. Using event study and difference-in-difference models we find that state closure policies (stay-at-home or non-essential business closures) are associated with large declines in ambulatory visits, with effects differing by type of care. State closure policies reduced overall outpatient visits by about 15-16 percent within two weeks. Outpatient visits for health check-ups and well care experience very large declines during the epidemic, with substantial effects from state closure policies. In contrast, mental health outpatient visits declined less than other care, and appear less affected by state closure policies. We find substitution to telehealth modalities may have played an important role in mitigating the decline in mental health care utilization. Aggregate trends in outpatient visits show a 40% decline after the first week of March 2020, only a portion of which is attributed to state policy. A rebound starts around mid April that does not appear to be explained by state reopening policy. Despite this rebound, care visits still remain below the pre-epidemic levels in most cases.

Effects of Social Distancing Policy on Labor Market Outcomes

This paper examines the impact of the social distancing policies states adopted between March and April of 2020 in response to the COVID-19 epidemic. These actions, together with voluntary social distancing, appear to have reduced the rate of new COVID-19 cases and deaths, but raised concerns about the costs experienced by workers and businesses. Estimates from difference-in-difference models that leverage cross-state variation in the timing of business closures and stay-at-home mandates suggest that the employment rate fell by about 1.7 percentage points for every extra 10 days that a state experienced a stay-at-home mandate during the period March 12-April 12, 2020;select business closure laws were associated with similar employment effects. Our estimates imply that about 40% of the 12 percentage point decline in employment rates between January and April 2020 was due to a nationwide shock while about 60% was driven by state social distancing policies. The negative employment effects of state policies were larger for workers in "non-essential" industries, workers without a college degree, and early-career workers. Policy caused relatively modest changes in hours worked and earnings among those who remain employed. We find no concerning evidence of pre-trends in the monthly (low-frequency) CPS data, but use high-frequency data on work-related mobility measured from cellphones, job-loss-related internet searches, and initial unemployment claims to investigate the possibility that the large employment effects experienced in April could have occurred after the March CPS but but before policy adoption. In those analyses, we find pre-trends for some outcomes but not others. Thus we cannot fully rule out that some employment effects shortly predated the policies. As states relax business closures, ensuring gains in labor market activities in ways that continue to mitigate COVID-19 "surges" and public health risks will be key considerations to monitor.

Determinants of Disparities in Covid-19 Job Losses

We make several contributions to understanding the socio-demographic divide in early labor market responses to the U.S. COVID-19 epidemic and its policies, benchmarked against two previous recessions. First, monthly Current Population Survey (CPS) data show greater declines in employment in April and May 2020 (relative to February) for Hispanics, younger workers, and those with high school degrees and some college. Between April and May, all the demographic subgroups considered regained some employment. Re-employment in May was broadly proportional to the employment drop that occurred through April, except for Blacks who experienced a smaller rebound. Further, we show that compared to the 2001 recession and the Great Recession, employment losses in the early COVID-19 recession were smaller for groups with very low or very high (vs. medium) education. Second, we show that job loss was larger in occupations that require more interpersonal contact and that cannot be performed remotely. Third, we find pre-COVID-19 sorting of workers into occupations and industries along demographic lines can explain a sizeable portion of the gender, race, and ethnic gaps in new unemployment. For example, while women did suffer more job losses than men, their disproportionate pre-epidemic sorting into remote work compatible occupations shielded women from what would have been even larger employment losses during the epidemic. However, there remain substantial gaps in employment losses across groups that cannot be explained by socio-economic differences. We find some larger gaps in labor market impacts when we consider the “employed but absent from work” measure present in the CPS, in addition to the more traditional employment and unemployment measures. We conclude with a discussion of policy lessons and future research needs implied by the disparities in early labor market losses from the COVID-19 crisis.

Back to Business and (Re)employing Workers? Labor Market Activity During State COVID-19 Reopenings

In the early phases of the COVID-19 epidemic labor markets exhibited considerable churn, which we relate to three primary findings. First, reopening policies generated asymmetrically large increases in reemployment of those out of work, compared to modest decreases in job loss among those employed. Second, most people who were reemployed appear to have returned to their previous employers, but the rate of reemployment decreases with time since job loss. Lastly, the groups that had the highest unemployment rates in April also tended to have the lowest reemployment rates, potentially making churn harmful to people and groups with more and/or longer job losses. Taken together, these estimates suggest that employment relationships are durable in the short run, but raise concerns that employment gains requiring new employment matches may not be as rapid and may be particularly slow for hard-hit groups including Hispanic and Black workers, youngest and oldest workers, and women.

Impacts of state COVID-19 reopening policy on human mobility and mixing behavior.

This study quantifies the effect of the 2020 state COVID economic activity reopening policies on daily mobility and mixing behavior, adding to the economic literature on individual responses to public health policy that addresses public contagion risks. We harness cellular device signal data and the timing of reopening plans to provide an assessment of the extent to which human mobility and physical proximity in the United States respond to the reversal of state closure policies. We observe substantial increases in mixing activities, 13.56% at 4 days and 48.65% at 4 weeks, following reopening events. Echoing a theme from the literature on the 2020 closures, mobility outside the home increased on average prior to these state actions. Furthermore, the largest increases in mobility occurred in states that were early adopters of closure measures and hard-hit by the pandemic, suggesting that psychological fatigue is an important barrier to implementation of closure policies extending for prolonged periods of time.

Vaccinations Against COVID-19 May Have Averted Up To 140,000 Deaths In The United States.

COVID-19 vaccination campaigns continue in the United States, with the expectation that vaccines will slow transmission of the virus, save lives, and enable a return to normal life in due course. However, the extent to which faster vaccine administration has affected COVID-19-related deaths is unknown. We assessed the association between US state-level vaccination rates and COVID-19 deaths during the first five months of vaccine availability. We estimated that by May 9, 2021, the US vaccination campaign was associated with a reduction of 139,393 COVID-19 deaths. The association varied in different states. In New York, for example, vaccinations led to an estimated 11.7 fewer COVID-19 deaths per 10,000, whereas Hawaii observed the smallest reduction, with an estimated 1.1 fewer deaths per 10,000. Overall, our analysis suggests that the early COVID-19 vaccination campaign was associated with reductions in COVID-19 deaths. As of May 9, 2021, reductions in COVID-19 deaths associated with vaccines had translated to value of statistical life benefit ranging between $625 billion and $1.4 trillion.