Quantifying the Effect of Public Activity Intervention Policies on COVID-19 Pandemic Containment Using Epidemiologic Data From 145 Countries.

OBJECTIVES: Most countries have adopted public activity intervention policies to control the coronavirus disease 2019 (COVID-19) pandemic. Nevertheless, empirical evidence of the effectiveness of different interventions on the containment of the epidemic was inconsistent. METHODS: We retrieved time-series intervention policy data for 145 countries from the Oxford COVID-19 Government Response Tracker from December 31, 2019, to July 1, 2020, which included 8 containment and closure policies. We investigated the association of timeliness, stringency, and duration of intervention with cumulative infections per million population on July 1, 2020. We introduced a novel counterfactual estimator to estimate the effects of these interventions on COVID-19 time-varying reproduction number (Rt). RESULTS: There is some evidence that earlier implementation, longer durations, and more strictness of intervention policies at the early but not middle stage were associated with reduced infections of COVID-19. The counterfactual model proved to have controlled for unobserved time-varying confounders and established a valid causal relationship between policy intervention and Rt reduction. The average intervention effect revealed that all interventions significantly decrease Rt after their implementation. Rt decreased by 30% (22%-41%) in 25 to 32 days after policy intervention. Among the 8 interventions, school closing, workplace closing, and public events cancellation demonstrated the strongest and most consistent evidence of associations. CONCLUSIONS: Our study provides more reliable evidence of the quantitative effects of policy interventions on the COVID-19 epidemic and suggested that stricter public activity interventions should be implemented at the early stage of the epidemic for improved containment.

Socioeconomic privilege and political ideology are associated with racial disparity in COVID-19 vaccination.

Vaccine uptake is critical for mitigating the impact of COVID-19 in the United States, but structural inequities pose a serious threat to progress. Racial disparities in vaccination persist despite the increased availability of vaccines. We ask what factors are associated with such disparities. We combine data from state, federal, and other sources to estimate the relationship between social determinants of health and racial disparities in COVID-19 vaccinations at the county level. Analyzing vaccination data from 19 April 2021, when nearly half of the US adult population was at least partially vaccinated, we find associations between racial disparities in COVID-19 vaccination and median income (negative), disparity in high school education (positive), and vote share for the Republican party in the 2020 presidential election (negative), while vaccine hesitancy is not related to disparities. We examine differences in associations for COVID-19 vaccine uptake as compared with influenza vaccine. Key differences include an amplified role for socioeconomic privilege factors and political ideology, reflective of the unique societal context in which the pandemic has unfolded.