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Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities.
Cevasco, Kevin E; Roess, Amira A; North, Hayley M; Zeitoun, Sheryne A; Wofford, Rachel N; Matulis, Graham A; Gregory, Abigail F; Hassan, Maha H; Abdo, Aya D; von Fricken, Michael E.
  • Cevasco KE; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • Roess AA; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • North HM; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • Zeitoun SA; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • Wofford RN; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • Matulis GA; Department of Biology, College of Science, George Mason University, Fairfax, VA, USA.
  • Gregory AF; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • Hassan MH; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • Abdo AD; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
  • von Fricken ME; Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA. mvonfric@gmu.edu.
BMC Public Health ; 21(1): 1985, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1501997
ABSTRACT

BACKGROUND:

During March of 2020 the Centers for Disease Control and Prevention (CDC) announced non-pharmaceutical intervention (NPI) guidance as the primary mitigation strategy against growing COVID-19 community spread due to the absence of a vaccine or effective treatment at that time. CDC guidance states that NPIs are most effective when instituted in an early, targeted, and layered fashion. NPIs are effective in slowing spread, and measures should be custom-tailored to each population. This study examines factors associated with implementation and timing of NPI interventions across large public and private U.S. universities at the onset of the COVID-19 pandemic.

METHODS:

NPI decisions of interest include when U.S. universities canceled international travel, shifted to online learning, moved faculty/staff to remote work, limited campus housing, and closed campus for all non-essential personnel. Cox proportional hazard analyses of retrospective data were conducted to assess the time to NPI events. Hazard ratios were calculated for university governance, campus setting, religious affiliation, health infrastructure, faculty diversity, and student demographics. The methods control for variance inflation factors, COVID case prevalence, and time varying covariates of spring break and states' state of emergency (SOE) orders. This study captures NPI decisions at 575 U.S. universities during spring of 2020 which affected the movement of seven million students and two million employees.

RESULTS:

Universities located in districts represented by Democratic party congressional members reported earlier NPI implementation than Republican (Cox proportional hazard ratio (HR) range 0.61-0.80). University religious affiliation was not associated with the timing any of the NPI decisions. Universities with more diverse faculty showed an association with earlier NPI implementation (HR range 0.65-0.76). The existence of university-affiliated health infrastructure was not associated with NPI timing.

CONCLUSION:

University NPI implementation was largely driven by local COVID-19 epidemiology, culture and political concerns. The timing of university NPI decisions varied by regional politics, faculty demographics, university governance, campus setting, and foreign student prevalence adjusting for COVID-19 state case prevalence and spring break timing. Religious affiliation and presence of university health infrastructure were not associated with timing.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-12035-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-12035-6