Differences in Rapid Increases in County-Level COVID-19 Incidence by Implementation of Statewide Closures and Mask Mandates — United States, June 1–September 30, 2020

Authors

• Sharoda Dasgupta, Centers for Disease Control and Prevention
• Ahmed M. Kassem, Centers for Disease Control and Prevention
• Gregory Sunshine, Centers for Disease Control and Prevention
• Tiebin Liu, Centers for Disease Control and Prevention
• Charles Rose, Centers for Disease Control and Prevention
• Gloria J. Kang, Centers for Disease Control and Prevention
• Rachel Silver, Centers for Disease Control and Prevention
• Brandy L.Peterson Maddox, Centers for Disease Control and Prevention
• Christina Watson, Centers for Disease Control and Prevention
• Mara Howard-Williams, Centers for Disease Control and Prevention
• Maxim Gakh, University of Nevada, Las VegasFollow
• Russell McCord, Centers for Disease Control and Prevention
• Regen Weber, Centers for Disease Control and Prevention
• Kelly Fletcher, Centers for Disease Control and Prevention
• Trieste Musial, Centers for Disease Control and Prevention
• Michael A. Tynan, Centers for Disease Control and Prevention
• Rachel Hulkower, Centers for Disease Control and Prevention
• Amanda Moreland, Centers for Disease Control and Prevention
• Dawn Pepin, Centers for Disease Control and Prevention
• Lisa Landsman, Centers for Disease Control and Prevention
• Amanda Brown, Centers for Disease Control and Prevention
• Siobhan Gilchrist, Centers for Disease Control and Prevention
• Catherine Clodfelter, Centers for Disease Control and Prevention
• Michael Williams, Centers for Disease Control and Prevention
• Ryan Cramer, Centers for Disease Control and Prevention
• Alexa Limeres, Centers for Disease Control and Prevention
• Adebola Popoola, Centers for Disease Control and Prevention
• Sebnem Dugmeoglu, Centers for Disease Control and Prevention
• Julia Shelburne, Centers for Disease Control and Prevention

Document Type

Article

Publication Date

2-14-2021

Publication Title

Annals of Epidemiology

Volume

57

First page number:

46

Last page number:

53

Abstract

Background and Objective: Community mitigation strategies could help reduce COVID-19 incidence, but there are few studies that explore associations nationally and by urbanicity. In a national county-level analysis, we examined the probability of being identified as a county with rapidly increasing COVID-19 incidence (rapid riser identification) during the summer of 2020 by implementation of mitigation policies prior to the summer, overall and by urbanicity. Methods: We analyzed county-level data on rapid riser identification during June 1–September 30, 2020 and statewide closures and statewide mask mandates starting March 19 (obtained from state government websites). Poisson regression models with robust standard error estimation were used to examine differences in the probability of rapid riser identification by implementation of mitigation policies (P-value< .05); associations were adjusted for county population size. Results: Counties in states that closed for 0–59 days were more likely to become a rapid riser county than those that closed for >59 days, particularly in nonmetropolitan areas. The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening (adjusted prevalence ratio = 0.57; 95% confidence intervals = 0.51–0.63); when stratified by urbanicity, associations were more pronounced in nonmetropolitan areas. Conclusions: These results underscore the potential value of community mitigation strategies in limiting the COVID-19 spread, especially in nonmetropolitan areas.

Keywords

Closures; COVID-19; Mask mandates; Mitigation strategies

Disciplines

Epidemiology | Public Health

File Format

PDF

File Size

1064 KB

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Repository Citation

Dasgupta, S., Kassem, A., Sunshine, G., Liu, T., Rose, C., Kang, G., Silver, R., Maddox, B., Watson, C., Howard-Williams, M., Gakh, M., McCord, R., Weber, R., Fletcher, K., Musial, T., Tynan, M., Hulkower, R., Moreland, A., Pepin, D., Landsman, L., Brown, A., Gilchrist, S., Clodfelter, C., Williams, M., Cramer, R., Limeres, A., Popoola, A., Dugmeoglu, S., Shelburne, J. (2021). Differences in Rapid Increases in County-Level COVID-19 Incidence by Implementation of Statewide Closures and Mask Mandates — United States, June 1–September 30, 2020. Annals of Epidemiology, 57 46-53.
http://dx.doi.org/10.1016/j.annepidem.2021.02.006