Title

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

Language

English

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