Assessing Non-Pharmaceutical Interventions on Covid Spread

1,465 Views | 4 Replies | Last: 3 yr ago by pocketrockets06
NASAg03
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Experts are starting to crunch the data, and although it's limited, it's pointing in the direction that a number of disease policy experts originally warned against: lockdowns don't prevent the spread of a highly contagious respiratory illness, but do cause many other problems.

It will be interesting to see the data from only the US in comparing different states, and the effectiveness of more specific measures like mandatory masks.

I'd summarizes the paper as follows:

Yes, you can implement policy to force people to change their actions in response to a pandemic. But rarely does this policy have more of an effect than the natural changes people make in response to risk perception.
In addition, some changes that people make might be worse than nothing at all, e.g. closing bars and other social settings pushing people to gather in homes with people who might not be at bars.

This new social dynamics results in a setting which is closer, more enclosed, and for longer periods of time. The Chicago mayor is already making this conclusion, noting that closing bars might be WORSE as this pushes humans (social creatures) into other social settings that cannot be controlled.

On to the actual paper!

https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.13484


Quote:

Empirical data for the characteristics of fatalities in the later wave before mrNPIs were adopted as compared with the first wave (when mrNPIs had been used) shows that the proportion of COVID-19 deaths that occurred in nursing homes was often higher under mrNPIs rather than under less restrictive measures. This further suggest that restrictive measures do not clearly achieve protection of vulnerable populations. Some evidence also suggests that sometimes under more restrictive measures, infections may be more frequent in settings where vulnerable populations reside relative to the general population.

In summary, we fail to find strong evidence supporting a role for more restrictive NPIs in the control of COVID in early 2020. We do not question the role of all public health interventions, or of coordinated communications about the epidemic, but we fail to find an additional benefit of stay-at-home orders and business closures. The data cannot fully exclude the possibility of some benefits. However, even if they exist, these benefits may not match the numerous harms of these aggressive measures. More targeted public health interventions that more effectively reduce transmissions may be important for future epidemic control without the harms of highly restrictive measures
notex
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AG
Discussion of the analyses has not generally been allowed on this board because I believe folks get quite upset questioning the efficacy of what has been policy now for around 10 months. Here is one thread that got into it.

https://texags.com/forums/84/topics/3173429/replies/58488155

There's little doubt NPI's have had a marginal impact on Covid spread, and I think a purely US analysis will certainly support that as well. Sweden being right in the middle of the average for the Scandinavian countries is another data point.

Good sanitation practices (hand washing, sanitizer etc), and social distancing when practical, however, make a lot of sense, and are tough to quantify.
pocketrockets06
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AG
How is Sweden in the middle of the other Scandinavian countries? Their death toll from COVID is 5x Denmark and almost 10x Norway and Finland. If you have way more deaths than the other three, and way less restrictions and mandatory NPIs how is Sweden an example of how NPIs don't work?

As I posted in another thread, there is no question that some NPIs are effective because the Rt of COVID since NPIs began has been much less than R0. Something is knocking that down. We may not know whether that thing is masks or hand washing or shutting down stadiums but something is making this less transmissible than doing nothing.
amercer
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AG
This study only covers spring 2020. I understand that it takes time to collect data and publish papers, but I think any analysis will need to cover a larger time period of the pandemic.

Just observationally It does seem that there isn't a great correlation between places in the US with more restrictions and lower cases. However, there is very good evidence at this point that restrictions have almost eliminated all other respiratory viruses this year. So it's really hard to imagine they haven't had any effect on Covid.
ham98
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pocketrockets06 said:

How is Sweden in the middle of the other Scandinavian countries? Their death toll from COVID is 5x Denmark and almost 10x Norway and Finland. If you have way more deaths than the other three, and way less restrictions and mandatory NPIs how is Sweden an example of how NPIs don't work?

As I posted in another thread, there is no question that some NPIs are effective because the Rt of COVID since NPIs began has been much less than R0. Something is knocking that down. We may not know whether that thing is masks or hand washing or shutting down stadiums but something is making this less transmissible than doing nothing.
Sweden has lower all cause mortality in the last year than their neighbors
pocketrockets06
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AG
If that were true (and I'm not sure it is), it would have to be because Sweden's all cause mortality is much lower in typical years than its neighbors. Sweden is showing significant excess mortality while Norway and Finland show none (Denmark is showing some but much less than Sweden). If those three countries excess mortality is that much lower than Sweden, the only way for Sweden's all cause to be lower would be if it's much lower in normal years. Sweden does have a higher life expectancy than the other three countries so it's possible but I would be surprised if this holds up through the end of 2020.

https://www.euromomo.eu/graphs-and-maps/
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