Public Health Interventions' Effect on Hospital Use in Patients With COVID-19: Comparative Study.
Bayes Theorem
COVID-19
/ epidemiology
China
/ epidemiology
Hospitalization
/ statistics & numerical data
Humans
Masks
/ statistics & numerical data
Models, Statistical
Physical Distancing
Public Health Practice
/ statistics & numerical data
Quarantine
/ statistics & numerical data
United States
/ epidemiology
COVID-19
China
United States
comparative
hospital
implementation
intervention
observational
prediction
public health
use
Journal
JMIR public health and surveillance
ISSN: 2369-2960
Titre abrégé: JMIR Public Health Surveill
Pays: Canada
ID NLM: 101669345
Informations de publication
Date de publication:
23 12 2020
23 12 2020
Historique:
received:
20
10
2020
accepted:
06
12
2020
revised:
12
11
2020
pubmed:
15
12
2020
medline:
6
1
2021
entrez:
14
12
2020
Statut:
epublish
Résumé
Different states in the United States had different nonpharmaceutical public health interventions during the COVID-19 pandemic. The effects of those interventions on hospital use have not been systematically evaluated. The investigation could provide data-driven evidence to potentially improve the implementation of public health interventions in the future. We aim to study two representative areas in the United States and one area in China (New York State, Ohio State, and Hubei Province), and investigate the effects of their public health interventions by time periods according to key interventions. This observational study evaluated the numbers of infected, hospitalized, and death cases in New York and Ohio from March 16 through September 14, 2020, and Hubei from January 26 to March 31, 2020. We developed novel Bayesian generalized compartmental models. The clinical stages of COVID-19 were stratified in the models, and the effects of public health interventions were modeled through piecewise exponential functions. Time-dependent transmission rates and effective reproduction numbers were estimated. The associations of interventions and the numbers of required hospital and intensive care unit beds were studied. The interventions of social distancing, home confinement, and wearing masks significantly decreased (in a Bayesian sense) the case incidence and reduced the demand for beds in all areas. Ohio's transmission rates declined before the state's "stay at home" order, which provided evidence that early intervention is important. Wearing masks was significantly associated with reducing the transmission rates after reopening, when comparing New York and Ohio. The centralized quarantine intervention in Hubei played a significant role in further preventing and controlling the disease in that area. The estimated rates that cured patients become susceptible in all areas were small (<0.0001), which indicates that they have little chance to get the infection again. The series of public health interventions in three areas were temporally associated with the burden of COVID-19-attributed hospital use. Social distancing and the use of face masks should continue to prevent the next peak of the pandemic.
Sections du résumé
BACKGROUND
Different states in the United States had different nonpharmaceutical public health interventions during the COVID-19 pandemic. The effects of those interventions on hospital use have not been systematically evaluated. The investigation could provide data-driven evidence to potentially improve the implementation of public health interventions in the future.
OBJECTIVE
We aim to study two representative areas in the United States and one area in China (New York State, Ohio State, and Hubei Province), and investigate the effects of their public health interventions by time periods according to key interventions.
METHODS
This observational study evaluated the numbers of infected, hospitalized, and death cases in New York and Ohio from March 16 through September 14, 2020, and Hubei from January 26 to March 31, 2020. We developed novel Bayesian generalized compartmental models. The clinical stages of COVID-19 were stratified in the models, and the effects of public health interventions were modeled through piecewise exponential functions. Time-dependent transmission rates and effective reproduction numbers were estimated. The associations of interventions and the numbers of required hospital and intensive care unit beds were studied.
RESULTS
The interventions of social distancing, home confinement, and wearing masks significantly decreased (in a Bayesian sense) the case incidence and reduced the demand for beds in all areas. Ohio's transmission rates declined before the state's "stay at home" order, which provided evidence that early intervention is important. Wearing masks was significantly associated with reducing the transmission rates after reopening, when comparing New York and Ohio. The centralized quarantine intervention in Hubei played a significant role in further preventing and controlling the disease in that area. The estimated rates that cured patients become susceptible in all areas were small (<0.0001), which indicates that they have little chance to get the infection again.
CONCLUSIONS
The series of public health interventions in three areas were temporally associated with the burden of COVID-19-attributed hospital use. Social distancing and the use of face masks should continue to prevent the next peak of the pandemic.
Identifiants
pubmed: 33315585
pii: v6i4e25174
doi: 10.2196/25174
pmc: PMC7759508
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25174Informations de copyright
©Xiaofeng Wang, Rui Ren, Michael W Kattan, Lara Jehi, Zhenshun Cheng, Kuangnan Fang. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 23.12.2020.
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