Evaluating Effectiveness of Public Health Intervention Strategies for Mitigating COVID-19 Pandemic

TL;DR

This study evaluates the effectiveness of various COVID-19 public health interventions in the US using a novel causal inference method, revealing lockdowns significantly reduce transmission while reopening bars increases it, with disparities linked to demographic factors.

Contribution

Introduces a nested case-control design with propensity score weighting to estimate causal effects of interventions on COVID-19 transmission, accounting for disease dynamics and state-level factors.

Findings

Lockdowns significantly reduce COVID-19 transmission.

Reopening bars increases transmission risk.

Higher non-white population correlates with greater impact of reopening bars.

Abstract

Coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global public health challenge. In the United States (US), state governments have implemented various non-pharmaceutical interventions (NPIs), such as physical distance closure (lockdown), stay-at-home order, mandatory facial mask in public in response to the rapid spread of COVID-19. To evaluate the effectiveness of these NPIs, we propose a nested case-control design with propensity score weighting under the quasi-experiment framework to estimate the average intervention effect on disease transmission across states. We further develop a method to test for factors that moderate intervention effect to assist precision public health intervention. Our method takes account of the underlying dynamics of disease transmission and balance state-level pre-intervention characteristics. We prove that our estimator provides causal intervention effect under assumptions. We apply this method to analyze US COVID-19 incidence cases to estimate the effects of six interventions. We show that lockdown has the largest effect on reducing transmission and reopening bars significantly increase transmission. States with a higher percentage of non-white population are at greater risk of increased $R_t$ associated with reopening bars.