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.
翻译:2019年科罗纳病毒(COVID-19)大流行是一个前所未有的全球公共卫生挑战。在美国(美国),州政府实施了各种非药物性干预措施,如实际关闭距离(封锁)、家庭秩序、针对COVID-19的迅速蔓延在公众中强制戴面罩等。为了评估这些NPI的效力,我们建议采用嵌套式病例控制设计,在准试验框架下,对流行性分数进行加权,以估计对国家间疾病传播的平均干预影响。我们进一步开发了一种方法,测试中度干预效应的各种因素,以帮助精确的公共卫生干预措施。我们的方法考虑到疾病传播的基本动态以及州一级干预前特点的平衡。我们证明我们的估计者根据假设提供了因果干预效应。我们用这种方法分析美国CVID-19的病例来估计六种干预措施的影响。我们表明,封锁在减少传播和重新开业方面影响最大。非白人人口比例较高的国家面临着与重新开业相关的增加美元风险。