The effectiveness of the states’ crisis response policies: Survival analysis on the COVID-19 transmission suppression in the United States

Abstract

Objective This study aims to evaluate the effectiveness of various COVID-19 response policies in the United Sates that facilitated rapid virus transmission suppression and promoted quick return to normalcy during the first three years of the pandemic. Method We constructed comprehensive and unique time-to-event panel data that tracks the timeline of all policy implementations, and transmission waves, specifically measuring the duration from peak transmission to the desired suppression level, over 157 weeks. We then conducted a survival analysis to estimate the effectiveness of COVID-19 response policies in relation to the virus transmission dynamics. Our analysis focuses on the ten most populous U.S. states, representing diverse geographic, cultural, and political landscapes across the country. The survival analysis leverages the extensive time-to-event panel data collected from multiple sources. Results Our findings indicate that not all policies were equally effective in facilitating rapid transmission and promoting swift suppression return to normalcy. Containment or closure policies, such as school closures and stay-at-home orders, are associated with a shorter duration for returning to normalcy, highlighting their effectiveness in curbing COVID-19 transmission. In contrast, health system policies and vaccine policies showed mixed results. Conclusion The findings from our survival analysis of the novel data set provide practical insights for prioritizing policy measures among various options to effectively and timely suppress the transmission of highly contagious diseases. These insights can also enhance resource utilization and allocation within and across public health systems, while minimizing restrictions on people’s daily lives.