BACKGROUND The Great COVID Shutdown aimed to eliminate or slow SARS-CoV-2, the virus that causes COVID-19 . The US has no national policy leaving states to independently implement public health guidelines that are predicated on a sustained decline in COVID . Operationalization of 'sustained decline' varies by state and county . Existing models of COVID transmission rely on parameters such as case estimates or R0 and are dependent on intensive data collection efforts . Static statistical models do not capture all of the relevant dynamics required to measure sustained declines . Moreover, existing COVID models use data that are subject to significant measurement error and contamination .
OBJECTIVE This study will generate novel metrics of speed, acceleration, jerks and 7-day lag in acceleration of COVID transmission using state government tallies of COVID infections including state-level dynamics of COVID infections . This study provides the prototype for a global surveillance system to inform public health practice including novel standardized metrics of COVID transmission for use in combination with traditional surveillance tools .
METHODS Dynamic panel data (DPD) models are estimated with the Arellano-Bond estimator utilizing the Generalized Method of Moments . This statistical technique allows for control of a variety of deficiencies in the existing data . Tests of the validity of the model and statistical techniques are applied .
RESULTS 1) The statistical approach is validated based on the regression results; they determine recent changes in the pattern of infection; and 2) during the weeks of August 17-23 and August 24-30 there were substantial regional differences in the evolution of the US pandemic . Census regions 1 and 2 were relatively quiet with a small but significant persistence effect that remained relatively unchanged over the past two weeks . Census region 3 was sensitive to the number of tests administered, with a high constant rate of cases . A weekly special analysis showed that these results were driven by states with a high number of positive tests reports at Universities . Census region 4 had a high constant number of cases and a significantly increased persistence effect during the week of August 24-30th . This change represents an increase in the transmission model R value for that week, and is consistent with a re-emergence of the pandemic .
CONCLUSIONS Opening America comes with three certainties : 1) the``social"end of the pandemic and re-opening is going to occur before the``medical"end even while the pandemic is growing . We need improved standardized surveillance techniques to inform leaders when it is safer to open sections of America; 2) varying public health policy and guidelines unnecessarily result in varying degrees of transmission and outbreaks; and 3) even those states most successful in containing the US pandemic are still seeing a small but constant stream of daily new cases . CLINICALTRIAL