Sen, S., Karaca-Madnic, P., & Georgiou, A. (2020). Association of Stay-at-Home Orders With COVID-19 Hospitalizations in 4 States. JAMA.

doi:10.1001/jama.2020.9176

University of Michigan - Ann Arbor

- Association of Stay-at-Home Orders With COVID-19 Hospitalizations in 4 States
- Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic
- Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China

JAMA Papers for Control Strategies for COVID-19

Unlike case counts (which are conservative estimates) and death counts (which are delayed and insufficient estimates), COVID-19 hospitalizations provide a stronger metric for evaluating the effectiveness of stay-at-home measures. An analysis of data from four U.S. states (Colorado, Minnesota, Ohio, and Virginia)—selected for having at least 7 consecutive days of cumulative hospitalizations before and 17 days following the orders—demonstrated a correlation between the implementation of stay-at-home orders and a subsequent decrease in hospitalizations.

Correlation Between Stay-at-Home Orders and Decreased COVID-19 Hospitalizations in Four U.S. States

Baum, A., & Schwartz, M. (2020). Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic. JAMA.
*doi:10.1001/jama.2020.9972

Admissions to Veterans Affairs Hospitals for Emergency Conditions During the COVID-19 Pandemic

Lai X, Wang M, Qin C, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Netw Open. May 21 2020;3(5):e209666. doi:10.1001/jamanetworkopen.2020.9666

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766227

Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China

In four U.S. states (Colorado, Minnesota, Ohio, and Virginia), cumulative COVID-19 hospitalizations from March 2020 to April 2020 fit an exponential growth curve leading up to the effective stay-at-home date better than a linear fit: exponential $$R^2$$ = 0.973 (Colorado), 0.965 (Minnesota), 0.98 (Ohio), and 0.994 (Virginia), versus linear $$R^2$$ = 0.695, 0.865, 0.803, and 0.775 respectively. The exponential model was used to estimate 95% prediction bands for post-order hospitalizations, per Table 1 of Sen et al. (2020, JAMA).

Association between decreased hospitalizations and stay-at-home orders in four states in U.S. Table 1.

Figure 1 shows the projected and observed COVID-19 hospitalizations in four states (Colorado, Minnesota, Ohio, and Virginia) before and after the effective stay-at-home dates. In each state, cumulative hospitalizations deviated from the exponential growth curve models to fall outside of the 95% prediction bands soon after the effective stay-at-home date. 

*It's important to note that other factors such as school closures, social distancing, and avoidance of hospitals may have affected COVID-19 hospitalizations. 

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