Query: Importance of social distancing in covid 19

title: Coagulopathy and Antiphospholipid Antibodies in Patients with Covid 19
abstract: Coagulopathy in Critical Illness with Covid 19 The authors describe a 69 year old man with Covid 19 diagnosed in January 2020 in Wuhan, China, along with two other critically ill patients with Covid 19 who were also seen in the same intensive care unit. Coagulopathy and antiphospholipid antibodies were seen in all three patients.

title: Severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) and coronavirus disease 2019 (COVID 19) The epidemic and the challenges
abstract: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS CoV 2; previously provisionally named 2019 novel coronavirus or 2019 nCoV) disease (COVID 19) in China at the end of 2019 has caused a large global outbreak and is a major public health issue. As of 11 February 2020, data from the World Health Organization (WHO) have shown that more than 43 000 confirmed cases have been identified in 28 countries/regions, with >99% of cases being detected in China. On 30 January 2020, the WHO declared COVID 19 as the sixth public health emergency of international concern. SARS CoV 2 is closely related to two bat derived severe acute respiratory syndrome like coronaviruses, bat SL CoVZC45 and bat SL CoVZXC21. It is spread by human to human transmission via droplets or direct contact, and infection has been estimated to have mean incubation period of 6.4 days and a basic reproduction number of 2.24 3.58. Among patients with pneumonia caused by SARS CoV 2 (novel coronavirus pneumonia or Wuhan pneumonia) fever was the most common symptom, followed by cough. Bilateral lung involvement with ground glass opacity was the most common finding from computed tomography images of the chest. The one case of SARS CoV 2 pneumonia in the USA is responding well to remdesivir, which is now undergoing a clinical trial in China. Currently, controlling infection to prevent the spread of SARS CoV 2 is the primary intervention being used. However, public health authorities should keep monitoring the situation closely, as the more we can learn about this novel virus and its associated outbreak, the better we can respond.

title: Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID 19 in the New York City Area.
abstract: Importance There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019  To describe the clinical characteristics and outcomes of patients with COVID 19 hospitalized in a US health care system.  The study included all sequentially hospitalized patients between March 1, 2020, and April 4, 2020, inclusive of these dates.  Confirmed severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample among patients requiring admission.  Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy, and death. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected.  A total of 5700 patients were included (median age, 63 years [interquartile range {IQR} 52 75; range, 0 107 years] 39.7% female) The most common comorbidities were hypertension (3026; 56.6% obesity (1737; 41.7% and diabetes (1808; 33.8% At triage, 30.7% of patients were febrile, 17.3% had a respiratory rate greater than 24 breaths/minute, and 27.8% received supplemental oxygen. The rate of respiratory virus co infection was 2.1% Outcomes were assessed for 2634 patients who were discharged or had died at the study end point. During hospitalization, 373 patients (14.2% (median age, 68 years [IQR, 56 78] 33.5% female) were treated in the intensive care unit care, 320 (12.2% received invasive mechanical ventilation, 81 (3.2% were treated with kidney replacement therapy, and 553 (21% died. Mortality for those requiring mechanical ventilation was 88.1% The median postdischarge follow up time was 4.4 days (IQR, 2.2 9.3) A total of 45 patients (2.2% were readmitted during the study period. The median time to readmission was 3 days (IQR, 1.0 4.5) for readmitted patients. Among the 3066 patients who remained hospitalized at the final study follow up date (median age, 65 years [IQR, 54 75] the median follow up at time of censoring was 4.5 days (IQR, 2.4 8.1)  This case series provides characteristics and early outcomes of sequentially hospitalized patients with confirmed COVID 19 in the New York City area.

title: Strong Social Distancing Measures In The United States Reduced The COVID 19 Growth Rate.
abstract: State and local governments imposed social distancing measures in March and April of 2020 to contain the spread of novel coronavirus disease 2019 (COVID 19) These included large event bans, school closures, closures of entertainment venues, gyms, bars, and restaurant dining areas, and shelter in place orders (SIPOs) We evaluated the impact of these measures on the growth rate of confirmed COVID 19 cases across US counties between March 1, 2020 and April 27, 2020. An event study design allowed each policy's impact on COVID 19 case growth to evolve over time. Adoption of government imposed social distancing measures reduced the daily growth rate by 5.4 percentage points after 1 5 days, 6.8 after 6 10 days, 8.2 after 11 15 days, and 9.1 after 16 20 days. Holding the amount of voluntary social distancing constant, these results imply 10 times greater spread by April 27 without SIPOs (10 million cases) and more than 35 times greater spread without any of the four measures (35 million) Our paper illustrates the potential danger of exponential spread in the absence of interventions, providing relevant information to strategies for restarting economic activity.

title: Social Distancing Has Merely Stabilized COVID 19 in the US
abstract: Social distancing measures, with varying degrees of restriction, have been imposed around the world in order to stem the spread of COVID 19. In this work we analyze the effect of current social distancing measures in the United States. We quantify the reduction in doubling rate, by state, that is associated with social distancing. We find that social distancing is associated with a statistically significant reduction in the doubling rate for all but three states. At the same time, we do not find significant evidence that social distancing has resulted in a reduction in the number of daily confirmed cases. Instead, social distancing has merely stabilized the spread of the disease. We provide an illustration of our findings for each state, including point estimates of the effective reproduction number, R, both with and without social distancing. We also discuss the policy implications of our findings.

title: Ties that Bind (and Social Distance) How Social Capital Helps Communities Weather the COVID 19 Pandemic
abstract: The COVID 19 pandemic represents the largest world wide shock in at least a decade. Moreover, the spread of the virus has been highly heterogeneous. This paper investigates the role of social capital as a potential mediating factor for the spread of the COVID 19 virus. On one hand, higher social capital could imply greater in person interaction and risk of contagion. On the other hand, because social capital is associated with greater trust and relationships within a community, it could endow individuals with a greater concern for others, thereby leading to more hygienic practices and social distancing. Our results suggest that moving a county from the 25 to the 75 percentile of the distribution of social capital would lead to a 20% decline in the number of infections, as well as a 0.28 percentage point decline in the growth rate of the virus (nearly 20% of the median growth rate) Moreover, our results are robust to many demographic characteristics, controls, and alternative measures of social capital.

title: Civic Capital and Social Distancing During the Covid 19 Pandemic
abstract: Using mobile phone and survey data, we show that during the early phases of COVID 19, voluntary social distancing was greater in areas with higher civic capital and amongst individuals exhibiting a higher sense of civic duty This effect is robust to including controls for political ideology, income, age, education, and other local level characteristics This result is present for U S individuals and U S counties as well as European regions Moreover, we show that after U S states began re opening, high civic capital counties maintained a more sustained level of social distancing, while low civic capital counties did not Finally, we show that U S individuals report a higher tendency to use protective face masks in high civic capital counties Our evidence points to the importance of considering the level of civic capital in designing public policies not only in response to pandemics, but also more generally

title: Social distancing strategies for curbing the COVID 19 epidemic
abstract: The SARS CoV 2 pandemic is straining healthcare resources worldwide, prompting social distancing measures to reduce transmission intensity. The amount of social distancing needed to curb the SARS CoV 2 epidemic in the context of seasonally varying transmission remains unclear. Using a mathematical model, we assessed that one time interventions will be insufficient to maintain COVID 19 prevalence within the critical care capacity of the United States. Seasonal variation in transmission will facilitate epidemic control during the summer months but could lead to an intense resurgence in the autumn. Intermittent distancing measures can maintain control of the epidemic, but without other interventions, these measures may be necessary into 2022. Increasing critical care capacity could reduce the duration of the SARS CoV 2 epidemic while ensuring that critically ill patients receive appropriate care.

title: Spreading of COVID 19 in Brazil: Impacts and uncertainties in social distancing strategies
abstract: Brazil's continental dimension poses a challenge to the control of the spread of COVID 19. Due to the country specific scenario of high social and demographic heterogeneity, combined with limited testing capacity, lack of reliable data, under reporting of cases, and restricted testing policy, the focus of this study is twofold: (i) to develop a generalized SEIRD model that implicitly takes into account the quarantine measures, and (ii) to estimate the response of the COVID 19 spread dynamics to perturbations/uncertainties. By investigating the projections of cumulative numbers of confirmed and death cases, as well as the effective reproduction number, we show that the model parameter related to social distancing measures is one of the most influential along all stages of the disease spread and the most influential after the infection peak. Due to such importance in the outcomes, different relaxation strategies of social distancing measures are investigated in order to determine which strategies are viable and less hazardous to the population. The results highlight the need of keeping social distancing policies to control the disease spread. Specifically, the considered scenario of abrupt social distancing relaxation implemented after the occurrence of the peak of positively diagnosed cases can prolong the epidemic, with a significant increase of the projected numbers of confirmed and death cases. An even worse scenario could occur if the quarantine relaxation policy is implemented before evidence of the epidemiological control, indicating the importance of the proper choice of when to start relaxing social distancing measures.

title: Measuring voluntary social distancing behavior during the COVID 19 pandemic
abstract: Staying home is an important part of the effort to contain COVID 19 and limit deaths. Every state in the United States has enacted policies to encourage distancing and staying home. An important question is how these policies interact with individuals voluntary responses to COVID 19 cases and deaths. We find evidence of a non trivial voluntary response to local and nationally reported COVID 19 cases and deaths.