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

The authors argue that unlike case count (which is a conservative estimate) and death count (which is a delayed and insufficient estimate), hospitalizations due to COVID-19 are a stronger metric for evaluating the effectiveness of stay-at-home measures. The study consisted of four states (Colorado, Minnesota, Ohio, and Virginia) that fit the inclusion criteria of having at least 7 consecutive days of cumulative hospitalization before and 17 days following the stay-at-home date.

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

Association of Stay-at-Home Orders With COVID-19 Hospitalizations in 4 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 states (Colorado, Minnesota, Ohio, and Virginia), cumulative hospitalizations from March 2020 to April 2020 fit an exponential growth curve leading up to the effective stay-at-home date (R2 = 0.973  in Colorado, 0.965 in Minnesota, 0.98  in Ohio, and 0.994 in Virginia) compared to a linear fit (R2= 0.695 in Colorado, 0.865 in Minnesota, 0.803 in Ohio, and 0.775 in Virginia). The exponential model fit was used to estimate the 95% prediction bands for future hospitalizations.

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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