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.

The simulations showed that control measures aimed at reducing social mixing in the population can be effective in reducing the magnitude and delaying the peak of the COVID-19 outbreak.

University of Michigan - Ann Arbor

Physical distancing, also known as social distancing, is being used as a strategy to delay the progression of COVID-19 by reducing direct transmission of infection. The three most used methods are:
Physical Distancing,
Isolation,
Quarantine

Physical Distancing to Prevent the Spread of COVID-19

Prem, K., Liu, Y., Russell, T. W., Kucharski, A. J., Eggo, R. M., Davies, N., ... & Abbott, S. (2020). The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study. The Lancet Public Health.

The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study

Physical distancing measures including but not limited to school and workplace closures and health promotions that encourage the general public to avoid crowded places, are designed to drastically shift social mixing patterns and are often used in epidemic settings. A distance of 6 feet is encouraged between people not living with each other in public spaces.

What is Physical Distancing?

Depending on the severity of physical distancing intervention, it could have an impact on delaying the epidemic peak. The various outcomes are evaluated using predictive models.

Potential Outcomes of Physical Distancing Interventions

The SEIR model simulates the outbreak over a 1 year period

The population is divided into four categories based on infection status:
Susceptible (S)
Exposed (E)
Infected (I)
Removed (R)

SEIR Model of COVID-19 Outbreak in Wuhan, China

There were three different levels of intervention used for the model to predict the outcomes of the COVID-19 epidemic in Wuhan, China:

**First level:** no change to social mixing patterns

**Second level:** minor to moderate change in social mixing patters due to holiday and school breaks (no intervention)

**Third level:** intense intervention (changes to school and work)

Different Levels of Intervention for Modeling

Key Point: Physical Distancing is Effective

Quarantining refers to the practice of keeping potentially infected people away from healthy people. The quarantine period can last as long as the disease's communicable period or expedited through a negative infection test.

What is quarantine?

Isolation refers to keeping infected persons away from healthy people. 

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