Covid-19 Social Distancing Interventions by State Mandate and their Correlation to Mortality in the United States

Background Evaluate the correlation between U.S. state mandated social interventions and Covid-19 mortality using a retrospective analysis of Institute for Health Metrics and Evaluation (IHME) data. Methods Twenty-seven (27) states in the United States were selected on June 17, 2020 from IHME data which had clearly defined and dated establishment of statewide mandates for social distancing measures to include: School closures, Prohibition on mass gatherings, business closures, stay at home orders, severe travel restrictions, and closure of non-essential businesses. The state Covid-19 mortality prevalence was defined as total normalized deaths to the peak daily mortality rate. The state mortality prevalence was correlated to the total number of mandates-days from their date of establishment to the peak daily mortality date. The slope of the maximum daily mortality rate was also correlated to mandate-days. Results The standardized mortality per state to the initial peak mortality rate did not demonstrate a discernable correlation to the total mandate days (R 2 = 0.000006, p= 0.995). The standardized peak mortality rate per state suggested a slight correlation to the total mandate days (R 2 = 0.053,p=0.246), but was not statistically significant. There was a significant correlation between standardized mortality and state population density (R 2 = 0.524,p=0.00002). Conclusions The analysis appears to suggest no mandate effective reduction in Covid-19 mortality nor a reduction in Covid-19 mortality rate to its defined initial peak when interpreting the mean-effect of the mandates as present in the data. A strong correlation to population density suggests human interaction frequency does affect the total mortality and maximum mortality rate. Trial Registration Public data is not patient specific and made available for public download on IHME Websites which can be used, shared, modified or built upon by non-commercial users via the Creative Commons Attribution-NonCommercial 4.0 International License. https://creativecommons.org/licenses/by-nc/4.0/ Précis The mean-effects of Covid-19 mandated social interventions were found to have no affect the maximum slope of the daily mortality nor the overall mortality but did correlate to the population density.