Shelter-In-Place Orders Reduced COVID-19 Mortality And Reduced The Rate Of Growth In Hospitalizations

Health Aff (Millwood). 2020 Sep;39(9):1615-1623. doi: 10.1377/hlthaff.2020.00719. Epub 2020 Jul 9.

Abstract

Most states enacted shelter-in-place orders when mitigating the coronavirus disease 2019 (COVID-19) pandemic. Emerging evidence indicates that these orders have reduced COVID-19 cases. Using data starting at different dates in March and going through May 15, 2020, we examined the effects of shelter-in-place orders on daily growth rates of both COVID-19 deaths and hospitalizations, using event study models. We found that shelter-in-place orders reduced both the daily mortality growth rate nearly three weeks after their enactment and the daily growth rate of hospitalizations two weeks after their enactment. After forty-two days from enactment, the daily mortality growth rate declined by up to 6.1 percentage points. Projections suggest that as many as 250,000-370,000 deaths were possibly averted by May 15 in the forty-two states plus Washington, D.C., that had statewide shelter-in-place orders. The daily hospitalization growth rate examined in nineteen states with shelter-in-place orders and three states without them that had data on hospitalizations declined by up to 8.4 percentage points after forty-two days. This evidence suggests that shelter-in-place orders have been effective in reducing the daily growth rates of COVID-19 deaths and hospitalizations.

Keywords: COVID-19; Diseases; Government programs and policies; Hospital care; Hospital quality; Hospital stays; Hospitalizations; Mortality; Pandemics; Patients; Policy mandates; Shelter in place; State mandates; Stay at home; coronavirus; health policy; hospitals; nursing homes.

Publication types

  • Review

MeSH terms

  • COVID-19
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / prevention & control*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Mortality / trends*
  • Pandemics / prevention & control*
  • Pandemics / statistics & numerical data
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control*
  • Policy Making
  • Primary Prevention / legislation & jurisprudence*
  • Quality Improvement
  • Quarantine / legislation & jurisprudence*
  • United States