Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities

Abstract Background During March of 2020 the Centers for Disease Control and Prevention (CDC) announced non-pharmaceutical intervention (NPI) guidance as the primary mitigation strategy against growing COVID-19 community spread due to the absence of a vaccine or effective treatment at that time. CDC...

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Autores principales:	Kevin E. Cevasco, Amira A. Roess, Hayley M. North, Sheryne A. Zeitoun, Rachel N. Wofford, Graham A. Matulis, Abigail F. Gregory, Maha H. Hassan, Aya D. Abdo, Michael E. von Fricken
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	COVID-19 Non-pharmaceutical interventions U.S. universities Pandemic response Timing Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/2a6cd69ecbd54cd69faeb86ef5a5b485
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spelling	oai:doaj.org-article:2a6cd69ecbd54cd69faeb86ef5a5b4852021-11-08T10:43:48ZSurvival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities10.1186/s12889-021-12035-61471-2458https://doaj.org/article/2a6cd69ecbd54cd69faeb86ef5a5b4852021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12035-6https://doaj.org/toc/1471-2458Abstract Background During March of 2020 the Centers for Disease Control and Prevention (CDC) announced non-pharmaceutical intervention (NPI) guidance as the primary mitigation strategy against growing COVID-19 community spread due to the absence of a vaccine or effective treatment at that time. CDC guidance states that NPIs are most effective when instituted in an early, targeted, and layered fashion. NPIs are effective in slowing spread, and measures should be custom-tailored to each population. This study examines factors associated with implementation and timing of NPI interventions across large public and private U.S. universities at the onset of the COVID-19 pandemic. Methods NPI decisions of interest include when U.S. universities canceled international travel, shifted to online learning, moved faculty/staff to remote work, limited campus housing, and closed campus for all non-essential personnel. Cox proportional hazard analyses of retrospective data were conducted to assess the time to NPI events. Hazard ratios were calculated for university governance, campus setting, religious affiliation, health infrastructure, faculty diversity, and student demographics. The methods control for variance inflation factors, COVID case prevalence, and time varying covariates of spring break and states’ state of emergency (SOE) orders. This study captures NPI decisions at 575 U.S. universities during spring of 2020 which affected the movement of seven million students and two million employees. Results Universities located in districts represented by Democratic party congressional members reported earlier NPI implementation than Republican (Cox proportional hazard ratio (HR) range 0.61–0.80). University religious affiliation was not associated with the timing any of the NPI decisions. Universities with more diverse faculty showed an association with earlier NPI implementation (HR range 0.65–0.76). The existence of university-affiliated health infrastructure was not associated with NPI timing. Conclusion University NPI implementation was largely driven by local COVID-19 epidemiology, culture and political concerns. The timing of university NPI decisions varied by regional politics, faculty demographics, university governance, campus setting, and foreign student prevalence adjusting for COVID-19 state case prevalence and spring break timing. Religious affiliation and presence of university health infrastructure were not associated with timing.Kevin E. CevascoAmira A. RoessHayley M. NorthSheryne A. ZeitounRachel N. WoffordGraham A. MatulisAbigail F. GregoryMaha H. HassanAya D. AbdoMichael E. von FrickenBMCarticleCOVID-19Non-pharmaceutical interventionsU.S. universitiesPandemic responseTimingPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 Non-pharmaceutical interventions U.S. universities Pandemic response Timing Public aspects of medicine RA1-1270
spellingShingle	COVID-19 Non-pharmaceutical interventions U.S. universities Pandemic response Timing Public aspects of medicine RA1-1270 Kevin E. Cevasco Amira A. Roess Hayley M. North Sheryne A. Zeitoun Rachel N. Wofford Graham A. Matulis Abigail F. Gregory Maha H. Hassan Aya D. Abdo Michael E. von Fricken Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities
description	Abstract Background During March of 2020 the Centers for Disease Control and Prevention (CDC) announced non-pharmaceutical intervention (NPI) guidance as the primary mitigation strategy against growing COVID-19 community spread due to the absence of a vaccine or effective treatment at that time. CDC guidance states that NPIs are most effective when instituted in an early, targeted, and layered fashion. NPIs are effective in slowing spread, and measures should be custom-tailored to each population. This study examines factors associated with implementation and timing of NPI interventions across large public and private U.S. universities at the onset of the COVID-19 pandemic. Methods NPI decisions of interest include when U.S. universities canceled international travel, shifted to online learning, moved faculty/staff to remote work, limited campus housing, and closed campus for all non-essential personnel. Cox proportional hazard analyses of retrospective data were conducted to assess the time to NPI events. Hazard ratios were calculated for university governance, campus setting, religious affiliation, health infrastructure, faculty diversity, and student demographics. The methods control for variance inflation factors, COVID case prevalence, and time varying covariates of spring break and states’ state of emergency (SOE) orders. This study captures NPI decisions at 575 U.S. universities during spring of 2020 which affected the movement of seven million students and two million employees. Results Universities located in districts represented by Democratic party congressional members reported earlier NPI implementation than Republican (Cox proportional hazard ratio (HR) range 0.61–0.80). University religious affiliation was not associated with the timing any of the NPI decisions. Universities with more diverse faculty showed an association with earlier NPI implementation (HR range 0.65–0.76). The existence of university-affiliated health infrastructure was not associated with NPI timing. Conclusion University NPI implementation was largely driven by local COVID-19 epidemiology, culture and political concerns. The timing of university NPI decisions varied by regional politics, faculty demographics, university governance, campus setting, and foreign student prevalence adjusting for COVID-19 state case prevalence and spring break timing. Religious affiliation and presence of university health infrastructure were not associated with timing.
format	article
author	Kevin E. Cevasco Amira A. Roess Hayley M. North Sheryne A. Zeitoun Rachel N. Wofford Graham A. Matulis Abigail F. Gregory Maha H. Hassan Aya D. Abdo Michael E. von Fricken
author_facet	Kevin E. Cevasco Amira A. Roess Hayley M. North Sheryne A. Zeitoun Rachel N. Wofford Graham A. Matulis Abigail F. Gregory Maha H. Hassan Aya D. Abdo Michael E. von Fricken
author_sort	Kevin E. Cevasco
title	Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities
title_short	Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities
title_full	Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities
title_fullStr	Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities
title_full_unstemmed	Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities
title_sort	survival analysis of factors affecting the timing of covid-19 non-pharmaceutical interventions by u.s. universities
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2a6cd69ecbd54cd69faeb86ef5a5b485
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Survival analysis of factors affecting the timing of COVID-19 non-pharmaceutical interventions by U.S. universities

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