Related Experiment Video
Updated: Nov 2, 2025
Setup of Consumer Wearable Devices for Exposure and Health Monitoring in Population Studies
Published on: February 3, 2023
Stay-at-home orders associate with subsequent decreases in COVID-19 cases and fatalities in the United States
James H Fowler1,2, Seth J Hill2, Remy Levin3
1Infectious Diseases and Global Public Health Division, University of California, San Diego, San Diego, CA, United States of America.
Insights
Stay-at-home orders significantly reduced COVID-19 cases and fatalities in the US. These public health interventions led to substantial decreases in weekly cases and deaths within three weeks of implementation.
Area of Science:
- Epidemiology
- Public Health Policy
- Biostatistics
Background:
- Stay-at-home orders are a key non-pharmaceutical intervention to control infectious disease spread.
- The effectiveness of these orders during the COVID-19 pandemic in the US, lacking national coordination, requires empirical evaluation.
Purpose of the Study:
- To quantify the impact of stay-at-home orders on COVID-19 cases and fatalities at the county level in the United States.
- To assess the association between the implementation of stay-at-home orders and changes in disease transmission and mortality.
Main Methods:
- Utilized a difference-in-differences design comparing counties with and without stay-at-home orders.
- Integrated county-level daily COVID-19 case and fatality data with the timing of stay-at-home orders for the initial seven weeks of the outbreak.
- Controlled for unmeasured local (e.g., healthcare capacity) and temporal (e.g., national policies) confounders.
Main Results:
- Stay-at-home orders were associated with significant reductions in weekly COVID-19 cases: 30.2% after one week, 40.0% after two weeks, and 48.6% after three weeks.
- A 59.8% average reduction in weekly fatalities was observed three weeks after order implementation.
- Estimated that these orders potentially averted 390,000 cases and 41,000 fatalities within three weeks in implementing localities.
Conclusions:
- Stay-at-home orders demonstrated a significant association with reduced COVID-19 cases and fatalities in the early stages of the pandemic.
- The findings support the utility of stay-at-home orders as an effective public health strategy for mitigating disease spread and mortality.
- Policy implications highlight the importance of timely and geographically varied implementation of such measures.
Abstract:
Governments issue "stay-at-home" orders to reduce the spread of contagious diseases, but the magnitude of such orders' effectiveness remains uncertain. In the United States these orders were not coordinated at the national level during the coronavirus disease 2019 (COVID-19) pandemic, which creates an opportunity to use spatial and temporal variation to measure the policies' effect. Here, we combine data on the timing of stay-at-home orders with daily confirmed COVID-19 cases and fatalities at the county level during the first seven weeks of the outbreak in the United States. We estimate the association between stay-at-home orders and alterations in COVID-19 cases and fatalities using a difference-in-differences design that accounts for unmeasured local variation in factors like health systems and demographics and for unmeasured temporal variation in factors like national mitigation actions and access to tests. Compared to counties that did not implement stay-at-home orders, the results show that the orders are associated with a 30.2 percent (11.0 to 45.2) average reduction in weekly incident cases after one week, a 40.0 percent (23.4 to 53.0) reduction after two weeks, and a 48.6 percent (31.1 to 61.7) reduction after three weeks. Stay-at-home orders are also associated with a 59.8 percent (18.3 to 80.2) average reduction in weekly fatalities after three weeks. These results suggest that stay-at-home orders might have reduced confirmed cases by 390,000 (170,000 to 680,000) and fatalities by 41,000 (27,000 to 59,000) within the first three weeks in localities that implemented stay-at-home orders.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:11Residuals and Least-Squares Property
If the observed data point lies above the line, the residual is positive, and the line underestimates the actual data value for y. If the observed data point lies below the line, the residual is negative, and the line overestimates the actual data value for y.
The process of fitting the best-fit...
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...