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CHOP/Penn Study: May Reopening Could Lead to Late Summer COVID Infections 2-3x Higher Than Before

Updated: Apr 25, 2020

CHOP's PolicyLab Graph for Dauphin County shows COVID infections resurgence in summer at more than twice the rate of pre-shutdown infections if the county partially reopens in May.

PHILADELPHIA (Apr 24, 2020) – Data from a new county-level model released this week projects that a mid-May partial reopening in Pennsylvania could result in a mid-summer resurgence of the novel coronavirus at infection rates up to three times the highest experienced prior to the statewide shutdown. The analysis, developed by PolicyLab at Children’s Hospital of Philadelphia (CHOP) concluded that, while higher temperatures would help slow the spread, the most impactful factors in reducing COVID-19 infections were social distancing policies and population density. An interdisciplinary team of public health, epidemiology, and biostatistics experts from CHOP and the University of Pennsylvania collaborated with global experts to develop the model. The model currently forecasts until early August the effects of partially relaxing social distancing policies to halfway back to normal activity starting May 15. Dr. David Rubin, director of PolicyLab and a professor of Pediatrics at the University of Pennsylvania's Perelman School of Medicine, said that the volume of research that comes out of CHOP, not only pediatric research, but also multidisciplinary health services research in general, is what makes CHOP an ideal place to conduct this study. “To me, it’s the right people, at the right time, asking the right questions, and then we quickly crowdsource an amazing team,” Dr. Rubin said. “All of that comes together to create a unique modeling team that is going to add tremendous value in terms of understanding the epidemic.” The model, known as COVID-Lab: Mapping COVID-19 in Your Community, represents 58% of the total U.S. population and includes data from every state. The researchers factored into their analysis unique local data, including population age, insurance status, and smoking prevalence, along with density of the specific counties included in the study, to evaluate the anticipated number of COVID-19 infections over time across a county. The COVID-Lab model projects the risk and timing of a potential renewed wave of infections this summer. “As our leaders plan for when and how to reopen communities, understanding the highly contagious nature of this virus and the factors that impact its spread must inform those decisions,” said Dr. Rubin. “Complementary to other national models, our data differ in that they illustrate the situation in our own backyards. With our model, we hope to help city leaders and public health officials build more targeted strategies for reopening communities that consider not only the strain on our health care systems, but also how to deploy other strategies such as masking and workplace safety regulations to maintain some distancing as people leave the confines of their homes.” Included in the model are seven Pennsylvania counties –Allegheny, Bucks, Delaware, Dauphin, Lehigh, Montgomery, and Philadelphia. The team evaluated what would happen if there were to be a return to about half the pre-COVID traffic to non-essential businesses by mid-May. The researchers project that, by about late July, Allegheny and Lehigh counties would see a return to infection rates approaching pre-shutdown rates. Alarmingly, in the other five counties, they say a mid-May partial reopening results in significantly greater infection rates -- as much as two to three times the highest rates those counties have experienced to date. “Measured against a number of local factors, we saw that strict social distancing policies and low population density, and, to a lesser extent, warming weather were all important in slowing the spread of this dangerous virus,” said Dr. Gregory Tasian, faculty member at PolicyLab, assistant professor of Urology and Epidemiology and senior scholar in the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania’s Perelman School of Medicine. “We were especially interested to find that rising temperatures may have helped reduce the spread of COVID-19, particularly in our less populous counties, but unfortunately the effect of weather, in the absence of strict social distancing policies, has not been strong enough to prevent resurgent transmission in our most crowded cities and their metropolitan areas.” While the models shows that many less densely populated counties benefit from warmer weather in reducing transmission, the researchers caution those counties still needed to implement strong mitigation strategies to ensure they can keep cases low by early fall, when temperatures begin to decline. Such mitigation strategies, they said, include strong workplace safety regulations, sufficient testing capacity, and universal masking in public. The team will continue updating the model based on policy changes and mitigation strategies that counties make to forecast viral transmission well into fall and winter when they anticipate many more counties will have significant outbreaks. The data are publicly available in the form of interactive maps, here: https://policylab.chop.edu/covid-lab-mapping-covid-19-your-community

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