Carl Bonander1, Debora Stranges2, Johanna Gustavsson3, Matilda Almgren4, Malin Inghammar5, Mahnaz Moghaddassi6, Anton Nilsson2, Joan Capdevila Pujol7, Claire Steves8, Paul W Franks9,10, Maria F Gomez11, Tove Fall12, Jonas Björk2,4. 1. Health Economics & Policy, School of Public Health & Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 2. Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden. 3. Centre for Societal Risk Research, Faculty of Arts and Social Sciences, Karlstad University, Karlstad, Sweden. 4. Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden. 5. Department of Clinical Sciences Lund, Section for Infection Medicine, Skåne University Hospital, Lund University, Lund, Sweden. 6. Department of Clinical Sciences Malmö, Social Medicine and Global Health, Lund University, Malmö, Sweden. 7. ZOE Limited, London, UK. 8. Department of Twin Research and Genetic Epidemiology, King's College London, London, UK. 9. Department of Clinical Sciences, Lund University Diabetes Center, Skåne University Hospital, Malmö, Sweden. 10. Department of Nutrition, Harvard Chan School of Public Health, Boston, MA, USA. 11. Department of Clinical Sciences in Malmö, Diabetic Complications Unit, Lund University Diabetes Centre, Lund, Sweden. 12. Department of Medical Sciences, Molecular Epidemiology, and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
Abstract
BACKGROUND: This article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (COVID-19) pandemic (March to July 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household. METHODS: We used a regression discontinuity design-in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96 053; age range: 39-79 years) and national register data (age range: 39-100+ years) on severe COVID-19 disease (hospitalization or death, n = 21 804) and confirmed cases (n = 48 984)-to estimate the effects of the policy. RESULTS: Our primary analyses showed a sharp drop in the weekly number of visits to crowded places (-13%) and severe COVID-19 cases (-16%) at the 70-year threshold. These results imply that the age-specific recommendations prevented approximately 1800-2700 severe COVID-19 cases, depending on model specification. CONCLUSIONS: It seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.
BACKGROUND: This article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (COVID-19) pandemic (March to July 2020). The policy stated that people aged 70 years or older should avoid crowded places and contact with people outside the household. METHODS: We used a regression discontinuity design-in combination with self-reported isolation data from COVID Symptom Study Sweden (n = 96 053; age range: 39-79 years) and national register data (age range: 39-100+ years) on severe COVID-19 disease (hospitalization or death, n = 21 804) and confirmed cases (n = 48 984)-to estimate the effects of the policy. RESULTS: Our primary analyses showed a sharp drop in the weekly number of visits to crowded places (-13%) and severe COVID-19 cases (-16%) at the 70-year threshold. These results imply that the age-specific recommendations prevented approximately 1800-2700 severe COVID-19 cases, depending on model specification. CONCLUSIONS: It seems that the non-mandatory, age-specific recommendations helped control COVID-19 disease during the first wave of the pandemic in Sweden, as opposed to not implementing a social distancing policy aimed at older adults. Our study provides empirical data on how populations may react to non-mandatory, age-specific social distancing policies in the face of a novel virus.
Authors: Thomas Hale; Noam Angrist; Rafael Goldszmidt; Beatriz Kira; Anna Petherick; Toby Phillips; Samuel Webster; Emily Cameron-Blake; Laura Hallas; Saptarshi Majumdar; Helen Tatlow Journal: Nat Hum Behav Date: 2021-03-08
Authors: Carole H Sudre; Karla A Lee; Mary Ni Lochlainn; Thomas Varsavsky; Benjamin Murray; Mark S Graham; Cristina Menni; Marc Modat; Ruth C E Bowyer; Long H Nguyen; David A Drew; Amit D Joshi; Wenjie Ma; Chuan-Guo Guo; Chun-Han Lo; Sajaysurya Ganesh; Abubakar Buwe; Joan Capdevila Pujol; Julien Lavigne du Cadet; Alessia Visconti; Maxim B Freidin; Julia S El-Sayed Moustafa; Mario Falchi; Richard Davies; Maria F Gomez; Tove Fall; M Jorge Cardoso; Jonathan Wolf; Paul W Franks; Andrew T Chan; Tim D Spector; Claire J Steves; Sébastien Ourselin Journal: Sci Adv Date: 2021-03-19 Impact factor: 14.136
Authors: David A Drew; Long H Nguyen; Tim D Spector; Andrew T Chan; Claire J Steves; Cristina Menni; Maxim Freydin; Thomas Varsavsky; Carole H Sudre; M Jorge Cardoso; Sebastien Ourselin; Jonathan Wolf Journal: Science Date: 2020-05-05 Impact factor: 47.728