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Preprint en Inglés | medRxiv | ID: ppmedrxiv-20119131

RESUMEN

BackgroundAs states reopen in May 2020, the United States is still trying to curb the spread of the COVID-19 pandemic. To appropriately design policies and anticipate behavioral change, it is important to understand how different Americans social distancing behavior shifts in relation to policy announcements according to individual characteristics, and community vulnerability. MethodsThis cross-sectional study used Unacasts social distancing data from February 24th - May 10th, 2020 to study how social distancing changed before and after: 1) The World Health Organizations declaration of a global pandemic, 2) White House announcement of "Opening Up America Again" (OUAA) guidelines, and 3) the week of April 27 when several states reopened. To measure intention to social distance, we assessed the difference between weekday and weekend behavior as more individuals have more control over weekend leisure time. To investigate social distancings sensitivity to different population characteristics, we compared social distancing time-series data across county vulnerability as measured by the COVID-19 Community Vulnerability Index (CCVI) which defines vulnerability across socioeconomic, household composition, minority status, epidemiological, and healthcare-system related factors. We also compared social distancing across population groupings by race, 2016 presidential election voting choice, and employment sectors. ResultsMovement reduced significantly throughout March reaching peak reduction on April 12th (-56.1%) prior the enactment of any reopening policies. Shifts in social distancing began after major announcements but prior to specific applied policies: Following the WHO declaration, national social distancing significantly increased on weekdays and weekends (-18.6% and -41.3% decline in mobility, respectively). Social distancing significantly declined on weekdays and weekends after OUAA guidelines (i.e. before state reopening) (+1.1% and +5.3% increase in mobility, respectively) with additional significant decline after state reopening (+10.0% and +20.9% increase in mobility, respectively). Social distancing was significantly greater on weekends than weekdays throughout March, however, the trend reversed by early May with significantly less social distancing on weekends, suggesting a shift in intent to social distance during leisure time. In general, vulnerable counties social distanced less than non-vulnerable counties, and had a greater difference between weekday and weekend behavior until state reopening. This may be driven by structural barriers that vulnerable communities face, such as higher rates of employment in particular sectors. At all time periods studied, the average black individual in the US social distanced significantly more than the average white individual, and the average 2016 Clinton voter social distanced significantly more than the average 2016 Trump voter. Social distancing behavior differed across industries with three clusters of employment sectors. ConclusionBoth signaling of a policy change and implementation of a policy are important factors that seem to influence social distancing. Behaviors shifted with national announcements prior to mandates, though social distancing further declined nationwide as the first states reopened. The variation in behavioral drivers including vulnerability, race, political affiliation, and employment industry demonstrates the need for targeted policy messaging and interventions tailored to address specific barriers for improved social distancing and mitigation.

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