Early COVID-19 Interventions Failed to Replicate 1918 St. Louis vs. Philadelphia Outcomes in the United States

Abstract

<jats:p>The Coronavirus disease 2019 (COVID-19) pandemic has elicited an abrupt pause in the United States in multiple sectors of commerce and social activity. As the US faces this health crisis, the magnitude, and rigor of their initial public health response was unprecedented. As a response, the entire nation shutdown at the state-level for the duration of approximately one to three months. These public health interventions, however, were not arbitrarily decided, but rather, implemented as a result of evidence-based practices. These practices were a result of lessons learned during the 1918 influenza pandemic and the city-level non-pharmaceutical interventions (NPIs) taken across the US. During the 1918 pandemic, two model cities, St. Louis, MO, and Philadelphia, PA, carried out two different approaches to address the spreading disease, which resulted in two distinctly different outcomes. Our group has evaluated the state-level public health response adopted by states across the US, with a focus on New York, California, Florida, and Texas, and compared the effectiveness of reducing the spread of COVID-19. Our assessments show that while the states mentioned above benefited from the implementations of early preventative measures, they inadequately replicated the desired outcomes observed in St. Louis during the 1918 crisis. Our study indicates that there are other factors, including health disparities that may influence the effectiveness of public health interventions applied. Identifying more specific health determinants may help implement targeted interventions aimed at preventing the spread of COVID-19 and improving health equity.</jats:p>

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

“…The left column describes the main categories in this group of articles. Subcategory Country and references Effects on spreading Argentina, Bolivia, Brazil, Chile, Colombia, Paraguay, Peru, and Uruguay [309] ; Australia [310] Bangladesh [311] ; China [31] , [32] , [33] , [312] , [313] , [314] , [315] ; China, Germany, India, Italy, Singapore, South Korea, Spain, UK, USA [316] ; Italy [317] , [318] ; New Zealand [319] ; Puerto Rico [320] ; South Korea [321] ; Taiwan [322] ; USA [323] , [324] , [325] , [326] , [327] , [328] ; 44 countries [329] ; 53 countries [330] ; 56 countries [331] ; 142 countries [332] ; 149 countries [333] Effects on behaviors China [334] ; China, Italy [335] ; Denmark, Sweden [336] ; Germany [337] USA [338] , [339] , [340] , [341] ; 20 countries [342] ; 67 countries [343] Effects on medical practice Italy [344] ; Netherlands [345] ; UK [346] …”

“…These articles study the impact on the unfolding of the disease focusing on the measures adopted in a specific country [31] , [32] , [33] , [309] , [310] , [311] , [312] , [313] , [315] , [317] , [318] , [319] , [320] , [322] , [323] , [324] , [325] , [326] , [327] , proposing multi country analyses [316] , [329] , [330] , [331] , [332] , [333] , and characterizing the effects of NPIs on other diseases [314] , [321] , [328] .…”

Delayed Interventions, Low Compliance, and Health Disparities Amplified the Early Spread of COVID-19

“…Four of the main NPIs implemented in the US included restrictions on mass gatherings, stay at home orders, face mask requirements, and screening for COVID-19. While similar interventions were used in many states, we observed a disproportionate early spread of the Coronavirus in some states, including New York, California, Florida, and Texas (Jalali et al, 2020).…”

“…The effectiveness of NPIs implemented was dependent on four factors that included the concurrent use of NPIs, early intervention, duration, and the rigor of the preventative measure (Hatchett et al, 2007). Seemingly rigorous and early preventative measures that were employed to slow the spread of the COVID-19 have, unfortunately, resulted in subpar and inconsistent outcomes across the US (Jalali et al, 2020).…”

Biopsychosocial and Spiritual Implications of Patients with COVID-19 Dying in Isolation

“…Funeral practices, including planning a meaningful funeral, memorializing lost one, mourning the collective loss, and the ability to personalize the funeral shown to have an impact on how the family received closure or went through the bereavement process (Burrell and Selman, 2020). Social distancing practices, including the inability to gather in masses, stay at home orders, and facemask requirements have also negatively hampered the ability for families to personalize this experience (Jalali et al, 2020). The ongoing pandemic further complicates the grieving process as families have to do so in isolation, without face-to-face mourning rituals, with financial uncertainties, and not being able to plan for the end-of-life care of their loved ones (Carr et al, 2020).…”