JMIR Publications

ABSTRACT

Background:

The emergence of SARS-CoV-2, the virus that causes COVID-19, has led to a widespread global pandemic not seen since the 1918 influenza outbreak. The empirical question is if the current pandemic would attenuate from an approach taken by President Wilson used during the Influenza Pandemic of 1918 that killed some 675,000 Americans and up to 50 million people worldwide or by the approach President Franklin Roosevelt implemented to control malaria in the 1940s.

Objective:

To test COVID-19 control policies at the federal and state level with surveillance metrics including 1) speed, 2) acceleration, 3) jerk, 4) 7-day persistence. We will surveil COVID transmission using standard surveillance techniques, novel rates of increase and persistence, combined with overall caseload. Novel indicators improve our understanding of where and how rapidly SARS-CoV-2 is transmitting, and quantifies shifts in the rate of acceleration or deceleration by state to inform policy targeting mitigation and prevention strategies in the U.S.

Methods:

Using a longitudinal trend analysis study design, we extracted 60 days of COVID data from public health registries. We use an empirical difference equation to measure daily case numbers in 50 US states and Washington D.C. as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments (GMM) approach by implementing the Arellano-Bond estimator in R.

Results:

There is variation between and within states with some exemplars of good public health practice such as VT, NH, and ME. The overall U.S. caseload and increases in rates of infection translate into the country with highest caseload of coronavirus infections and deaths. The US 7-Day Persistence rate means super spreader events such as rallies, college parties, and other social gatherings not only infect large numbers of people but those infections echo forward with additional infections. Moving forward, blaming the virus on China or Spain was neither warranted nor helpful in controlling COVID-19 or the Influenza Pandemic; nor is censorship of the media or misinformation via social media. Other obstacles to recovery such as expressing skepticism of science and overt denial of the facts didn’t work for President Wilson during the 1918 influenza pandemic nor is it helpful today. We need a Roosevelt and not a Wilson response to the pandemic to return to normal. The current U.S. response to COVID-19 parallels President Wilson’s response to the 1918 Influenza Pandemic that killed 50 million people based on 1) no national response to control the outbreak; 2) misinformation; 3) unclear communication with the public; 4) widespread mistrust and panic.

Conclusions:

There is variation between and within states with some exemplars of good public health practice such as VT, NH, and ME. The overall U.S. caseload and increases in rates of infection translate into the country with highest caseload of coronavirus infections and deaths. The US 7-Day Persistence rate means super spreader events such as rallies, college parties, and other social gatherings not only infect large numbers of people but those infections echo forward with additional infections. Moving forward, blaming the virus on China or Spain was neither warranted nor helpful in controlling COVID-19 or the Influenza Pandemic; nor is censorship of the media or misinformation via social media. Other obstacles to recovery such as expressing skepticism of science and overt denial of the facts didn’t work for President Wilson during the 1918 influenza pandemic nor is it helpful today. We need a Roosevelt and not a Wilson response to the pandemic to return to normal. The current U.S. response to COVID-19 parallels President Wilson’s response to the 1918 Influenza Pandemic that killed 50 million people based on 1) no national response to control the outbreak; 2) misinformation; 3) unclear communication with the public; 4) widespread mistrust and panic. Clinical Trial: NA