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Eur J Public Health . A regression discontinuity analysis of the social distancing recommendations for older adults in Sweden during COVID-19

tetano

Editor, Senior Moderator
Eur J Public Health


. 2022 Aug 13;ckac101.
doi: 10.1093/eurpub/ckac101. Online ahead of print.
A regression discontinuity analysis of the social distancing recommendations for older adults in Sweden during COVID-19


Carl Bonander[SUP] 1 [/SUP], Debora Stranges[SUP] 2 [/SUP], Johanna Gustavsson[SUP] 3 [/SUP], Matilda Almgren[SUP] 4 [/SUP], Malin Inghammar[SUP] 5 [/SUP], Mahnaz Moghaddassi[SUP] 6 [/SUP], Anton Nilsson[SUP] 2 [/SUP], Joan Capdevila Pujol[SUP] 7 [/SUP], Claire Steves[SUP] 8 [/SUP], Paul W Franks[SUP] 9 10 [/SUP], Maria F Gomez[SUP] 11 [/SUP], Tove Fall[SUP] 12 [/SUP], Jonas Björk[SUP] 2 4 [/SUP], COVID Symptom Study Sweden



Affiliations

Abstract

Background: This paper investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviors and disease outcomes in Sweden during the first wave of the 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 1,800 to 2,700 severe COVID-19 cases, depending on model specification.
Conclusion: 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.
Supplementary material: Online appendix with figures, tables, extra methods and results.

Keywords: Coronavirus; SARS-CoV-2; non-pharmaceutical interventions; policy evaluation; quasi-experimental design.
 
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