medRxiv, 26 June 2020 - preprint - Neighborhood income and physical distancing during the COVID-19 pandemic in the U.S.

Title:
Neighborhood income and physical distancing during the COVID-19 pandemic in the U.S.

Authors:
Jonathan Jay, Jacob Bor, Elaine Nsoesie, Sarah Ketchen Lipson, David K Jones, Sandro Galea  & Julia Raifman

Published:
medRxiv, 26 June 2020
[Keep in mind that this article is a preprint and not yet peer reviewed.]
https://www.medrxiv.org/content/10.1101/2020.06.25.20139915v1

Abstract:
Introduction:
Although physical distancing has been the primary strategy to reduce the spread of COVID-19 in the U.S., people's ability to distance may vary by socioeconomic characteristics, leading to higher transmission risk in low-income neighborhoods.

Methods:
We used mobility data from a large, anonymized sample of smartphone users to assess the relationship between neighborhood median household income and physical distancing during the COVID-19 epidemic. We assessed changes in several behaviors including: spending the day entirely at home; working outside the home; and visits to supermarkets, parks, hospitals, and other locations. We also assessed differences in effects of state policies on physical distancing across neighborhood income levels.

Results:
We found a strong gradient between neighborhood income and physical distancing. Compared to January and February 2020, the proportion of individuals spending the day entirely at home in April 2020 increased by 10.9 percentage points in low-income neighborhoods and by 27.1 percentage points in high-income neighborhoods. During April 2020, people in low-income neighborhoods were more likely to work outside the home, compared to people in higher-income neighborhoods, but not more likely to visit non-work locations. State physical distancing orders were associated with a 1.5 percentage-point increase (95% CI [0.9, 2.1], p < 0.001) in staying home in low-income neighborhoods and a 2.4 percentage point increase (95% CI [1.4, 3.4], p < 0.001) in high-income neighborhoods.

Discussion:
People in lower-income neighborhoods have faced barriers to physical distancing, particularly the need to work outside the home. State physical distancing policies have not mitigated these disparities.

A Scholarly Article (Lancet, 1 June 2020) described as "poor quality research" - Physical Distancing, Face Masks, and Eye Protection to Prevent Person-To-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis

A: SCHOLARLY ARTICLE

Title:
Physical Distancing, Face Masks, and Eye Protection to Prevent Person-To-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis

Author:
Derek K Chu, Elie A Akl, Stephanie Duda, Karla Solo, Sally Yaacoub, Holger J Schünemann & COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors

Published:
Lancet, 1 June 2020
https://pubmed.ncbi.nlm.nih.gov/32497510/

Abstract:
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings.

Methods: We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047.

Findings: Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] -10·2%, 95% CI -11·5 to -7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD -14·3%, -15·9 to -10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12-16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD -10·6%, 95% CI -12·5 to -7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings.

Interpretation: The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance.


B: ASSESSING DISTANCE MEASURES REPORTED IN ABOVE-MENTIONED ARTICLE

Title:
COVID-19 Evidence is lacking for 2 meter distancing

Authors:
Carl Heneghan & Tom Jefferson

Published:
CEBM, 19 June 2020
https://www.cebm.net/covid-19/covid-19-evidence-is-lacking-for-2-meter-distancing/

From the article:
In assessing the distance measures reported in Figure 2 of this review we analysed the SARs and COVID-19 studies and found we could not replicate the results reported in the review for 13 out of the 15 papers. 

We reported some of these issues in the Telegraph.  There is no scientific evidence to support the disastrous two-metre rule. Poor quality research is being used to justify a policy with enormous consequences for us all (Access here).