COVID-19 Response: Limited Travel Before Onset of Coronavirus Crucial

March 26, 2020 Research 0 thoughts on “COVID-19 Response: Limited Travel Before Onset of Coronavirus Crucial”

What responses and variables have impacted nation-wide travel from outbreak epicenters?

Background

The first COVID-19 case in the United States was confirmed in Washington on January 20, 2020. Since then, the virus has spread throughout the country at an increasing rate. 

A handful of places/events have been identified as “epicenters” to regional outbreaks, including  the Life Care Center of Kirkland in Washington, the Young Israel of New Rochelle Synagogue in New York, and the Biogen Conference in Massachusetts. 

These three examples provide interesting perspectives into various responses, their effectiveness, and other variables that played a role in the national travel of potentially infected persons. 

The timelines associated with the exposure of COVID-19 at these gatherings and the steps that state and business leadership took to contain the spread of the disease in the first few weeks of exposure is crucial to the effectiveness of their efforts, but the data shows that other variables, including the inability to travel due to the nature of the epicenter, have had a lasting impact on national spread. 

Objective

Our objective is to analyze three known epicenters of COVID-19 and map the movements of devices identified as being in one of the epicenters during the original exposure window to better understand the impact responses to COVID-19 have had on mitigating further spread across the United States.

Methodology

We identified devices that were located at three known COVID-19 epicenters–Life Care Center of Kirkland in Washington, Biogen Conference in Boston, and Young Israel of New Rochelle Synagogue in New York–during a time period before or after the events. The devices were aggregated by Census Block Group. The density of devices in each Census Block Group were visualized via the size of the circle on the map. 

The map itself is a Choropleth map representing the amount of confirmed COVID-19 cases by state, with red being the most confirmed COVID-19 cases. 

Analysis

Life Care Center of Kirkland – Washington

Response: staff members were banned from working at other facilities

Response Time: 3 days

Median Distance Traveled of Devices from Epicenter: 7.2 miles

Average Distance Traveled of Devices from Epicenter: 98.0 miles

The Life Care Center of Kirkland, a long-term care and nursing facility in Washington state, began reporting dozens of residents with COVID-19 symptoms on February 29. By March 3, a case was confirmed to have come from Life Care and staff was instructed to stop working at other facilities1. Only one week later, on March 11, there were 374 confirmed cases statewide and 31 deaths due to COVID-19. 23 of those deaths were linked to Life Care.  

The first official response from Life Center regarding COVID-19 came on March 14, when a cleaning crew arrived to disinfect the still-occupied facility2. On March 18, Life Care updated its policy to say that “all visitors, nonessential healthcare personnel and vendors had been restricted from entering the chain’s facilities3.”

The response Life Care Center had to the outbreak has recently undergone criticism. For almost two weeks, their main prevention tactic was to ban their staff from working at other facilities, a practice that is followed by many in the Life Care community. 

Regardless of how ineffective Life Care Center’s response was to COVID-19, the actual travel associated with those at the epicenter during the exposure window is low compared to other outbreaks. This is likely due to the nature of life care facilities and the inability for residents to travel. Additionally, extensive travel (to conferences, etc.) isn’t required or common for the faculty. The average distance traveled for those at the epicenter during the exposure window was 98.0 miles. The median distance traveled was 7.2 miles.

Biogen Conference – Boston

Response: Conference Attendees Directed to Work from Home

Response Time: 7 Days 

Median Distance Traveled of Devices from Epicenter: 37.8 miles

Average Distance Traveled of Devices from Epicenter: 336.6 miles

One week after 175 Biogen executives met at the Marriott Long Wharf hotel in Boston for an annual conference and 2 days after attendees began reporting symptoms, Biogen directed conference attendees to work from home4

Although Biogen’s response to COVID-19 was fast and communicative, the reach of the exposure quickly became global: Biogen executives traveled from all over the world to meet in Boston and had already traveled home.

Before receiving any confirmation that a Biogen Conference attendee had COVID-19, Biogen was already communicating with state health officials and its employees about the importance of working from home and social distancing. 

That effort, however, was marred by the “off-site” nature of the event and the fact that attendees had to travel to/from its location. That fact is present in the data and evident in the map showing that those at the epicenter during the exposure window were able to travel an average of 336.6 miles after the event. The median distance traveled for those devices was 37.8 miles. 

Young Israel of New Rochelle Synagogue – New York

Response: State Directed Containment Area

Response Time: 7 days

Median Distance Traveled of Devices from Epicenter: 19.6 miles

Average Distance Traveled of Devices from Epicenter: 110.8 miles 

One week after the first confirmed case of COVID-19 in New York (Manhattan) and within days of the obvious spike in cases in New Rochelle, NY, Gov. Andrea Cuomo mandated a containment area of a 1-mile radius around its epicenter, the Young Israel of New Rochelle Synagogue5.

The containment zone around the epicenter limited travel of those potentially exposed with the goal of mitigating risk of further exposure to other communities. In the 7 days after the confirmation of New Rochelle’s first case but before the containment, however, still left time for those at the epicenter during the exposure window to travel to other communities across the United States, with an average distance traveled of 110.8 miles. The median distance traveled for those devices was 19.6 miles.

Conclusion

Life Care Center’s response to COVID-19 is much less aggressive than other epicenters, but surprisingly we found that the potential exposure to other communities across the United States is low when compared to Biogen, a company that went above and beyond to communicate with its public health officials and employees to limit the spread of COVID-19, and New Rochelle, a community that aggressively enacted a containment zone within one week of its first confirmed case.  

That effect is likely due to the nature of life care facilities and the inability of travel for the majority of residents. Unfortunately for both Biogen and New Rochelle, the “genie was out of the bottle” in the few days after exposure as people unknowingly traveled with the virus. 

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Sources

  1. Nursing home staff spread coronavirus to other facilities, CDC investigation finds https://www.latimes.com/world-nation/story/2020-03-18/coronavirus-spread-nursing-homes 
  2. Life Care employees tested for coronavirus; facility to be cleaned https://www.kiro7.com/news/local/us-department-health-strike-team-work-life-care-kirkland/EYNT43G5ZBH5BKZ3MATJOVVV5A/ 
  3. Statement from Life Care Centers of America regarding COVID-19 https://lcca.com/announcement/covid-19 
  4. How the Biogen leadership conference in Boston spread the Coronavirus https://www.bostonglobe.com/2020/03/11/nation/how-biogen-leadership-conference-boston-spread-coronavirus/?p1=Article_Inline_Text_Link&p1=Article_Inline_Text_Link 
  5. Coronavirus: New York Creates ‘Containment Area’ Around Cluster In New Rochelle https://www.npr.org/sections/health-shots/2020/03/10/814099444/new-york-creates-containment-area-around-cluster-in-new-rochelle 
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