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If the District gleans anything from this moment, it should be that implementing radical policies early and comprehensively work in slowing disease spread and saving lives. The city’s COVID-19 case and fatality rates, per capita, were among the lowest in the United States. A new report prepared for the Office of the D.C. Auditor concluded that swift policy action successfully slowed the spread of the coronavirus in the city.
Not only were the mask mandate and business restrictions helpful, but so were eviction and foreclosure moratoriums, hazard pay, sick leave adjustments, and unemployment and stimulus payments. It is not enough to tell people to stay home without offering some type of relief to those who cannot simply work from home. The report from Talus Analytics and the Georgetown University Center for Global Health Science and Security finds that D.C. implemented these policies earlier and more comprehensively than nearly anywhere in the country.
“As tough a challenge as COVID has been, it is heartening to know that public policy can make a difference — and that the breadth of the mitigations DC put in place, and their duration, seem to have kept more of us healthier through the fall surge,” says D.C. Auditor Kathy Patterson in a statement via email.
According to the report, D.C. saw more cases and deaths than the average state during the spring of 2020, when a deadly but poorly understood virus swept the world, peaking at 27.4 cases per 100,000 people and 1.7 deaths. But D.C. reversed the trend after implementing policies and changing behaviors, and throughout the rest of the year, experienced fewer cases than most of the country. The city peaked at 47 cases per 100,000, while the United States peaked at 71 cases. Deaths also decreased during the fall surge, relative to both the spring and U.S. average at the time, peaking at 0.83 deaths per 100,000. (The report notes that D.C. and other states with fewer cases at their peaks as compared to the national average still saw a lot more cases than other parts of the world during their peaks, including Australia and New Zealand, which experienced 2.29 cases and 1.6 cases per 100,000, respectively.)
“D.C. residents blunted the curve. They did by their actions. They sacrificed a lot,” reflected Mayor Muriel Bowser a year into the pandemic. While D.C. fared better than most other places nationwide, 1,098 residents, including the mayor’s sister, Mercia, died of COVID-19.
While she has been criticized for her response to the coronavirus pandemic—like for reopening before DC Health’s metrics gave the OK—the report suggests that Mayor Bowser, her team, and the Council have done a good job as compared to governments in other states. The report also gives D.C. residents kudos for listening to coronavirus restrictions. Some of these restrictions weren’t really punitively enforced, namely the stay-at-home order and mask mandate. Still, residents heeded calls to stay home and mask up.
“The District of Columbia had a much larger change in mobility, compared to both the region and the U.S. average which suggests that more residents were able to work from home, and indicating that general social distancing policies aimed at encouraging people to avoid or reduce non-essential trips from home were successful in keeping people at home,” the report says.
Researchers also find that states with fewer cases and deaths, including D.C., tended to have a greater number and variety of policies. Although, this observation was not universal. For example, Rhode Island enacted quite a few policies but still experienced a difficult time in the fall.
What policies were most impactful? The report says that the strongest predictor of better outcomes in the fall surge was a broad, state-level mask mandate. Mitigation policies in bars, restaurants, concerts venues, and nightclubs were also associated with a lower case count, as were strong gathering restrictions. Interestingly, moderate gathering restrictions were still associated with lower case counts, suggesting that providing clear guidance is more critical.
Timing was also key. States with better outcomes in the fall had mask mandates, along with gathering restrictions and mitigation policies in bars/restaurants, earlier in the pandemic. D.C. still has the same mask mandate it did in the summer months, and has more restrictive measures on restaurants when compared to the rest of the region.
The report also finds that essential and frontline workers, who are concentrated in Wards 7 and 8, followed by 4 and 5, appeared to be more mobile. Another report from Talus Analytics found that wards with more essential and frontline workers generally had higher case counts and fatalities. D.C. wards with the highest fatalities rates also had greater proportions of Black residents. Enabling relief was especially critical for this population.
To understand how effective relief policies were, researchers looked at fatalities associated with COVID-19, given that existing research had found that essential workers were at disproportionate risk of exposure. When comparing fatalities during the fall surge relative to cases, states that had more deaths were also those that had few policies in places that supported workers, the report says. Although, there was no significant difference in the total number of policies when grouping states with the fewest to most cases, as shown in the chart below:
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