Fewer COVID-19 deaths in counties with intervention measures, more hospitals


Counties that banned in-person religious gatherings and those with a greater number of hospitals per capita were associated with a decreased case-fatality rate of COVID-19 during the pandemic’s first wave, according to a new University of Michigan study.

On the other hand, counties with a high prevalence of asthma and a greater concentration of people older than 65 were linked to higher fatality rates, the analysis showed.

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This study, published in PLOS ONE, was completed as part of the COVID-19 Dispersed Volunteer Research Network and was presented earlier this year at the World Microbe Forum, a collaborative virtual meeting conference hosted by the American Society for Microbiology and the Federation of European Microbiological Societies.

“Our work provides insights that may help officials target public health interventions and health care resources to locations that are at increased risk of COVID-19 fatalities in subsequent waves,” said Jess Millar, a graduate research assistant in the Medical School’s Department of Computational Medicine and Bioinformatics, and the School of Public Health’s Department of Epidemiology.

Millar and colleagues looked at public data from 3,000 counties to do the risk-factor analysis of demographic, socioeconomic and health-related variables during the first wave of the pandemic, from March 28-June 12, 2020. The case-fatality rate was defined as the number of deaths divided by the total number of confirmed COVID-19 cases.

Researchers found a reduction in case-fatality rates of:

  • 32 percent per additional hospital per 10,000 people.
  • 13 percent if religious gatherings were banned.
  • 1.5 percent per 1 percent increase in the proportion of population without health insurance.
  • 0.79 percent per 1 percent increase in the proportion of mobile homes.

They saw an increase in case-fatality rates of:

  • 9.5 percent per 1 percent increase in asthma prevalence.
  • 4.5 percent increase per 1 percent increase in population over age 65.
  • 3.2 percent per one additional hospital.
  • 0.97 percent per 1 percent increase in Black or African American population.

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