A regression discontinuity analysis of the social distancing recommendations for older adults in Sweden during COVID-19

Carl Bonander, Debora Stranges, Johanna Gustavsson, Matilda Almgren, Malin Inghammar, Mahnaz Moghaddassi, Anton Nilsson, Joan Capdevila Pujol, Claire Steves, Paul W. Franks, Maria F. Gomez, Tove Fall, Jonas Björk, Andrew T. Chan, Sébastien Ourselin, Tim D. Spector, Jonathan Wolf, Beatrice Kennedy, Hugo Fitipaldi, Ulf HammarMarlena Maziarz, Neli Tsereteli, Nikolay Oskolkov, Georgios Varotsis, Lampros Spiliopoulos

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: This article investigates the impact of a non-mandatory and age-specific social distancing recommendation on isolation behaviours and disease outcomes in Sweden during the first wave of the coronavirus disease 2019 (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 1800-2700 severe COVID-19 cases, depending on model specification. Conclusions: 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.

Original languageEnglish
Pages (from-to)799-806
Number of pages8
JournalEuropean Journal of Public Health
Volume32
Issue number5
DOIs
StatePublished - 1 Oct 2022

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