Variation in US states’ responses to COVID-19

Blavatnik School working paper
Ariq Hatibie
Saptarshi Majumdar
Monika Pyarali
Rachelle Koch
Andrew Wood
Abstract

BSG-WP-2020/034 Version 3.0 (May 2021)

The first 100 days of the Biden administration contained several important pandemic milestones. As the world passed the one-year anniversary of the pandemic, the US simultaneously experienced the rollout of vaccinations and the rollback of restrictions – even as hints of a fourth wave began. Using Oxford COVID-19 Government Response Tracker indicators and aggregate indices, we describe ongoing variation in state responses over time and by region and political leaning, and identify correlates of more or less intense responses.

The authors find that rollbacks of policy increased in the new year, with fewer states having active closure and containment policies than at any point since April 2020, and that Northeastern and Democrat-led states were more likely to experience higher stringency policies. They also explore a new set of policies around vaccine eligibility, showing that policies of universal eligibility took hold by early April, though with significant variation in how broadly or narrowly states made vaccines available on the path to universal availability.

Finally, the authors compare OxCGRT stringency indices alongside mobility data, showing that stringency coincided with changes in mobility, though mobility trends gradually shifted towards normal after periods of high policy stringency, indicating potential policy fatigue.

In combination, this paper provides an overview of US states’ COVID-19 policy action as well as unique applications of OxCGRT data to inform policy making and research as the US enters a new stage of both pandemic and political leadership.

Key findings

  • State policy responses to COVID-19 have decreased since the start of 2021 as measured by Oxford COVID-19 Government Response Tracker indicators, with the most precipitous drops in policy stringency occurring in March 2021. Fewer states had active closure and containment policies than at any point since April 2020.
  • Regional and political variation in stringency has continued, and even widened, with Northeastern and Democrat-led states having the most stringent policy responses and Midwest and Republican-led states having the least.
  • New federal action has consisted mostly of renewed recommendations, particularly around the areas of mask mandates and school reopenings.
  • Targeted geographic policies continued to lead where states lifted statewide policies, though these were often politically contested.
  • Mobility data shows that home permanence tended to increase and visits to non-essential retail tended to decrease when policy stringency was highest, though such effects seemed to gradually decline after periods of high stringency, possibly indicating policy fatigue.

Key trends in vaccine policies

  • Initial vaccination eligibility policies largely followed CDC guidance, though with significant variation in the definition of specific priority groups (such as categories of essential workers)
  • After a slow start in December that featured primarily healthcare workers and care home residents, more than half of US states had policies of universal vaccine eligibility by early April that allowed all residents aged 16+ to be vaccinated.  
  • States with early policies of universal eligibility did not always vaccinate fastest. Indeed, some of the last states to institute policies for universal vaccination eligibility ranked among the highest in vaccination rates by the end of April.

Data presented in this paper is available via GitHub.