Department of Nursing, School of Natural Sciences, Mathematics, and Engineering, California State University, Bakersfield, CA 93311, USA.
Institute for Advancing Health Equity, Sutter Health, Palo Alto, CA 94301, USA.
Int J Environ Res Public Health. 2021 Sep 8;18(18):9481. doi: 10.3390/ijerph18189481.
The objective of this study was to assess the relationship between public protests and county-level, novel coronavirus disease (COVID-19) hospitalization rates across California. Publicly available data were included in the analysis from 55 of 58 California state counties (29 March-14 October 2020). Mixed-effects negative binomial regression models were used to examine the relationship between daily county-level COVID-19 hospitalizations and two main exposure variables: any vs. no protests and 1 or >1 protest vs. no protests on a given county-day. COVID-19 hospitalizations were used as a proxy for viral transmission since such rates are less sensitive to temporal changes in testing access/availability. Models included covariates for daily county mobility, county-level characteristics, and time trends. Models also included a county-population offset and a two-week lag for the association between exposure and outcome. No significant associations were observed between protest exposures and COVID-19 hospitalization rates among the 55 counties. We did not find evidence to suggest that public protests were associated with COVID-19 hospitalization within California counties. These findings support the notion that protesting during a pandemic may be safe, ostensibly, so long as evidence-based precautionary measures are taken.
本研究旨在评估加利福尼亚州各地的公共抗议活动与县级新型冠状病毒病（COVID-19）住院率之间的关系。从加利福尼亚州的 58 个县中的 55 个县（2020 年 3 月 29 日至 10 月 14 日）获取了分析中使用的公开可用数据。采用混合效应负二项式回归模型来检验每日县级 COVID-19 住院率与两个主要暴露变量之间的关系：任何 vs. 无抗议活动和给定县日的 1 次或>1 次 vs. 无抗议活动。COVID-19 住院率被用作病毒传播的替代指标，因为这些比率对测试机会/可用性的时间变化不太敏感。模型包括每日县流动性、县一级特征和时间趋势的协变量。模型还包括了县人口偏移量和暴露与结果之间的两周滞后。在 55 个县中，抗议活动的暴露与 COVID-19 住院率之间没有观察到显著的关联。我们没有发现证据表明，在加利福尼亚县内，公共抗议活动与 COVID-19 住院率有关。这些发现支持了这样一种观点，即在大流行期间进行抗议活动可能是安全的，表面上看，只要采取基于证据的预防措施即可。
