Rapid real-time tracking of non-pharmaceutical interventions and their association with SARS-CoV-2 positivity: The COVID-19 Pandemic Pulse Study.


We sampled 1,030 individuals in Maryland from June 17 - June 28, 2020 to capture socio-demographically and geographically resolved information about NPI adoption, access to SARS-CoV-2 testing, and examine associations with self-reported SARS-CoV-2 positivity.

Overall, 92% reported traveling for essential services and 66% visited friends/family. Use of public transport was reported by 18%. In total, 68% reported strict social distancing indoors and 53% strict masking indoors; indoor social distancing was significantly associated with age, and race/ethnicity and income with masking. Overall, 55 participants (5.3%) self-reported ever testing positive for SARS-CoV-2 with strong dose-response relationships between several forms of movement frequency and SARS-CoV-2 positivity. In multivariable analysis, history of SARS-CoV-2 infection was negatively associated with strict social distancing (adjusted Odd Ratio for outdoor social distancing [aOR]: 0.10; 95% Confidence Interval: 0.03 - 0.33); only public transport use (aOR for ≥7 times vs. never: 4.29) and visiting a place of worship (aOR for ≥3 times vs. never: 16.0) remained significantly associated with SARS-CoV-2 infection after adjusting for strict social distancing and demographics.

These results support public health messaging that strict social distancing during most activities can reduce SARS-CoV-2 transmission. Additional considerations are needed for indoor activities with large numbers of persons (places of worship and public transportation) where even NPIs may not be possible or sufficient.

Current mitigation strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on population-wide adoption of non-pharmaceutical interventions (NPIs). Monitoring NPI adoption and their association with SARS-CoV-2 infection history can provide key information for public health.

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