Association between city-wide lockdown and COVID-19 hospitalization rates in multigenerational households in New York City

• Published in: PloS one Vol. 17; no. 3; p. e0266127
• Main Authors: Ghosh, Arnab K, Venkatraman, Sara, Reshetnyak, Evgeniya, Rajan, Mangala, An, Anjile, Chae, John K, Unruh, Mark A, Abramson, David, DiMaggio, Charles, Hupert, Nathaniel
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 30.03.2022; Public Library of Science (PLoS)
• Subjects: Bayes Theorem; Bayesian analysis; Child; Communicable Disease Control; Control; Coronaviruses; COVID-19; COVID-19 - epidemiology; Disease transmission; Earth Sciences; Emergency preparedness; Epidemics; Health risks; Health sciences; Hospital care; Hospitalization; Households; Housing; Housing conditions; Humans; Mathematical models; Medical schools; Medicine; Medicine and Health Sciences; Morbidity; Mortality; New York; New York City - epidemiology; Pandemics; People and places; Population; Postal codes; Public health; Quartiles; Regression analysis; Regression models; Risk analysis; Risk factors; SARS-CoV-2; Social Sciences; Socioeconomic factors; Software; Statistics; Supervision; Tabulation; Trends; New York City; New York; United States > US; New York City New York
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0266127

City-wide lockdowns and school closures have demonstrably impacted COVID-19 transmission. However, simulation studies have suggested an increased risk of COVID-19 related morbidity for older individuals inoculated by house-bound children. This study examines whether the March 2020 lockdown in New York City (NYC) was associated with higher COVID-19 hospitalization rates in neighborhoods with larger proportions of multigenerational households. We obtained daily age-segmented COVID-19 hospitalization counts in each of 166 ZIP code tabulation areas (ZCTAs) in NYC. Using Bayesian Poisson regression models that account for spatiotemporal dependencies between ZCTAs, as well as socioeconomic risk factors, we conducted a difference-in-differences study amongst ZCTA-level hospitalization rates from February 23 to May 2, 2020. We compared ZCTAs in the lowest quartile of multigenerational housing to other quartiles before and after the lockdown. Among individuals over 55 years, the lockdown was associated with higher COVID-19 hospitalization rates in ZCTAs with more multigenerational households. The greatest difference occurred three weeks after lockdown: Q2 vs. Q1: 54% increase (95% Bayesian credible intervals: 22-96%); Q3 vs. Q1: 48% (17-89%); Q4 vs. Q1: 66% (30-211%). After accounting for pandemic-related population shifts, a significant difference was observed only in Q4 ZCTAs: 37% (7-76%). By increasing house-bound mixing across older and younger age groups, city-wide lockdown mandates imposed during the growth of COVID-19 cases may have inadvertently, but transiently, contributed to increased transmission in multigenerational households.