Abstracts

Rationale:
Coronavirus disease 2019 (COVID-19) is now recognized as a complex multisystem diseases. The literature regarding neurological disorders, including epilepsy, of COVID-19 comprises a large number of case reports. One of the important COVID-19 strategies is prevention or mitigation. The CDC recommends that people wear masks in public settings when steps such as social distancing measures are difficult to maintain. Mask use in public during COVID-19, worsened by global shortage of supplies, has led to widespread use of homemade masks. Wearing a face mask in public places has been shown to reduce the spread of respiratory infectious diseases because asymptomatic COVID-19 positive patients can spread the virus. However, the direct investigation of how COVID-19 mitigation affects its incidence and case-fatality-ratios (CFR) are lacking. The purpose of this study was to characterize the relationship between mitigation strategies and COVID-19 cases.
Method:
The research design is examining changes in incidence and CFR between States mandating face masks (MFM) and no-mandating face masks (NMFM) usages in public from the periods of date of positive case 1 or death case 1 in each states to date of 20200823. On 20200823, there were more than 5,646,000 positive cases and 168,000 fatalities in the USA (CDC Provisional Counts).
Results:
MFM use in public (n=35 States and DC) is associated with significant less rate of positivity (5.9±0.5 % in MFM vs 8.6±1.1%, p < 0.05), with a 21% of decline in the COVID-19 overall incidence (positive cases divided by state population. 1.4 ± 0.1% in MFM vs 1.8 ± 0.1% in NMFM (n=16). p >0.05,). However, MFM-states have a 1.2-fold increase in the COVID-19 CFR and significantly higher average daily fatality when compared to NMFM States (p< 0.05). When comparing states with stay-at-home (SAH) order and masking, SAH + MFM states (n=34) have similar incidence and higher averaged daily new cases while comparing with no-SAH + NMFM states (629.9±144.9 cases in SAH+MFM or 672.7±207.7 cases in SAH+NMFM (n=9) vs 161.9±44.2 cases in no-SAH+NMFM (n=7), p < 0.05). There are significant higher CFR and average daily deaths in SAH + MFM and SAH + NMFM states comparing to no-SAH+NMFM (p< 0.05). There are no significant difference among groups in testing percentage in the population of the states and periods of pandemic.
Conclusion:
Our results were inconsistent with the intent of public health strategies in incidence and CFR. We believed SAH and masking in the general public could help with mitigation (as part of our data indicated) if the general public is informed on the correct types of masks and proper methods to wear, knows how to properly social distance, and, most importantly, follows strict isolation of contagious patients in designated places. Understanding the potential compromised mitigation could occurs during pandemic, the healthcare capacity, including the neurological society, needs be ready to face the challenges from COVID-19 and future potentially more contagious and fatal infectious diseases that could attack the neuronal system and cause epilepsy.
Funding:
:n/a