New data from the Center for Public Health Law Research captures the wide variety of mitigation policies from all 50 states and DC intended to prevent further spread and lessen the potential impact of the current COVID-19 pandemic.
This data currently includes orders and laws from 20 states from January 20, 2020 through April 30, 2020. Laws and orders from the remaining 30 states and DC will be added in the coming weeks.
The data are open access, and capture details about emergency declarations, travel requirements, stay at home orders, restaurant restrictions, school and other business closures, gathering bans, restrictions on medical procedures, and state orders addressing operations in correctional facilities.
As the team works on the third release of 10 states, we spoke with the Center’s Policy Research and Technology Director, Elizabeth Platt, JD/MA, about the data and how they can best support policymakers and researchers in their response to the pandemic.
CPHLR: There are a lot of different types of mitigation responses captured in these data. Why did the Center decide to look so broadly?
Elizabeth Platt: I think the public health research community is still wrestling with the types of evaluations that can be done using legal data to study the impact of state COVID-19 actions on the public’s health. We certainly want to be responsive to that need for legal data, but with such rapid developments, it’s a bit of a moving target. We wanted to be as inclusive as possible from the beginning in the types of legal action that we were collecting, but we also recognize that the actions we’re seeing now may look very different in a matter of weeks, if not days, so we need to be able to adapt to those changes. For example, when we were creating the coding questions in late March, no states were requiring, let alone recommending, the use of face masks in public. We almost took that question out. Fast forward a month, and we’re seeing face mask provisions escalate from city mandates to state requirements. We’re also starting to see this kind of rapid change as we work on the second batch of 10 states. As states begin to reopen, it’s important to have a baseline of the “before,” and then capture the “after.” And right now that “after” is looking very different from state to state even in a matter of days.
CPHLR: Why release the data in batches?
EP: It’s a definite departure from our usual methods, but in keeping with the theme of adapting to these daily changes, we felt we needed to develop rapid response surveillance techniques to balance the importance of tracking in real time without sacrificing our quality control standards. With our first batch of 10 states, released in early May, we saw more than 130 legal activities in a little more than a month. Releasing the data in smaller batches of states allows us to focus more specifically on the high volume of activity within a state, and get the extremely important information out to the public faster. We’ve now released two batches — bringing us up to 20 states — and we’ll be releasing the remaining states in the coming weeks.
CPHLR: One of the details captured in this dataset focuses on preemption, and how states are limiting local-level response; what are you seeing in the data?
EP: We’re seeing a bit of a mixed bag here so far. Half of the states in the first batch have taken some sort of preemptive action – but not an all-out ban on all local legal actions. The main trend seems to be states not wanting local ordinances to conflict with state stay at home orders, as is the case in Georgia where the state suspended the enforcement of local shelter-in-place ordinances that conflicts with the state order in any way.
CPHLR: One of the issues captured in the data focuses on essential medical services – and specifically asks about abortion. Can you give us some context for why it was important to capture this?
EP: Initially, as states started to require the postponement of elective medical procedures, the definitions on what constituted an elective medical procedure were quite vague. States often provided exceptions for emergency procedures and essential medical services, but did vary on what was considered “essential” and when. This ambiguity appears to have led to confusion on how these restrictions applied to abortion access during the pandemic, with some states seeking to clarify their orders by explicitly stating that surgical abortion is not to be considered essential, as was the case in Alaska and Arkansas. This has also led to court action in Alabama and Iowa; we also know that this will be something to track in our later batches of states, particularly in places like Texas (which is in our second batch of states), where a temporary abortion prohibition was repeatedly challenged and upheld in federal courts before ultimately expiring under a modified state executive order.
CPHLR: How do you and your team hope these data will be used, by researchers and by policymakers?
EP: Our hope is that researchers will use these legal data to evaluate the effectiveness and impact of state-level mitigation policies on health outcomes in relation to COVID-19. These data track not only whether or not a state took emergency legal action, but also capture the longitudinal details of what action was taken and when, and, as we’re starting to see with the second release, when these actions are lifted. By tracking these policy changes over time, we’re not overwriting each step to provide the current status – the longitudinal nature of this legal data allows researchers to see all of the policy steps along the way. Our goal is for researchers to use these data to determine which features of COVID-19 mitigation policies were the most and least effective over time, and for policymakers to use that information to make evidence-based decisions about legal action needed to reduce the spread of COVID-19 and similar outbreaks in the future.
You can explore the state emergency declarations and mitigation response dataset at LawAtlas.org.