Modeling Severe Acute Respiratory Syndrome Coronavirus 2019 (SARS-CoV-19) Incidence across Conterminous US Counties: A Spatial Perspective

Abstract. This study examines the spatial distribution of COVID-19 incidence and mortality rates across the counties in the conterminous US in the first 604 days of the pandemic. The dataset was acquired from Emory University, Atlanta, United States, which includes socio-economic variables and health outcomes variables (N = 3106). OLS estimates accounted for 31% of the regression plain (adjusted R2 = 0.31) with AIC value of 9263, and Breusch-Pagan test for heteroskedasticity indicated 472.4, and multicollinearity condition number of 74.25. This result necessitated spatial autoregressive models, which were performed on GeoDa 1.18 software. ArcGIS 10.7 was used to map the residuals and selected significant variables. Generally, the Spatial Lag Model (SLM) and Spatial Error Model (SEM) models accounted for substantial percentages of the regression plain. While the efficiency of the models is the order of SLM (AIC: 8264.4: BreucshPagan test: 584.4; Adj. R2 = 0.56) > SEM (AIC: 8282.0; Breucsh-Pagan test: 697.2; Adj. R2 = 0.56). In this case, the least predictive model is SEM. The significant contribution of male, black race, poverty and urban and rural dummies to the regression plain indicated that COVID-19 transmission is more of a function of socio-economic, and rural/urban conditions rather than health outcomes. Although, diabetes and obesity showed a positive relationship with COVID-19 incidence. However, the relationship was relatively low based on the dataset. This study further concludes that the policymakers and health practitioners should consider spatial peculiarities, rural-urban migration and access to resources in reducing the transmission of COVID-19 disease.