key: cord-0905315-z02qme44 authors: Zeitoun, J.-D.; Faron, M.; Manternach, s.; Fourquet, J.; Lavielle, M.; lefevre, j. title: Reciprocal association between participation to a national election and the epidemic spread of COVID-19 in France: nationwide observational and dynamic modeling study. date: 2020-05-19 journal: nan DOI: 10.1101/2020.05.14.20090100 sha: eb599cc918a436f5e6a5393f6343f97abdb81303 doc_id: 905315 cord_uid: z02qme44 Objective: To investigate possible reciprocal associations between the intensity of the COVID-19 epidemic in France and the level of participation at national elections. Design: Observational study and dynamic modelling using a sigmoidal mixed effects model. Setting: All hospitals where patients were admitted for COVID-19. Participants: All admitted patients from March 18, 2020 to April 17, 2020. Main outcome measures: Abstention and admission rate for COVID-19. Results: Mean abstention rate in 2020 among departments was 52.5%+/-6.4 and had increased by a mean of 18.8% as compared with the 2014 election. There was a high degree of similarity of abstention between the two elections among the departments (p<0.001). Among departments with a high outbreak intensity before the election, those with a higher participation were not affected by a significantly higher number of COVID-19 admissions after the elections. The sigmoidal model fitted the data from the different departments with a high degree of consistency. The covariate analysis showed that a significant association between participation and number of admitted patients was observed for both elections (2020: B=-5.36, p<1e-9 and 2014: B=-3.15, p<1e-6) contradicting a direct specific causation of the 2020 election. Participation was not associated with the position of the inflexion point suggesting no effect in the speed of spread. Conclusions: Our results suggest that the surrounding intensity of the COVID-19 epidemic in France did not have any local impact on citizens participation to a national election. The level of participation to the 2020 election had no impact on the spread of the pandemic. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted May 19, 2020 . . https://doi.org/10.1101 /2020 A b s t r a c t O b j e c t i v e : T o i n v e s t i g a t e p o s s i b l e r e c i p r o c a l a s s o c i a t i o n s b e t w e e n t h e i n t e n s i t y o f t h e C O V I D -1 9 e p i d e m i c i n F r a n c e a n d t h e l e v e l o f p a r t i c i p a t i o n a t n a t i o n a l e l e c t i o g d e p a r t m e n t s w i t h a h i g h o u t b r e a k i n t e n s i t y b e f o r e t h e e l e c t i o n , t h o s e w i t h a h i g h e r p a r t i c i p a t i o n w e r e n o t a f f e c t e d b y a s i g n i f i c a n t l y h i g h e r n u m b e r o f C O V I D -1 9 a d m i s s i o n s a f t e r t h e e l e c t i o n s . T h e s i g m o i d a l m o d e l f i t t e d t h e d a t a f r o m t h e d i f f e r e n t d e p a r t m e n t s w i t h a h i g h d e g r e e o f c o n s i s t e n c y . T h e c o v a r i a t e a n a l y s i s s h o w e d t h a t a s i g n i f i c a n t a s s o c i a t i o n b e t w e e n p a r t i c i p a t i o n a n d n u m b e r o f a d m i t t e . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. . https://doi.org/10.1101/2020.05.14.20090100 doi: medRxiv preprint W e r e t r i e v e d d e m o g r a p h i c c h a r a c t e r i s t i c s r e g a r d i n g t h e 9 5 F r e n c h d e p a r t m e n t s , w h i c h w e r e o u r g e o g r a p h i c u n i t o f a n a l y s i s : n u m b e r o f i n h a b i t a n t s a n d s u r f a c e . W e a l s o c o l l e c t e d d a t a r e g a r d i n g t h e e p i d e m i c a r o u n d t h e t i m e o f t h e e l e c t i o n s a n d a f t e r t h e e l e c t i o n s : . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. . https://doi.org/10.1101/2020.05.14.20090100 doi: medRxiv preprint S t a t i s t i c a l a n a l y s i s a n d m o d e l i n g A s i g m o i d a l m i x e d e f f e c t s m o d e l w a s u s e d t o d e s c r i b e t h e c u m u l a d e g r e e o f s i m i l a r i t y b e t w e e n 2 0 1 4 a n d 2 0 2 0 w i t h r e s p e c t t o t h e p a t t e r n s o f d e p a r t m e n t s a s c o m p a r e d t o o t h e r s , i . e . r e g a r d l e s s o f t h e a b s o l u t e l e v e l o f v o t i n g , " h i g h e r p a r t i c i p a n t s " w e r e a p p r o x i m a t e l y t h e s a m e d e p a r t m e n t s a t b o t h e l e c t i o n s a n . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. . https://doi.org/10.1101/2020.05.14.20090100 doi: medRxiv preprint n g s m a y h a v e i m p l i c a t i o n s . T h e f a c t t h a t p e o p l e p a r t i c i p a t i o n w a s i n i t i a l l y f o u n d t o b e c o m m e n s u r a t e t o t h e l o c a l i n t e n s i t y o f t h e e p i d e m i c c o u l d h a v e s u g g e s t e d t h a t w h e n p r e v a l e n t a n d a g g r e s s i v e , t h e o u t b r e a k d e t e r r e d c i t i z e n s t o g o v o t i n . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020 . . https://doi.org/10.1101 /2020 t r a n s m i s s i o n , w e d i d n o t m e a s u r e a n y s t a t i s t i c a l a s s o c i a t i o n b e t w e e n p a r t i c i p a t i o n a t a l o c a l l e v e l a n d s u b s e q u e n t e v o l u t i o n o f t h e e p i d e m i c . O u r r e s u l t s d o n o t s u p p o r t t h e e l e c t i o n a s a n i n t e r f e r i n g f a c t o r f o r o u t b r e a k o u t c o . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. . https://doi.org/10.1101/2020.05.14.20090100 doi: medRxiv preprint C o n c e p t , d e s i g n a n d a c q u i s i t i o n : Z e i t o u n , F o u r q u e t , M a n t e r n a c h . S t a t i s t i c a l a n a l y s i s : L a v i e l l e , F a r o n a n d L e f e v r . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. *: p<0.0001 Table 1 . COVID-19 epidemic, demographic data in the pre-electoral period and participation to the vote. . It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 19, 2020. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted May 19, 2020. Total proven cases Demographic characteristics Median population (IQR) Electoral Data 2020 141) Ratio registered/population (IQR) 72.38% (68 Electoral Data Median registered individuals (IQR) Total admitted patients (min-max)