A, Total medical spending in dollars and (B) relative to week 9. High-activity refers to high cumulative incidence of confirmed COVID-19 cases by April 7, 2020. Early vs late social distancing refers to state order to stay at home, shelter in place, or close nonessential businesses before vs after April 1, 2020. Lower spending during the week of January 1, 2020, is consistent with overlap with a national holiday (utilization was consistently lower in 2019 during holiday weeks). COVID-19 indicates coronavirus disease 2019.