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2020 ; 20
(11
): 1247-1254
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Association between mobility patterns and COVID-19 transmission in the USA: a
mathematical modelling study
#MMPMID32621869
Badr HS
; Du H
; Marshall M
; Dong E
; Squire MM
; Gardner LM
Lancet Infect Dis
2020[Nov]; 20
(11
): 1247-1254
PMID32621869
show ga
BACKGROUND: Within 4 months of COVID-19 first being reported in the USA, it
spread to every state and to more than 90% of all counties. During this period,
the US COVID-19 response was highly decentralised, with stay-at-home directives
issued by state and local officials, subject to varying levels of enforcement.
The absence of a centralised policy and timeline combined with the complex
dynamics of human mobility and the variable intensity of local outbreaks makes
assessing the effect of large-scale social distancing on COVID-19 transmission in
the USA a challenge. METHODS: We used daily mobility data derived from aggregated
and anonymised cell (mobile) phone data, provided by Teralytics (Zürich,
Switzerland) from Jan 1 to April 20, 2020, to capture real-time trends in
movement patterns for each US county, and used these data to generate a social
distancing metric. We used epidemiological data to compute the COVID-19 growth
rate ratio for a given county on a given day. Using these metrics, we evaluated
how social distancing, measured by the relative change in mobility, affected the
rate of new infections in the 25 counties in the USA with the highest number of
confirmed cases on April 16, 2020, by fitting a statistical model for each
county. FINDINGS: Our analysis revealed that mobility patterns are strongly
correlated with decreased COVID-19 case growth rates for the most affected
counties in the USA, with Pearson correlation coefficients above 0·7 for 20 of
the 25 counties evaluated. Additionally, the effect of changes in mobility
patterns, which dropped by 35-63% relative to the normal conditions, on COVID-19
transmission are not likely to be perceptible for 9-12 days, and potentially up
to 3 weeks, which is consistent with the incubation time of severe acute
respiratory syndrome coronavirus 2 plus additional time for reporting. We also
show evidence that behavioural changes were already underway in many US counties
days to weeks before state-level or local-level stay-at-home policies were
implemented, implying that individuals anticipated public health directives where
social distancing was adopted, despite a mixed political message. INTERPRETATION:
This study strongly supports a role of social distancing as an effective way to
mitigate COVID-19 transmission in the USA. Until a COVID-19 vaccine is widely
available, social distancing will remain one of the primary measures to combat
disease spread, and these findings should serve to support more timely policy
making around social distancing in the USA in the future. FUNDING: None.