Estimating effects of physical distancing on the COVID-19 pandemic using an urban mobility index

Abstract

BackgroundGovernments have implemented population-wide physical distancing measures to control COVID-19, but metrics evaluating their effectiveness are not readily available.MethodsWe used a publicly available mobility index from a popular transit application to evaluate the effect of physical distancing on infection growth rates and reproductive numbers in 40 jurisdictions between March 23 and April 12, 2020.FindingsA 10% decrease in mobility was associated with a 14.6% decrease (exp(β) = 0·854; 95% credible interval: 0·835, 0·873) in the average daily growth rate and a −0·061 (95% CI: −0·071, −0·052) change in the instantaneous reproductive number two weeks later.InterpretationOur analysis demonstrates that decreases in urban mobility were predictive of declines in epidemic growth. Mobility metrics offer an appealing method to calibrate population-level physical distancing policy and implementation, especially as jurisdictions relax restrictions and consider alternative physical distancing strategies.FundingNo external funding was received for this study.Research in ContextEvidence before this studyWidespread physical distancing interventions implemented in response to the COVID-19 pandemic led to sharp declines in global mobility throughout March 2020. Real-time metrics to evaluate the effects of these measures on future case growth rates will be useful for calibrating further interventions, especially as jurisdictions begin to relax restrictions. We searched PubMed on May 22, 2020 for studies reporting the use of aggregated mobility data to measure the effects of physical distancing on COVID-19 cases, using the keywords “COVID-19”, “2019-nCoV”, or “SARS-CoV-2” in combination with “mobility”, “movement”, “phone”, “Google”, or “Apple”. We scanned 252 published studies and found one that used mobility data to estimate the effects of physical distancing. This study evaluated temporal trends in reported cases in four U.S. metropolitan areas using a metric measuring the percentage of cell phone users leaving their homes. Many published papers examined how national and international travel predicted the spatial distribution of cases (particularly outflow from Wuhan, China), but very little has been published on metrics that could be used as prospective, proximal indicators of future case growth. We also identified a series of reports released by the Imperial College COVID-19 Response Team and several manuscripts deposited on preprint servers such as medRxiv addressing this topic, demonstrating this is an active area of research.Added value of this studyWe demonstrate that changes in a publicly available urban mobility index reported in over 40 global cities were associated with COVID-19 case growth rates and estimated reproductive numbers two to three weeks later. These cities, spread over 5 continents, include many regional epicenters of COVID-19 outbreaks. This is one of only a few studies using a mobility metric applicable to future growth rates that is both publicly available and international in scope.Implications of all the available evidenceRestrictions on human mobility have proved effective for controlling COVID-19 in China and the rest of the world. However, such drastic public health measures cannot be sustained indefinitely and are currently being relaxed in many jurisdictions. Publicly available mobility metrics offer a method of estimating the effects of changes in mobility before they are reflected in the trajectory of COVID-19 case growth rates and thus merit further evaluation.