synchronized travel restrictions across cities can be effective in covid 19 control CORD-Papers-2021-10-25 (Version 1)

Title: Synchronized travel restrictions across cities can be effective in COVID-19 control
Abstract: Mobility control measures are of crucial importance for public health planning in combating the COVID-19 pandemic. Previous studies established the impact of population outflow from Wuhan on the spatial spread of coronavirus in China and hinted the impact of the other three mobility patterns, i.e., population outflow from Hubei province excluding Wuhan, population inflow from cities outside Hubei, and intra-city population movement. However, the overall impact of all mobility patterns, or the impact of the different timing of mobility restriction intervention, are not systematically analyzed. Here we apply the cumulative confirmed cases and mobility data of 350 Chinese cities outside Hubei to explore the relationships between all mobility patterns and epidemic spread, and estimate the impact of local travel restrictions, both in terms of level and timing, on the epidemic control based on mobility change. The relationships were identified by using Pearson correlation analysis and stepwise multivariable linear regression, while scenario simulation was used to estimate the mobility change caused by local travel restrictions. Our analysis shows that: (1) all mobility patterns correlated with the spread of the coronavirus in Chinese cities outside Hubei, while the corrleations droppd with the implemetation of travel restrictions; (2) the cumulative confirmed cases in two weeks after the Wuhan lockdown was mainly brought by three patterns of inter-city population movement, while those in the third and fourth weeks after was significantly influenced by the number of intra-city population movement; (3) the local travel restrictions imposed by cities outside Hubei have averted 1,960 (95%PI: 1,474-2,447) more infections, taking 22.4% (95%PI: 16.8%-27.9%) of confirmed ones, in two weeks after the Wuhan lockdown, while more synchronized implementation would further decrease the number of confirmed cases in the same period by 15.7% (95%PI:15.4%-16.0%) or 1,378 (95%PI: 1,353-1,402) cases; and (4) local travel restrictions on different mobility patterns have different degrees of protection on cities with or without initial confirmed cases until the Wuhan lockdown. Our results prove the effectiveness of local travel restrictions and highlight the importance of synchronized implementation of mobility control across cities in mitigating the COVID-19 transmission.
Published: 4/6/2020
DOI: 10.1101/2020.04.02.20050781
DOI_URL: http://doi.org/10.1101/2020.04.02.20050781
Author Name: Liu, H
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_h
Author Name: Bai, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/bai_x
Author Name: Shen, H
Author link: https://covid19-data.nist.gov/pid/rest/local/author/shen_h
Author Name: Pang, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/pang_x
Author Name: Liang, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liang_z
Author Name: Liu, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_y
sha: 44f53741c57e2fa42d3bd9dc174e86fbb2bd4dc3
license: medrxiv
source_x: MedRxiv; WHO
source_x_url: https://www.who.int/
url: http://medrxiv.org/cgi/content/short/2020.04.02.20050781v1?rss=1 https://doi.org/10.1101/2020.04.02.20050781
has_full_text: TRUE
Keywords Extracted from Text Content: coronavirus https://doi outflow Wuhan 1,474-2,447 org/10.1101org/10 1,960 medRxiv Hubei province Hubei COVID-19 Wuhan lockdown 1,353-1,402 [11] [12] medRxiv preprint S2 Wuhan inflow ‫ݓ‬ chunyun ܱ Figure S1 Hubei (13, 032) ‫ܧ‬ medRxiv preprint Hubei medRxiv preprint 2019 Hubei (Table S1 BX epidemic-stricken p<0.01 Baidu Intra-city Mobility Index 1-2 Hubei excluding LY LBS people human medRxiv Hubei province PX Wuhan lockdown SH LH Hubei Province preprint ߝ outflow COVID-19, 6-10 Hubei excluding Wuhan ݄ earth's medRxiv preprint Hubei ‫ܫ‬ COVID-19 Hubei (Scenario 1
Extracted Text Content in Record: First 5000 Characters:Mobility control measures are of crucial importance for public health planning in combating the COVID-19 pandemic. Previous studies established the impact of population outflow from Wuhan on the spatial spread of coronavirus in China and hinted the impact of the other three mobility patterns, i.e., population outflow from Hubei province excluding Wuhan, population inflow from cities outside Hubei, and intra-city population movement. However, the overall impact of all mobility patterns, or the impact of the different timing of mobility restriction intervention, are not systematically analyzed. Here we apply the cumulative confirmed cases and mobility data of 350 Chinese cities outside Hubei to explore the relationships between all mobility patterns and epidemic spread, and estimate the impact of local travel restrictions, both in terms of level and timing, on the epidemic control based on mobility change. The relationships were identified by using Pearson correlation analysis and stepwise multivariable linear regression, while scenario simulation was used to estimate the mobility change caused by local travel restrictions. Our analysis shows that: (1) all mobility patterns correlated with the spread of the coronavirus in Chinese cities outside Hubei, while the corrleations droppd with the implemetation of . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi. org/10.1101org/10. /2020 travel restrictions; (2) the cumulative confirmed cases in two weeks after the Wuhan lockdown was mainly brought by three patterns of inter-city population movement, while those in the third and fourth weeks after was significantly influenced by the number of intra-city population movement; (3) the local travel restrictions imposed by cities outside Hubei have averted 1,960 (95%PI: 1,474-2,447) more infections, taking 22.4% (95%PI: 16.8%-27.9%) of confirmed ones, in two weeks after the Wuhan lockdown, while more synchronized implementation would further decrease the number of confirmed cases in the same period by 15.7% (95%PI:15.4%-16.0%) or 1,378 (95%PI: 1,353-1,402) cases; and (4) local travel restrictions on different mobility patterns have different degrees of protection on cities with or without initial confirmed cases until the Wuhan lockdown. Our results prove the effectiveness of local travel restrictions and highlight the importance of synchronized implementation of mobility control across cities in mitigating the COVID-19 transmission. Previous studies prove it is the population mobility that accelerates the spatial spread of the epidemic, while travel restrictions could contribute to the epidemic control. [5] [6] [7] [8] [9] [10] [11] [12] [13] The spring migration ("chunyun" in Chinese) of 2020 started on Jan 10, which is the earth's most massive annual human migration. 13 Although Wuhan, the capital city of Hubei Province, suspended all in and out public transport since 10:00 am Jan 23, 2020, about five million people already left Wuhan before the quarantine. 14 Studies show that while the Wuhan lockdown greatly slowed the spread of COVID-19, 6-10 the number of population emigration from Wuhan highly correlated to the imported cases in other cities in China. 8, [11] [12] [13] [15] [16] [17] [18] While the impact of the population outflow from Wuhan is well established, the impact of other mobility patterns on the epidemic trajectory has not been well understood. Local population mobility for a city includes both intra-city and inter-city patterns. The inter-city mobility can be categorized into three sources, i.e., from Wuhan, from Hubei province (excluding Wuhan), and from cities outside Hubei. As nearly two-thirds of population outflow from Wuhan flooded into other cities within the Hubei Province, 13, 17 it is important to consider the population outflow from Hubei (excluding Wuhan) as a potentially most significant source of epidemic transmission risk after Jan 23. The intra-city population movement is also an essential factor-research shows that cities introduced pre-emptive intra-city movement restrictions have 33.3% less confirmed cases in the first week of the epidemic outbreak compared to those started restrictions after the emerging of confirmed cases, 6 pointing to the importance of timing of introducing these measures. For inter-city population movement among cities outside Hubei, which are restricted after the Wuhan lockdown, different studies hold inconsistent reviews. On the one hand, the implementation of inter-city travel restrictions cannot significantly reduce the number of confirmed cases during the first week of city outbreaks; 6 on the other hand, the transmission model of the COVID-19 cannot be accurately established without the inter-city connections. 19 Most of these existing studies are based on one o
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