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1.
medrxiv; 2021.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2021.12.14.21267606

ABSTRACT

The Delta variant of concern of SARS-CoV-2 has spread globally causing large outbreaks and resurgences of COVID-19 cases. The emergence of Delta in the UK occurred on the background of a heterogeneous landscape of immunity and relaxation of non-pharmaceutical interventions. Here we analyse 52,992 Delta genomes from England in combination with 93,649 global genomes to reconstruct the emergence of Delta, and quantify its introduction to and regional dissemination across England, in the context of changing travel and social restrictions. Through analysis of human movement, contact tracing, and virus genomic data, we find that the focus of geographic expansion of Delta shifted from India to a more global pattern in early May 2021. In England, Delta lineages were introduced >1,000 times and spread nationally as non-pharmaceutical interventions were relaxed. We find that hotel quarantine for travellers from India reduced onward transmission from importations; however the transmission chains that later dominated the Delta wave in England had been already seeded before restrictions were introduced. In England, increasing inter- regional travel drove Delta's nationwide dissemination, with some cities receiving >2,000 observable lineage introductions from other regions. Subsequently, increased levels of local population mixing, not the number of importations, was associated with faster relative growth of Delta. Among US states, we find that regions that previously experienced large waves also had faster Delta growth rates, and a model including interactions between immunity and human behaviour could accurately predict the rise of Delta there. Delta's invasion dynamics depended on fine scale spatial heterogeneity in immunity and contact patterns and our findings will inform optimal spatial interventions to reduce transmission of current and future VOCs such as Omicron.

2.
researchsquare; 2021.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-1159614.v1

ABSTRACT

The Delta variant of concern of SARS-CoV-2 has spread globally causing large outbreaks and resurgences of COVID-19 cases. The emergence of Delta in the UK occurred on the background of a heterogeneous landscape of immunity and relaxation of non-pharmaceutical interventions. Here we analyse 52,992 Delta genomes from England in combination with 93,649 global genomes to reconstruct the emergence of Delta, and quantify its introduction to and regional dissemination across England, in the context of changing travel and social restrictions. Through analysis of human movement, contact tracing, and virus genomic data, we find that the focus of geographic expansion of Delta shifted from India to a more global pattern in early May 2021. In England, Delta lineages were introduced >1,000 times and spread nationally as non-pharmaceutical interventions were relaxed. We find that hotel quarantine for travellers from India reduced onward transmission from importations; however the transmission chains that later dominated the Delta wave in England had been already seeded before restrictions were introduced. In England, increasing inter-regional travel drove Delta's nationwide dissemination, with some cities receiving >2,000 observable lineage introductions from other regions. Subsequently, increased levels of local population mixing, not the number of importations, was associated with faster relative growth of Delta. Among US states, we find that regions that previously experienced large waves also had faster Delta growth rates, and a model including interactions between immunity and human behaviour could accurately predict the rise of Delta there. Delta’s invasion dynamics depended on fine scale spatial heterogeneity in immunity and contact patterns and our findings will inform optimal spatial interventions to reduce transmission of current and future VOCs such as Omicron.

3.
researchsquare; 2021.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-405658.v1

ABSTRACT

Background: Understanding seasonal human mobility at subnational scales has important implications across sciences, from urban planning efforts to disease modelling and control. Assessing how, when, and where populations move over the course of the year, however, requires spatially and temporally resolved datasets spanning large periods of time, which can be rare, contain sensitive information, or may be proprietary. Here, we aim to explore how a set of broadly available covariates can describe seasonal subnational mobility in Kenya, therefore enabling better modelling of seasonal mobility across low- and middle-income country (LMIC) settings. Methods: To do this, we used the Google Aggregated Mobility Research Dataset, containing anonymized mobility flows aggregated over users who have turned on the Location History setting, which is off by default. We combined this with socioeconomic and geospatial covariates from 2018 to 2019 to quantify seasonal changes in domestic and international mobility patterns across years. We undertook a spatiotemporal analysis within a Bayesian framework to identify relevant geospatial and socioeconomic covariates important to predicting human movement patterns, while accounting for spatial and temporal autocorrelations. Results: Mobility patterns in Kenya mostly consisted of shorter, within-county trips, followed by longer domestic travel between counties and international travel, respectively, across both years. Mobility peaked in August and December, closely corresponding to school holiday seasons, which was found to be an important predictor in our model. We further found that socioeconomic variables including urbanicity, poverty, and female education strongly predicted mobility patterns, in addition to geospatial covariates such as accessibility to major population centres and temperature. Conclusions: These findings derived from novel data sources elucidate broad spatiotemporal patterns of how populations move within and beyond Kenya, and can be easily generalized to other LMIC settings before the COVID-19 pandemic. Understanding such pre-pandemic mobility patterns provides a crucial baseline to interpret both how these patterns have changed as a result of the pandemic, as well as whether human mobility patterns have been permanently altered once the pandemic subsides. Our findings outline key correlates and predictors of mobility using broadly available covariates, alleviating the data bottlenecks of highly sensitive and proprietary mobile phone datasets, which many researchers do not have access to. These results further provide novel insight on monitoring mobility proxies in the context of disease surveillance and control efforts through LMIC settings. 

4.
researchsquare; 2021.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-208849.v1

ABSTRACT

Following the first wave of SARS-CoV-2 infections in spring 2020, Europe experienced a resurgence of the virus starting late summer that was deadlier and more difficult to contain. Relaxed intervention measures and summer travel have been implicated as drivers of the second wave. Here, we build a phylogeographic model to evaluate how newly introduced lineages, as opposed to the rekindling of persistent lineages, contributed to the COVID-19 resurgence in Europe. We inform this model using genomic, mobility and epidemiological data from 10 West European countries and estimate that in many countries more than 50% of the lineages circulating in late summer resulted from new introductions since June 15th. The success in onwards transmission of these lineages is predicted by SARS-CoV-2 incidence during this period. Relatively early introductions from Spain into the United Kingdom contributed to the successful spread of the 20A.EU1/B.1.177 variant. The pervasive spread of variants that have not been associated with an advantage in transmissibility highlights the threat of novel variants of concern that emerged more recently and have been disseminated by holiday travel. Our findings indicate that more effective and coordinated measures are required to contain spread through cross-border travel.

5.
arxiv; 2020.
Preprint in English | PREPRINT-ARXIV | ID: ppzbmed-2012.12839v2

ABSTRACT

The Mumbai Suburban Railways, \emph{locals}, are a key transit infrastructure of the city and is crucial for resuming normal economic activity. To reduce disease transmission, policymakers can enforce reduced crowding and mandate wearing of masks. \emph{Cohorting} -- forming groups of travelers that always travel together, is an additional policy to reduce disease transmission on \textit{locals} without severe restrictions. Cohorting allows us to: ($i$) form traveler bubbles, thereby decreasing the number of distinct interactions over time; ($ii$) potentially quarantine an entire cohort if a single case is detected, making contact tracing more efficient, and ($iii$) target cohorts for testing and early detection of symptomatic as well as asymptomatic cases. Studying impact of cohorts using compartmental models is challenging because of the ensuing representational complexity. Agent-based models provide a natural way to represent cohorts along with the representation of the cohort members with the larger social network. This paper describes a novel multi-scale agent-based model to study the impact of cohorting strategies on COVID-19 dynamics in Mumbai. We achieve this by modeling the Mumbai urban region using a detailed agent-based model comprising of 12.4 million agents. Individual cohorts and their inter-cohort interactions as they travel on locals are modeled using local mean field approximations. The resulting multi-scale model in conjunction with a detailed disease transmission and intervention simulator is used to assess various cohorting strategies. The results provide a quantitative trade-off between cohort size and its impact on disease dynamics and well being. The results show that cohorts can provide significant benefit in terms of reduced transmission without significantly impacting ridership and or economic \& social activity.

6.
medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.12.13.20248129

ABSTRACT

Disease dynamics, human mobility, and public policies co-evolve during a pandemic such as COVID-19. Understanding dynamic human mobility changes and spatial interaction patterns are crucial for understanding and forecasting COVID-19 dynamics. We introduce a novel graph-based neural network(GNN) to incorporate global aggregated mobility flows for a better understanding of the impact of human mobility on COVID-19 dynamics as well as better forecasting of disease dynamics. We propose a recurrent message passing graph neural network that embeds spatio-temporal disease dynamics and human mobility dynamics for daily state-level new confirmed cases forecasting. This work represents one of the early papers on the use of GNNs to forecast COVID-19 incidence dynamics and our methods are competitive to existing methods. We show that the spatial and temporal dynamic mobility graph leveraged by the graph neural network enables better long-term forecasting performance compared to baselines.

7.
arxiv; 2020.
Preprint in English | PREPRINT-ARXIV | ID: ppzbmed-2007.15367v1

ABSTRACT

The ongoing COVID-19 pandemic has created a global crisis of massive scale. Prior research indicates that human mobility is one of the key factors involved in viral spreading. Indeed, in a connected planet, rapid world-wide spread is enabled by long-distance air-, land- and sea-transportation among countries and continents, and subsequently fostered by commuting trips within densely populated cities. While early travel restrictions contribute to delayed disease spread, their utility is much reduced if the disease has a long incubation period or if there is asymptomatic transmission. Given the lack of vaccines, public health officials have mainly relied on non-pharmaceutical interventions, including social distancing measures, curfews, and stay-at-home orders. Here we study the impact of city organization on its susceptibility to disease spread, and amenability to interventions. Cities can be classified according to their mobility in a spectrum between compact-hierarchical and decentralized-sprawled. Our results show that even though hierarchical cities are more susceptible to the rapid spread of epidemics, their organization makes mobility restrictions quite effective. Conversely, sprawled cities are characterized by a much slower initial spread, but are less responsive to mobility restrictions. These findings hold globally across cities in diverse geographical locations and a broad range of sizes. Our empirical measurements are confirmed by a simulation of COVID-19 spread in urban areas through a compartmental model. These results suggest that investing resources on early monitoring and prompt ad-hoc interventions in more vulnerable cities may prove most helpful in containing and reducing the impact of present and future pandemics.

8.
medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.07.27.20159996

ABSTRACT

Timely interventions and early preparedness of healthcare resources are crucial measures to tackle the \mbox{COVID-19} disease. To aid these efforts, we developed the Mobility-Augmented SEIR model (\mbox{MA-SEIR}) that leverages Google's aggregate and anonymized mobility data to augment classic compartmental models. We show in a retrospective analysis how this method can be applied at an early stage in the \mbox{COVID-19} epidemic to forecast its subsequent spread and onset in different geographic regions, with minimal parameterization of the model. This provides insight into the role of near real-time aggregate mobility data in disease spread modeling by quantifying substantial changes in how populations move both locally and globally. These changes would be otherwise very hard to capture using less timely data.

9.
medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.06.16.20132688

ABSTRACT

As rates of new COVID-19 cases decline across Europe due to non-pharmaceutical interventions such as social distancing policies and lockdown measures, countries require guidance on how to ease restrictions while minimizing the risk of resurgent outbreaks. Here, we use mobility and case data to quantify how coordinated exit strategies could delay continental resurgence and limit community transmission of COVID-19. We find that a resurgent continental epidemic could occur as many as 5 weeks earlier when well-connected countries with stringent existing interventions end their interventions prematurely. Further, we found that appropriate coordination can greatly improve the likelihood of eliminating community transmission throughout Europe. In particular, synchronizing intermittent lockdowns across Europe meant half as many lockdown periods were required to end community transmission continent-wide.

10.
medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.06.05.20123760

ABSTRACT

This work quantifies the impact of interventions to curtail mobility and social interactions in order to control the COVID-19 pandemic. We analyze the change in world-wide mobility at multiple spatio-temporal resolutions -- county, state, country -- using an anonymized aggregate mobility map that captures population flows between geographic cells of size 5 km2. We show that human mobility underwent an abrupt and significant change, partly in response to the interventions, resulting in 87% reduction of international travel and up to 75% reduction of domestic travel. Taking two very different countries sampled from the global spectrum, we observe a maximum reduction of 42% in mobility across different states of the United States (US), and a 68% reduction across the states of India between late March and late April. Since then, there has been an uptick in flows, with the US seeing 53% increase and India up to 38% increase with respect to flows seen during the lockdown. As we overlay this global map with epidemic incidence curves and dates of government interventions, we observe that as case counts rose, mobility fell -- often before stay-at-home orders were issued. Further, in order to understand mixing within a region, we propose a new metric to quantify the effect of social distancing on the basis of mobility. We find that population mixing has decreased considerably as the pandemic has progressed and are able to measure this effect across the world. Finally, we carry out a counterfactual analysis of delaying the lockdown and show that a one week delay would have doubled the reported number of cases in the US and India. To our knowledge, this work is the first to model in near real-time, the interplay of human mobility, epidemic dynamics and public policies across multiple spatial resolutions and at a global scale.

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