Vaccination, human mobility, and COVID-19 health outcomes: Empirical comparison before and during the outbreak of SARS-Cov-2 B.1.1.529 (Omicron) variant.

The B.1.1.529 (Omicron) variant surge has raised concerns about the effectiveness of vaccines and the impact of imprudent reopening. Leveraging over two years of county-level COVID-19 data in the US, this study aims to investigate relationships among vaccination, human mobility, and COVID-19 health outcomes (assessed via case rate and case-fatality rate), controlling for socioeconomic, demographic, racial/ethnic, and partisan factors. A set of cross-sectional models was first fitted to empirically compare disparities in COVID-19 health outcomes before and during the Omicron surge. Then, time-varying mediation analyses were employed to delineate how the effects of vaccine and mobility on COVID-19 health outcomes vary over time. Results showed that vaccine effectiveness against case rate lost significance during the Omicron surge, while its effectiveness against case-fatality rate remained significant throughout the pandemic. We also documented salient structural inequalities in COVID-19-related outcomes, with disadvantaged populations consistently bearing a larger brunt of case and death tolls, regardless of high vaccination rates. Last, findings revealed that mobility presented a significantly positive relationship with case rates during each wave of variant outbreak. Mobility substantially mediated the direct effect from vaccination to case rate, leading to a 10.276 % (95 % CI: 6.257, 14.294) decrease in vaccine effectiveness on average. Altogether, our study implies that sole reliance on vaccination to halt COVID-19 needs to be re-examined. Well-resourced and coordinated efforts to enhance vaccine effectiveness, mitigate health disparity and selectively loosen non-pharmaceutical interventions are essential to bringing the pandemic to an end.

Interactive COVID-19 Mobility Impact and Social Distancing Analysis Platform

The research team has utilized privacy-protected mobile device location data, integrated with COVID-19 case data and census population data, to produce a COVID-19 impact analysis platform that can inform users about the effects of COVID-19 spread and government orders on mobility and social distancing. The platform is being updated daily, to continuously inform decision-makers about the impacts of COVID-19 on their communities, using an interactive analytical tool. The research team has processed anonymized mobile device location data to identify trips and produced a set of variables, including social distancing index, percentage of people staying at home, visits to work and non-work locations, out-of-town trips, and trip distance. The results are aggregated to county and state levels to protect privacy, and scaled to the entire population of each county and state. The research team is making their data and findings, which are updated daily and go back to January 1, 2020, for benchmarking, available to the public to help public officials make informed decisions. This paper presents a summary of the platform and describes the methodology used to process data and produce the platform metrics.

Interactive COVID-19 Mobility Impact and Social Distancing Analysis Platform.

The research team has utilized privacy-protected mobile device location data, integrated with COVID-19 case data and census population data, to produce a COVID-19 impact analysis platform that can inform users about the effects of COVID-19 spread and government orders on mobility and social distancing. The platform is being updated daily, to continuously inform decision-makers about the impacts of COVID-19 on their communities, using an interactive analytical tool. The research team has processed anonymized mobile device location data to identify trips and produced a set of variables, including social distancing index, percentage of people staying at home, visits to work and non-work locations, out-of-town trips, and trip distance. The results are aggregated to county and state levels to protect privacy, and scaled to the entire population of each county and state. The research team is making their data and findings, which are updated daily and go back to January 1, 2020, for benchmarking, available to the public to help public officials make informed decisions. This paper presents a summary of the platform and describes the methodology used to process data and produce the platform metrics.

Health disparity in the spread of COVID-19: Evidence from social distancing, risk of interactions, and access to testing

Objective – To identify and assess whether three major risk factors that due to differential access to flexible resources might help explain disparities in the spread of COVID-19 across communities with different socioeconomic status, including socioeconomic inequalities in social distancing, the potential risk of interpersonal interactions, and access to testing. Methods Analysis uses ZIP code level weekly COVID-19 new cases, weekly population movement flows, weekly close-contact index, and weekly COVID-19 testing sites in Southern California from March 2020 to April 2021, merged with the U.S. census data to measure ZIP code level socioeconomic status and cofounders. This study first develops the measures for social distancing, the potential risk of interactions, and access to testing. Then we employ a spatial lag regression model to quantify the contributions of those factors to weekly COVID-19 case growth. Results Results identify that, during the first COVID-19 wave, new case growth of the low-income group is two times higher than that of the high-income group. The COVID-19 case disparity widens to four times in the second COVID-19 wave. We also observed significant disparities in social distancing, the potential risk of interactions, and access to testing among communities with different socioeconomic status. In addition, all of them contribute to the disparities of COVID-19 incidences. Among them, the potential risk of interactions is the most important contributor, whereas testing accessibility contributes least. We also found that close-contact is a more effective measure of social distancing than population movements in examining the spread of COVID-19. Conclusion – This study answers critically unaddressed questions about health disparities in the spread of COVID-19 by assessing factors that might explain why the spread is different in different groups.

COVID-19 and income profile: How communities in the United States responded to mobility restrictions in the pandemic's early stages.

Mobility interventions in communities play a critical role in containing a pandemic at an early stage. The real-world practice of social distancing can enlighten policymakers and help them implement more efficient and effective control measures. A lack of such research using real-world observations initiates this article. We analyzed the social distancing performance of 66,149 census tracts from 3,142 counties in the United States with a specific focus on income profile. Six daily mobility metrics, including a social distancing index, stay-at-home percentage, miles traveled per person, trip rate, work trip rate, and non-work trip rate, were produced for each census tract using the location data from over 100 million anonymous devices on a monthly basis. Each mobility metric was further tabulated by three perspectives of social distancing performance: "best performance," "effort," and "consistency." We found that for all 18 indicators, high-income communities demonstrated better social distancing performance. Such disparities between communities of different income levels are presented in detail in this article. The comparisons across scenarios also raise other concerns for low-income communities, such as employment status, working conditions, and accessibility to basic needs. This article lays out a series of facts extracted from real-world data and offers compelling perspectives for future discussions.

COVID-19 vaccine hesitancy cannot fully explain disparities in vaccination coverage across the contiguous United States.

Vaccine hesitancy has been identified as a major obstacle preventing comprehensive coverage against the COVID-19 pandemic. However, few studies have analyzed the association between ex-ante vaccine hesitancy and ex-post vaccination coverage. This study leveraged one-year county-level data across the contiguous United States to examine whether the prospective vaccine hesitancy eventually translates into differential vaccination rates, and whether vaccine hesitancy can explain socioeconomic, racial, and partisan disparities in vaccine uptake. A set of structural equation modeling was fitted with vaccine hesitancy and vaccination rate as endogenous variables, controlling for various potential confounders. The results demonstrated a significant negative link between vaccine hesitancy and vaccination rate, with the difference between the two continuously widening over time. Counties with higher socioeconomic statuses, more Asian and Hispanic populations, more elderly residents, greater health insurance coverage, and more Democrats presented lower vaccine hesitancy and higher vaccination rates. However, underlying determinants of vaccination coverage and vaccine hesitancy were divergent regarding their different associations with exogenous variables. Mediation analysis further demonstrated that indirect effects from exogenous variables to vaccination coverage via vaccine hesitancy only partially explained corresponding total effects, challenging the popular narrative that portrays vaccine hesitancy as a root cause of disparities in vaccination. Our study highlights the need of well-funded, targeted, and ongoing initiatives to reduce persisting vaccination inequities.

Do racial and ethnic disparities in following stay-at-home orders influence COVID-19 health outcomes? A mediation analysis approach.

Racial/ethnic disparities are among the top-selective underlying determinants associated with the disproportional impact of the COVID-19 pandemic on human mobility and health outcomes. This study jointly examined county-level racial/ethnic differences in compliance with stay-at-home orders and COVID-19 health outcomes during 2020, leveraging two-year geo-tracking data of mobile devices across ~4.4 million point-of-interests (POIs) in the contiguous United States. Through a set of structural equation modeling, this study quantified how racial/ethnic differences in following stay-at-home orders could mediate COVID-19 health outcomes, controlling for state effects, socioeconomics, demographics, occupation, and partisanship. Results showed that counties with higher Asian populations decreased most in their travel, both in terms of reducing their overall POIs' visiting and increasing their staying home percentage. Moreover, counties with higher White populations experienced the lowest infection rate, while counties with higher African American populations presented the highest case-fatality ratio. Additionally, control variables, particularly partisanship, median household income, percentage of elders, and urbanization, significantly accounted for the county differences in human mobility and COVID-19 health outcomes. Mediation analyses further revealed that human mobility only statistically influenced infection rate but not case-fatality ratio, and such mediation effects varied substantially among racial/ethnic compositions. Last, robustness check of racial gradient at census block group level documented consistent associations but greater magnitude. Taken together, these findings suggest that US residents' responses to COVID-19 are subject to an entrenched and consequential racial/ethnic divide.

Examining spatiotemporal evolution of racial/ethnic disparities in human mobility and COVID-19 health outcomes: Evidence from the contiguous United States.

Social distancing has become a key countermeasure to contain the dissemination of COVID-19. This study examined county-level racial/ethnic disparities in human mobility and COVID-19 health outcomes during the year 2020 by leveraging geo-tracking data across the contiguous US. Sets of generalized additive models were fitted under cross-sectional and time-varying settings, with percentage of mobility change, percentage of staying home, COVID-19 infection rate, and case-fatality ratio as dependent variables, respectively. After adjusting for spatial effects, built environment, socioeconomics, demographics, and partisanship, we found counties with higher Asian populations decreased most in travel, counties with higher White and Asian populations experienced the least infection rate, and counties with higher African American populations presented the highest case-fatality ratio. Control variables, particularly partisanship and education attainment, significantly influenced modeling results. Time-varying analyses further suggested racial differences in human mobility varied dramatically at the beginning but remained stable during the pandemic, while racial differences in COVID-19 outcomes broadly decreased over time. All conclusions hold robust with different aggregation units or model specifications. Altogether, our analyses shine a spotlight on the entrenched racial segregation in the US as well as how it may influence the mobility patterns, urban forms, and health disparities during the COVID-19.

Flatten the curve: Empirical evidence on how non-pharmaceutical interventions substituted pharmaceutical treatments during COVID-19 pandemic.

During the outbreak of the COVID-19 pandemic, Non-Pharmaceutical and Pharmaceutical treatments were alternative strategies for governments to intervene. Though many of these intervention methods proved to be effective to stop the spread of COVID-19, i.e., lockdown and curfew, they also posed risk to the economy; in such a scenario, an analysis on how to strike a balance becomes urgent. Our research leverages the mobility big data from the University of Maryland COVID-19 Impact Analysis Platform and employs the Generalized Additive Model (GAM), to understand how the social demographic variables, NPTs (Non-Pharmaceutical Treatments) and PTs (Pharmaceutical Treatments) affect the New Death Rate (NDR) at county-level. We also portray the mutual and interactive effects of NPTs and PTs on NDR. Our results show that there exists a specific usage rate of PTs where its marginal effect starts to suppress the NDR growth, and this specific rate can be reduced through implementing the NPTs.

An Interactive Covid-19 Mobility Impact and Social Distancing Analysis Platform

The research team has utilized privacy-protected mobile device location data, integrated with COVID-19 case data and census population data, to produce a COVID-19 impact analysis platform that can inform users about the effects of COVID-19 spread and government orders on mobility and social distancing. The platform is being updated daily, to continuously inform decision-makers about the impacts of COVID-19 on their communities using an interactive analytical tool. The research team has processed anonymized mobile device location data to identify trips and produced a set of variables including social distancing index, percentage of people staying at home, visits to work and non-work locations, out-of-town trips, and trip distance. The results are aggregated to county and state levels to protect privacy and scaled to the entire population of each county and state. The research team are making their data and findings, which are updated daily and go back to January 1, 2020, for benchmarking, available to the public in order to help public officials make informed decisions. This paper presents a summary of the platform and describes the methodology used to process data and produce the platform metrics.

Examining spatiotemporal changing patterns of bike-sharing usage during COVID-19 pandemic.

The COVID-19 pandemic has led to a globally unprecedented change in human mobility. Leveraging two-year bike-sharing trips from the largest bike-sharing program in Chicago, this study examines the spatiotemporal evolution of bike-sharing usage across the pandemic and compares it with other modes of transport. A set of generalized additive (mixed) models are fitted to identify relationships and delineate nonlinear temporal interactions between station-level daily bike-sharing usage and various independent variables including socio-demographics, land use, transportation features, station characteristics, and COVID-19 infections. Results show: 1) the proportion of commuting trips is substantially lower during the pandemic; 2) the trend of bike-sharing usage follows an "increase-decrease-rebound" pattern; 3) bike-sharing presents as a more resilient option compared with transit, driving, and walking; 4) regions with more white, Asian, and fewer African-American residents are found to become less dependent on bike-sharing; 5) open space and residential areas exhibit less decrease and earlier start-to-recover time; 6) stations near the city center, with more docks, or located in high-income areas go from more increase before the pandemic to more decrease during the pandemic. Findings provide a timely understanding of bike-sharing usage changes and offer suggestions on how different stakeholders should respond to this unprecedented crisis.

A big-data driven approach to analyzing and modeling human mobility trend under non-pharmaceutical interventions during COVID-19 pandemic.

During the unprecedented coronavirus disease 2019 (COVID-19) challenge, non-pharmaceutical interventions became a widely adopted strategy to limit physical movements and interactions to mitigate virus transmissions. For situational awareness and decision-support, quickly available yet accurate big-data analytics about human mobility and social distancing is invaluable to agencies and decision-makers. This paper presents a big-data-driven analytical framework that ingests terabytes of data on a daily basis and quantitatively assesses the human mobility trend during COVID-19. Using mobile device location data of over 150 million monthly active samples in the United States (U.S.), the study successfully measures human mobility with three main metrics at the county level: daily average number of trips per person; daily average person-miles traveled; and daily percentage of residents staying home. A set of generalized additive mixed models is employed to disentangle the policy effect on human mobility from other confounding effects including virus effect, socio-demographic effect, weather effect, industry effect, and spatiotemporal autocorrelation. Results reveal the policy plays a limited, time-decreasing, and region-specific effect on human movement. The stay-at-home orders only contribute to a 3.5%-7.9% decrease in human mobility, while the reopening guidelines lead to a 1.6%-5.2% mobility increase. Results also indicate a reasonable spatial heterogeneity among the U.S. counties, wherein the number of confirmed COVID-19 cases, income levels, industry structure, age and racial distribution play important roles. The data informatics generated by the framework are made available to the public for a timely understanding of mobility trends and policy effects, as well as for time-sensitive decision support to further contain the spread of the virus.

Mobile device location data reveal human mobility response to state-level stay-at-home orders during the COVID-19 pandemic in the USA.

One approach to delaying the spread of the novel coronavirus (COVID-19) is to reduce human travel by imposing travel restriction policies. Understanding the actual human mobility response to such policies remains a challenge owing to the lack of an observed and large-scale dataset describing human mobility during the pandemic. This study uses an integrated dataset, consisting of anonymized and privacy-protected location data from over 150 million monthly active samples in the USA, COVID-19 case data and census population information, to uncover mobility changes during COVID-19 and under the stay-at-home state orders in the USA. The study successfully quantifies human mobility responses with three important metrics: daily average number of trips per person; daily average person-miles travelled; and daily percentage of residents staying at home. The data analytics reveal a spontaneous mobility reduction that occurred regardless of government actions and a 'floor' phenomenon, where human mobility reached a lower bound and stopped decreasing soon after each state announced the stay-at-home order. A set of longitudinal models is then developed and confirms that the states' stay-at-home policies have only led to about a 5% reduction in average daily human mobility. Lessons learned from the data analytics and longitudinal models offer valuable insights for government actions in preparation for another COVID-19 surge or another virus outbreak in the future.

Who left riding transit? Examining socioeconomic disparities in the impact of COVID-19 on ridership

The COVID-19 pandemic has led to a globally unprecedented decline in transit ridership. This paper leveraged the 20-years daily transit ridership data in Chicago to infer the impact of COVID-19 on ridership using the Bayesian structural time series model, controlling confounding effects of trend, seasonality, holiday, and weather. A partial least square regression was then employed to examine the relationships between the impact of ridership and various explanatory factors. Results suggested: (1) COVID-19 pandemic exerted significant effects on 95% of transit stations, leading to an average 72.4% drop in ridership. (2) Ridership declined more in regions with more commercial lands and higher percentages of white, educated, and high-income individuals. (3) Regions with more jobs in trade, transportation, and utility sectors presented smaller declines. (4) Regions with more COVID-19 cases/deaths presented smaller declines in transit ridership. Findings provide a timely understanding of the significantly reduced ridership during the pandemic and help transit agencies adjust services across different socioeconomic groups and space to better constrain virus transmission.

Mobile device data reveal the dynamics in a positive relationship between human mobility and COVID-19 infections.

Accurately estimating human mobility and gauging its relationship with virus transmission is critical for the control of COVID-19 spreading. Using mobile device location data of over 100 million monthly active samples, we compute origin-destination travel demand and aggregate mobility inflow at each US county from March 1 to June 9, 2020. Then, we quantify the change of mobility inflow across the nation and statistically model the time-varying relationship between inflow and the infections. We find that external travel to other counties decreased by 35% soon after the nation entered the emergency situation, but recovered rapidly during the partial reopening phase. Moreover, our simultaneous equations analysis highlights the dynamics in a positive relationship between mobility inflow and the number of infections during the COVID-19 onset. This relationship is found to be increasingly stronger in partially reopened regions. Our study provides a quick reference and timely data availability for researchers and decision makers to understand the national mobility trends before and during the pandemic. The modeling results can be used to predict mobility and transmissions risks and integrated with epidemics models to further assess the public health outcomes.

Higher immune response induced by vaccination in Houhai acupoint relates to the lymphatic drainage of the injection site.

Houhai acupoint (HA) is a site for acupuncture stimulation, located in the fossa between the anus and tail base in animals. To evaluate HA as a potential immunization site, the immune responses were compared when HA and the conventional site nape were vaccinated in rats. The results showed that injection of a porcine epidemic diarrhea virus (PEDV) vaccine in HA induced significantly higher IgG, IgG1, IgG2, splenocyte proliferation and mRNA expression of IL-2, IL-4 and IFN-γ than in the nape. To search for the underlying mechanisms, the draining lymph nodes for HA and the nape were investigated. When rats were injected in HA with Indian ink, 11 lymph nodes including caudal mesenteric lymph node and bilateral gluteal lymph nodes, posterior inguinal lymph nodes, lumbar lymph nodes, internal iliac lymph nodes and popliteal lymph nodes were visibly stained with the ink and injection of a model antigen ovalbumin (OVA) in HA resulted in detection of OVA by western blotting while in the same lymph nodes only a pair of lymph nodes (central brachial lymph nodes) were observed when Indian ink or OVA was injected in the nape. IL-2 mRNA expression was detected in all the lymph nodes when PEDV vaccine was injected. Therefore, the enhanced immune response elicited by vaccination in HA may be attributed to more lymphocytes activated.