State heterogeneity in the associations of human mobility with COVID-19 epidemics in the European Union

ABSTRACT

Background: Human mobility was associated with epidemic changes of coronavirus disease 2019 (COVID-19) in the countries, where strict public health interventions reduced human mobility and COVID-19 epidemics. But its association with COVID-19 epidemics in the European Union (EU) is unclear. Methods: In this quasi-experimental interrupted time-series study, we modelled trends in human mobility and epidemics of COVID-19 in 27 EU states between January 15 and May 9, 2020. The associations of lockdown-date, and turning points of these trends were assessed. Results: There were 982,332 laboratory-confirmed COVID-19 cases in the EU states (median 7,896, interquartile 1,689 to 25,702 for individual states) during the study-period. COVID-19 and human mobility had 3 trend-segments, including an upward trend in COVID-19 daily incidence and a downward trend in most human mobilities in the middle segment. Compared with the states farther from Italy, the state-wide lockdown dates were more likely linked to turning points of human mobilities in the states closer to Italy, which were also more likely linked to second turning points of COVID-19 epidemics. Among the examined human mobilities, the second turning points in driving mobility and the first turning points in parks mobility were the best factors that connected lockdown dates and COVID-19 epidemics in the EU states closer to Italy. Conclusions: We show state- and mobility-heterogeneity in the associations of public health interventions and human mobility with the changes of COVID-19 epidemics in the EU. These findings may help inform policymakers on the best timing and monitoring-parameters of state-level interventions in the EU.