Abstract

Mobility restrictions have been a heated topic during the global pandemic of coronavirus disease 2019 (COVID-19). However, multiple recent findings have verified its importance in blocking virus spread. Evidence on the association between mobility, cases imported from abroad and local medical resource supplies is limited. To reveal the association, this study quantified the importance of inter- and intra-country mobility in containing virus spread and avoiding hospitalizations during early stages of COVID-19 outbreaks in India, Japan, and China. We calculated the time-varying reproductive number (Rt) and duration from illness onset to diagnosis confirmation (Doc), to represent conditions of virus spread and hospital bed shortages, respectively. Results showed that inter-country mobility fluctuation could explain 80%, 35%, and 12% of the variance in imported cases and could prevent 20 million, 5 million, and 40 million imported cases in India, Japan and China, respectively. The critical time for screening and monitoring of imported cases is 2 weeks at minimum and 4 weeks at maximum, according to the time when the Pearson’s Rs between Rt and imported cases reaches a peak (>0.8). We also found that if local transmission is initiated, a 1% increase in intra-country mobility would result in 1430 (±501), 109 (±181), and 10 (±1) additional bed shortages, as estimated using the Doc in India, Japan, and China, respectively. Our findings provide vital reference for governments to tailor their pre-vaccination policies regarding mobility, especially during future epidemic waves of COVID-19 or similar severe epidemic outbreaks.

Highlights

  • The novel coronavirus SARS-CoV-2 has appeared and affected human societies for more than a year as of this writing [1]

  • Effective measures were put in place to reduce virus spread, which is reflected in the fluctuating reproductive number (Rt) curves

  • We analyzed the relationship between inter-country mobility, imported cases and time-varying reproductive number, and found that intercountry mobility led to more imported cases, which initiated local transmission of COVID19 whose correlation with Rt peaks at around 2 weeks and drops at around 4 weeks, providing a reference for the optimal surveillance period

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Summary

Objectives

We aimed to quantify the importance of both inter- and intra-country mobility in containing virus spread and conserving hospital bed availability during early outbreak periods, and to provide policy recommendations in cases of recurring outbreaks

Methods
Results
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