Abstract

Limited evidence on the effectiveness of various types of social distancing measures, from voluntary physical distancing to a community-wide quarantine, exists for the Western Pacific Region (WPR) which has large urban and rural populations. We estimated the time-varying reproduction number (R t ) in a Bayesian framework using district-level mobility data provided by Facebook (i) to assess how various social distancing policies have contributed to the reduction in transmissibility of SARS-COV-2 and (ii) to examine within-country variations in behavioural responses, quantified by reductions in mobility, for urban and rural areas. Social distancing measures were largely effective in reducing transmissibility, with R t estimates decreased to around the threshold of 1. Within-country analysis showed substantial variation in public compliance across regions. Reductions in mobility were significantly lower in rural and remote areas than in urban areas and metropolitan cities (p < 0.001) which had the same scale of social distancing orders in place. Our findings provide empirical evidence that public compliance and consequent intervention effectiveness differ between urban and rural areas in the WPR. Further work is required to ascertain the factors affecting these differing behavioural responses, which can assist in policy-making efforts and increase public compliance in rural areas where populations are older and have poorer access to healthcare.

Highlights

  • Targeted nonpharmaceutical interventions, including the quarantine of potentially infected individuals and isolation of confirmed positive cases, form the basis for control of respiratory infectious disease epidemics in the absence of widely available vaccines and prophylactics

  • We examined the trends in mobility and transmissibility of COVID-19 over the six months in the early stage of the pandemic (March 1 to August 31, 2020) to exclude any potential effects of other factors that could affect behavioural responses and public adherence to social distancing measures

  • Our findings show that initial social distancing measures implemented by most Western Pacific Region (WPR) during the COVID-19 pandemic have been largely effective in reducing mobility (Figures 1(a) and 1(b)) and transmissibility (Figures 1(c) and 1(d)), with the effective reproduction number reduced in 61 of 70 subregions included in the study

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Summary

Introduction

Targeted nonpharmaceutical interventions, including the quarantine of potentially infected individuals and isolation of confirmed positive cases, form the basis for control of respiratory infectious disease epidemics in the absence of widely available vaccines and prophylactics. Social distancing measures including lockdowns have been used by many countries to limit the number of contact events between individuals and thereby reduce transmission [1,2,3]. While it has affected all six WHO regions, countries and areas in the Western Pacific Region (hereafter, “WPRs”) including Japan (Jan 15); South Korea (Jan 20); and Singapore (Jan 23) were among the first to report confirmed cases of COVID-19 outside mainland China [4]. Limited evidence on the effectiveness of various types of social distancing measures, from voluntary physical distancing to a community-wide quarantine, exists for the Western Pacific Region (WPR) which has large urban and rural populations. Further work is required to ascertain the factors affecting these differing behavioural responses, which can assist in policy-making efforts and increase public compliance in rural areas where populations are older and have poorer access to healthcare

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