Voluntary Restrictions Research Articles

Use of mental health services and psychotropic drugs and suicide rates in Sweden before, during, and after the COVID-19 pandemic

The COVID-19 pandemic led to reports of increased levels of psychological distress and mental health problems world-wide. In Sweden, contrary to most other countries, the COVID-19 strategy was mainly based on voluntary restrictions. It remains unclear whether this reduced mental health problems. We therefore aimed to investigate the long-term impact of the COVID-19 pandemic on mental health in Sweden in terms of mental health service utilisation, antidepressant and anxiolytic/sedative use, and suicide rates for the two years before, during and after the pandemic in a nationwide retrospective register study, covering the entire Swedish population from ten years of age between 1 January 2018 and 31 December 2023. Publicly available data from three national registers were used. We found that, despite the stress induced by the COVID-19 pandemic, there was neither an overall impact on mental health service utilisation nor a post-pandemic rebound. Nonetheless, there were vulnerable subgroups, which could be overlooked when only examining the population as a whole. Young women and girls fared worse in terms of psychoactive substance use and anxiety. Older men fared worse in terms of suicide rates. Identifying vulnerable populations already now, may be a means to effectively mitigate mental health problems during future pandemics.

New Data on the Distribution of Sperm Whales in the Western Mediterranean Highlights Insufficiency of Currently Proposed Protection Measures

ABSTRACTAs part of ongoing efforts to protect marine megafauna, especially cetaceans, in the NW Mediterranean Sea, a ‘Particularly Sensitive Sea Area’ (PSSA) was established in July 2023 by the governments of France, Italy, Spain and Monaco through the Marine Environment Protection Committee (MEPC) of the International Maritime Organisation (IMO). This is a legal instrument by which maritime traffic can be subject to advisories or controls to protect the natural environment. While the new PSSA is a significant step forward in terms of marine wildlife protection in the region, the current area only partially includes the waters that play a key ecological role for the conservation of Mediterranean sperm whales (Physeter macrocephalus) around the Balearics Archipelago. This isolated population is currently classified as endangered by the IUCN. Survey data from 2019 to 2022 show how the current area does not include portions of habitat in which calves are more likely to be encountered and risks displacing any maritime traffic that chooses to avoid the voluntary PSSA restrictions into habitat that is sensitive for calf survival. We argue therefore that this PSSA should be augmented to incorporate waters that are an important habitat for this endangered population.

O trudnych relacjach etyki z ekonomią i nowym początku

The purpose of the considerations carried out is to determine the nature of the relationship between business ethics and economics, and in particular to demonstrate that the axiological reorientation taking place in the economic sciences today opens space for overcoming differences regarding the assumptions adopted in both disciplines that characterize business practice. The author poses a key question: is it possible to see any basis for building a common or at least similar position representative of both the community of economists and business ethicists? Answering it requires, firstly, pointing out the differences in the ways of understanding economic phenomena adopted in ethics and economics; and secondly, taking into account the current state of the world and the need to adopt voluntary restrictions on the impact on the natural environment. A prerequisite for at least a partial reconciliation of the ethical and economic vision of the economy is a change of thinking in economics – the adoption of the perspective of post-growth economics and economics of restraint.

Improving the estimation of direct release rates and transport processes from the Fukushima Daiichi Nuclear Power Plant accident using higher-resolution oceanic dispersion model

A series of accidents at the Fukushima Daiichi Nuclear Power Station (F1NPS), following the 11 March 2011 earthquake and tsunami, resulted in the release of radioactive substances into the ocean. In particular, the release of large amounts of radioactive caesium has damaged the fishing industry, leading to voluntary restrictions on fishing and shipping. Oceanic dispersion simulations based on estimates of the pathways and fluxes of radioactive materials provide useful information for assessing the environmental impacts and formulating measures to mitigate the effects of the accident. For the direct release rate from the F1NPS site, an estimation method was developed using the results from nearby monitoring, and the seawater exchange rate was estimated in target volume using a numerical simulation. However, the influence of volume on the seawater exchange rate was not considered. Appropriate volumes must be considered when estimating the effects of future accidents. In addition, the directional coastal transport was underestimated in the simulations of the F1NPS accident because of the low resolution. To estimate the pathways and fluxes of radioactive material to the ocean and understand the distribution of the concentration of radioactive material based on ocean dispersion simulations, a study was conducted using a higher-resolution model. The horizontal resolution of the conventional ocean dispersion model Regional Ocean Modelling System (ROMS), was increased from 1 km to 200 m. The optimal settings of the seawater exchange rate were investigated, and the radioactive caesium transport process in the coastal direction was more accurately reflected. We found that the conventional volume for determining the seawater exchange rate, including the locations of release sources and observation points, is optimal. The validity of this finding was confirmed using experimental equations from previous oceanic tracer release experiments. To estimate future release rates, it an appropriate volume must be defined, for example, depending on the distance between the locations of the release sources and the observation point. In addition, improvements in the accuracy of the simulation of the coastal transport process were observed owing to the higher resolution, which increased reproducibility. However, with a horizontal resolution of 200 m, problems with repeatability near the harbours arose. A higher resolution, achieved using nesting or other methods, would be desirable to deal with releases smaller than those in the F1NPS accident.

Understanding factors for adhering to health recommendations during COVID-19 among older adults - a qualitative interview study using health belief model as analytical framework

IntroductionThe COVID-19 pandemic has presented a unique possibility to broaden the understanding of people’s reactions to a global crisis. Early on, it became evident that older adults were particularly vulnerable to the virus and that the actions of this age group would be crucial to the outcome. This qualitative interview study uses the Health Belief Model (HBM) framework as an analytical tool to examine older people’s experiences of adherence to recommendations during the initial phase of the COVID-19 pandemic. It is important to view this study in the context of Sweden’s voluntary restrictions, which further highlight the unique nature of this research.MethodIn April-May 2020, 41 adults aged 70–85 participated in unstructured phone interviews. The objective was to investigate older adults’ perceptions of the COVID-19 pandemic, particularly their understanding of the disease and the conditions that influenced their adherence to health recommendations. HBM was used as an analytical framework to guide the analysis of the interviews.ResultsDespite perceiving COVID-19 as a severe threat to health and society, participants did not let fear dominate their responses. Instead, they demonstrated remarkable resilience and a proactive approach. For some, the perceived susceptibility to the disease was the primary motivator for adherence to the Swedish national recommendations. Notably, trust in the authorities and family members’ requests significantly bolstered adherence. Moreover, adherence was found to contribute to feelings of safety. Conversely, potential barriers to adhering to recommendations included missing loved ones and frustration with sometimes ambiguous information from authorities.ConclusionsThe results from this study indicate that older adults are willing to adhere to voluntary restrictions during a global pandemic. Relatives of older people are a resource for communicating information regarding safety and health messages, a message that is preferably thorough and consistent. Further, much can be gained if loneliness during isolation can be mitigated since missing loved ones appears to be a potential barrier to adherence.

Possible role of cardiovascular stress induced by the volume load as a cause of anemia in hemodialysis patients: a case of a maintenance hemodialysis patient with a literature review

BackgroundAlthough a deficiency in erythropoietin relative to decreased hemoglobin levels is presumed to be the predominant cause of renal anemia, other factors may also exist that are not fully understood.Case presentationA 58-year-old man with pyelonephritis who had been on hemodialysis for 18 years presented a gradually decreasing serum creatinine level, possibly due to voluntary dietary restrictions, accompanied by a gradual increase in the cardiothoracic ratio from 48% to 56%. Concomitantly, his hemoglobin level decreased gradually from 14.5 to 8.7 g/dL by 6 months. Although he had no symptoms of heart failure and his left ventricular ejection fraction was 66.3%, which was almost identical to his condition 2 years prior, a drastic reduction in posthemodialysis body weight from 71.0 to 68.6 kg in 9 days was performed without apparent intrahemodialysis hypotension. His cardiothoracic ratio and serum prehemodialysis N-terminal pro-brain natriuretic peptide level decreased steeply, from 56% to 49% by 2 weeks and from 6139 to 647 pg/mL by 8 weeks, followed by a gradual increase in his hemoglobin level from 8.7 to 15.1 g/dL by 3 months. The patient was administered 50 mg/day sodium ferrous citrate but no erythropoietin-stimulating agents or hypoxia-inducible factor prolyl hydroxylase inhibitors. Although a modest increase in the serum protein level was observed immediately after the rapid reduction in posthemodialysis body weight, the patient’s hemoglobin level increased markedly and gradually, suggesting an improvement in anemia rather than hemoconcentration.ConclusionsCardiovascular stress induced by the volume load is one of the causes of anemia in hemodialysis patients.

An empirical application of herding behavior and compliance in the COVID‐19 crisis

AbstractThere is evidence that individuals engage in herding behavior in diverse settings, ranging from fashion choices to financial markets. By examining the exogenous shock caused by the outbreak of COVID‐19 and unique data measuring the footfalls in downtown Jönköping, Sweden, we empirically assess how individuals respond to the restrictions imposed by the government and to the behavior of others, that is, herding. To this end, a regression discontinuity analysis with time as the running variable is applied. We find a negative effect of the restriction on footfalls, indicating that individuals follow the imposed governmental restrictions. However, we also find indications that individuals imitate the actions of others and engage in herd behavior even when the cost of doing so is very high; that is, it could result in severe illness or even death. With the use the unique setting of Sweden, where there have been no enforced lockdowns, we contribute with knowledge related to how effective voluntary restrictions are and the influence of others on one's decision making. Although the nature of the studied sample limits the external generalizability of the results, it may offer guidance for future interventions in clearly delineated settings.

Residential Irrigation Restrictions and Water Conservation: A Review of Studies from 1978 to 2022

AbstractUrban water managers and policymakers have adopted demand management strategies to reduce water use and buffer against short‐term water supply shortfalls. This article provides a systematic review of publications from 1978‐2022 that examine the effectiveness of residential water use restrictions as the primary demand‐side management tool. Our results indicate the significant overall effect of restrictions on reducing water consumption, with an average reduction of 12.3% from the 23 studies reviewed in this article. When evaluating effect strength by restriction type (mandatory versus voluntary), voluntary restrictions have a significantly lower effect than mandatory restrictions on water use. We also find an inverse correlation between the number of irrigation days allowed and the estimated effect strength.

Self-imposed liquidity constraints via voluntary debt repayment

Debt-repayment flexibility should help temporarily liquidity-constrained households but not necessarily households struggling to save. In a natural experiment in which households can apply for free mortgage-repayment flexibility, I find that two-thirds of liquidity-constrained applicants with high-cost debt voluntarily restrict flexibility and forgo, on average, 4,070 EUR of low-cost liquidity. An overconsumption tendency reflecting self-control problems can explain the voluntary liquidity restrictions as well as the persistent liquidity constraints, the consumption drop at the predictable end of flexibility, and saving in other illiquid assets. Self-imposed liquidity constraints reflect characteristics instead of circumstances and reduce the potency of debt-forbearance offers in recessions.

Acceptability of restrictions in the COVID-19 pandemic: a population-based survey in Denmark and Sweden.

Denmark and Sweden initially adopted different responses to the COVID-19 pandemic although the two countries share many characteristics. Denmark responded swiftly with many mandatory restrictions. In contrast, Sweden relied on voluntary restrictions and a more "relaxed" response during the first wave of the pandemic. However, increased rates of COVID-19 cases led to a new approach that involved many more mandatory restrictions, thus making Sweden's response similar to Denmark's in the second wave of the pandemic. The aim was to investigate and compare the extent to which the populations in Denmark and Sweden considered the COVID-19 restrictions to be acceptable during the first two waves of the pandemic. The study also aimed to identify the characteristics of those who were least accepting of the restrictions in the two countries. Cross-sectional surveys were conducted in Denmark and Sweden in 2021. The study population was sampled from nationally representative web panels in the two countries, consisting of 2,619 individuals from Denmark and 2,633 from Sweden. The questionnaire captured key socio-demographic characteristics. Acceptability was operationalized based on a theoretical framework consisting of seven constructs and one overarching construct. The respondents' age and gender patterns were similar in the two countries. The proportion of respondents in Denmark who agreed with the statements ("agree" alternative) that captured various acceptability constructs was generally higher for the first wave than the second wave of the pandemic. The opposite pattern was seen for Sweden. In Denmark, 66% in the first wave and 50% in the second wave were accepting of the restrictions. The corresponding figures for Sweden was 42% (first wave) and 47% (second wave). Low acceptance of the restrictions, defined as the 25% with the lowest total score on the seven acceptability statements, was associated with younger age, male gender and lower education levels. Respondents in Sweden were more accepting of the restrictions in the second wave, when the country used many mandatory restrictions. In contrast, respondents in Denmark were more accepting of the restrictions in the first wave than in the second wave, implying an increased weariness to comply with the restrictions over time. There were considerable socio-demographic differences between those who expressed low acceptance of the restrictions and the others in both countries, suggesting the importance of tailoring communication about the pandemic to different segments of the population.

Effect of voluntary human mobility restrictions on vector-borne diseases during the COVID-19 pandemic in Japan: A descriptive epidemiological study using a national database (2016 to 2021).

The coronavirus disease 2019 (COVID-19) pandemic not only encouraged people to practice good hygiene but also caused behavioral inhibitions and resulted reduction in both endemic and imported infectious diseases. However, the changing patterns of vector-borne diseases under human mobility restrictions remain unclear. Hence, we aimed to investigate the impact of transborder and local mobility restrictions on vector-borne diseases through a descriptive epidemiological study. The analysis was conducted using data from the National Epidemiological Surveillance of Infectious Diseases system in Japan. We defined the pre-pandemic period as the period between the 1st week of 2016 to the 52nd week of 2019 and defined the pandemic period as from the 1st week of 2020 to the 52nd week of 2021, with the assumption that human mobility was limited throughout the pandemic period. This study addressed 24 diseases among notifiable vector borne diseases. Datasets were obtained from weekly reports from the National Epidemiological Surveillance of Infectious Diseases, and the incidence of each vector-borne disease was examined. Interrupted time series analysis was conducted on the epidemic curves for the two periods. Between the pre- and post-pandemic periods, the incidence of dengue fever and malaria significantly decreased, which may be related to limited human transboundary mobility (p = 0.003/0.002). The incidence of severe fever with thrombocytopenia syndrome, scrub typhus, and Japanese spotted fever did not show changes between the two periods or no association with human mobility. This study suggests that behavioral control may reduce the incidence of new mosquito-borne diseases from endemic areas but may not affect tick-borne disease epidemics within an endemic area.

Acoustic presence and vocal activity of North Atlantic right whales in the New York Bight: Implications for protecting a critically endangered species in a human‐dominated environment

AbstractNorth Atlantic right whale (NARW) distribution shifts have led to increased presence in the US mid‐Atlantic, which includes the New York Bight (NYB), an area with substantial vessel traffic. NARW vessel strikes are mitigated by a seasonal management area (SMA) that is active November–April. Within the SMA, vessels ≥ 19.8 m must travel at ≤10 knots. However, until recently, surveys of the NYB were not conducted after the NARW distribution shifted. Thus, it was unclear whether the SMA captured NARW presence in the NYB. Outside the SMA, voluntary speed restrictions are implemented over a limited area when NARW calls are acoustically detected; therefore, it was important to quantify NARW vocal activity. Acoustic recordings (2016–2020) were analyzed to determine NARW presence, vocal states, and diel pattern of vocal activity. NARWs were detected outside SMA boundaries, and medium/high vocal states (21–69 calls over 3–6 h) occurred while the SMA was inactive. Therefore, the SMA spatiotemporal boundaries should be revised. Vocal activity was highest at night (22:00–1:00), and NARWs were acoustically detected when they were not detected by aerial surveys, illustrating acoustic detections are a viable method for triggering mitigation measures when NARWs are vocalizing but are not visually observed.

Thirdhand Smoke Exposure in Homes with Children under 48 Months during the First Wave of the COVID-19 Pandemic Confinement in Barcelona (Spain)

Background/Objectives: Due to serious restrictions on mobility, some children might have increased exposure to THS due to home confinement. To characterize third-hand smoke (THS) exposure in children under 48 months at homes in Spain during the confinement of the first wave of COVID-19.Methods: Cross-sectional study of a non-probabilistic sample of parents (n = 311). The gathered information was about smoking status, second-hand smoke (SHS) exposure of their children, and voluntary regulation of tobacco consumption at their home. A variable of THS exposure at home was derived, classifying as ‘THS exposed’ those children whose parents reported living with a smoker or with smoking parents and non-exposed to SHS; ‘Non exposed’ children were, therefore, all other children.Results: Almost a quarter of the children (23.5%) were exposed to THS. This prevalence was significantly higher among those children whose parents increased tobacco consumption during confinement (40.5%), whose parents had lower or medium educational levels (42.9% and 41.7%), and with younger parents (24.8%). In contrast, the prevalence was significantly lower among those children living in homes with complete voluntary smoke restrictions (21.1%).Conclusions/Recommendations: To reduce THS exposure among children, it is important to work on information campaigns to raise awareness regarding THS exposure, promote recommendations to avoid exposure to THS, and develop legislation promoting smoke-free environments (in homes and vehicles).

Excess Mortality by Suicide Caused by COVID-19 in Japan

Background: Countermeasures against COVID-19 outbreak, such as lockdowns and voluntary restrictions against going out, adversely affect human stress and depress economic activity. Particularly, this stress might lead to suicide. Object: We examined excess mortality attributable to COVID-19 related suicide. Method: We applied the National Institute of Infectious Diseases (NIID) model to suicide deaths, by gender, throughout Japan during October 2009–January 2021. Effects of the great earthquake that struck eastern Japan on March 11, 2011 were incorporated into the estimation model. Results: Significant excess mortality from suicide was found during July–January for both genders. Its frequency was higher among females than among males. In total, 2276 cases of excess mortality were identified. Discussion and Conclusion: Excess mortality during the four months was more than twice that of COVID-19 deaths confirmed by PCR testing. Countermeasures against COVID-19 should be chosen carefully in light of suicide effects.

Demographics and exploitation of two Near Threatened freshwater eels, Anguilla bengalensis and Anguilla bicolor, in small‐scale subsistence fisheries and implications for conservation

Abstract Tropical freshwater eels (Anguilla bengalensis and Anguilla bicolor) contribute a major share of the world's wild‐caught eel production, having become the next major target owing to the declines in availability of both Anguilla japonica and Anguilla anguilla, species that have traditionally contributed to eel aquaculture and trade. Although both A. bengalensis and A. bicolor are assessed as Near Threatened on the International Union for Conservation of Nature Red List, these assessments are primarily based on anecdotal information and local knowledge on population declines. Demographics and exploitation levels of A. bengalensis and A. bicolor were determined from small coastal river systems, and their adjoining aquascapes in the Western Ghats hotspot of southern peninsular India, and the value of these data for future conservation planning discussed. The computed estimates of annual catch data for freshwater eels from the study region are between 0.17 (A. bicolor) to 0.30 t (A. bengalensis). Virtual population analysis of exploitation showed a drastic decline (in number) in the length groups >45 cm for both species, suggesting that they were less likely to attain their asymptotic length in the region. Current exploitation rates of A. bengalensis are unsustainable, and those for A. bicolor are almost close to reaching this level. Exploitation of all life stages from yellow eels to adults (29–171 cm) is likely to cause recruitment failure and significant mortality of spawning individuals of both species. An integrative conservation approach, including raising awareness (leading to voluntary restrictions), fishing closures in reservoirs, village‐level quotas, and regular monitoring of populations, will ensure a sustainable future for the freshwater eel species in the Western Ghats hotspot, and elsewhere in the tropics where these species are exploited.

Adaptive Travel Behaviors to Cope with COVID-19: A Swedish Qualitative Study Focusing on Everyday Leisure Trips

The COVID-19 pandemic has caused a rapid change in travel behavior for different types of trips, including everyday social and recreational leisure trips. People have used adaptive travel behaviors to cope with the new circumstances for activities and transport. Due to the Swedish strategy focusing on more voluntary restrictions, people have had reason to consider which trips and activities to skip and which to keep. The overall aim of the study is to explore and deepen the knowledge about adaptive behaviors used and seek to understand its possible implications for future travel behavior change towards sustainable mobility through the use of qualitative interviews focusing on everyday leisure trips. The results illustrate how people have used a range of adaptive behaviors to cope with the implications of the pandemic, with cancellation and change of transport mode being the ones most reflected upon by the interviewees. Further, the results reveal how the overall label “everyday leisure trips” in fact includes a variety of trip purposes that differ in terms of flexibility and importance and must thus be approached in different ways in transport policy measures.

Tariff and non-tariff instruments of OPEC+ trade wars

Under the influence of economic, technological and political factors, the oil market is prone to constant change, which requires analysis of its developmental trends. The purpose of this article is to do a comprehensive analysis of the impact of OPEC + countries on trade wars in the global oil market. The methodological basis of the study was the method of analysis, monitoring and grouping of subject-thematic materials through a logical sequence. The method of analysis is used to determine the features of world oil market globalization, followed by highlighting the advantages and disadvantages of its impact. The study then used monitoring to analyze the linkage of the generalized oil supply and demand balance over the past decade and the factors that affect the development of the oil market. Finally, the tariff and non-tariff instruments used in the OPEC + trade wars were grouped. It has been revealed that the interaction between the participants of the world oil market increases due to the excess of supply over demand within the global balance. This fact can lead to trade conflicts, including the use of non-tariff measures by OPEC + countries such as: voluntary state restrictions, license requirements, quarantine, quotas. In general, the results of the comprehensive analysis showed that the emergence of trade wars in a globalized oil market is influenced by the interaction of three components: institutional, economic and technological, which are complemented by the information base. However, at present, OPEC + performs the function of stabilizer, which reduces trade conflicts in the world oil market. The results obtained can be used in the development of strategies and methods of regulation of trade conflicts in the world oil market by both OPEC + countries and other countries of the world in the context of foreign policy.

Children\u2019s measured exposure to food and beverage advertising on television in Toronto (Canada), May 2011\u2013May 2019

ObjectiveExposure to unhealthy food advertising is a known determinant of children’s poor dietary behaviours. The purpose of this study was to quantify and characterize Canadian children’s exposure to food advertising on broadcast television and examine trends over time.MethodsObjectively measured advertising exposure data for 19 food categories airing on 30 stations broadcast in Toronto were licenced for May 2011 and May 2019. Using ad ratings data, the average number of food advertisements viewed by children aged 2–11 years, overall, by food category and by type of television station (child-appealing, adolescent-appealing and generalist stations), was estimated per time period.ResultsIn May 2019, children viewed an average of 136 food advertisements on television, 20% fewer than in May 2011. More than half of advertisements viewed in May 2019 promoted unhealthy food categories such as fast food (43% of exposure), candy (6%), chocolate (6%) and regular soft drinks (5%) and only 17% of their total exposure occurred on child-appealing stations. Between May 2011 and May 2019, children’s exposure increased the most, in absolute terms, for savory snack foods (+7.2 ad exposures/child), fast food (+5.4) and regular soft drinks (+5.3) with most of these increases occurring on generalist stations.ConclusionCanadian children are still exposed to advertisements promoting unhealthy food categories on television despite voluntary restrictions adopted by some food companies. Statutory restrictions should be adopted and designed such that children are effectively protected from unhealthy food advertising on both stations intended for general audiences and those appealing to younger audiences.

Voluntary fishing restrictions alone do not promote growth of bryozoan-dominated biogenic habitat on the Otago shelf, southeastern New Zealand

AbstractOn the continental shelf, New Zealand bryozoans dominate ecologically-important three-dimensional benthic habitat providing structural complexity which hosts a wide variety of fauna, including economically valuable species (e.g. oysters and blue cod). The association between these species and bryozoan-dominated biogenic habitat commonly results in trawling damage to the benthos; eliminating pressure from destructive fishing practices could support bryozoan regrowth. In 2002, a voluntary fishing restriction was designated over part of one such bryozoan-dominated biogenic habitat, but the efficacy of this ban has not been assessed. Statutory marine protected areas have been proposed in the same area; they aim to achieve bryozoan protection and recovery. A comparison of the bryozoan fauna using benthic images from 2003 and 2019 from the Otago shelf, South Island, New Zealand/Te Waipounamu, Aotearoa shows that a 17-year voluntary fishing ban has been ineffective at increasing the cover and richness of bryozoan-dominated biogenic habitat on the Otago shelf. This study provides a baseline for future monitoring and develops useful metrics for recovery, while calling for further research on the biology and ecology of habitat-forming bryozoans.

Evaluating Apple Inc Mobility Trend Data Related to the COVID-19 Outbreak in Japan: Statistical Analysis.

BackgroundIn Japan, as a countermeasure against the COVID-19 outbreak, both the national and local governments issued voluntary restrictions against going out from residences at the end of March 2020 in preference to the lockdowns instituted in European and North American countries. The effect of such measures can be studied with mobility data, such as data which is generated by counting the number of requests made to Apple Maps for directions in select countries/regions, sub-regions, and cities. ObjectiveWe investigate the associations of mobility data provided by Apple Inc and an estimate an an effective reproduction number R(t).MethodsWe regressed R(t) on a polynomial function of daily Apple data, estimated using the whole period, and analyzed subperiods delimited by March 10, 2020.ResultsIn the estimation results, R(t) was 1.72 when voluntary restrictions against going out ceased and mobility reverted to a normal level. However, the critical level of reducing R(t) to <1 was obtained at 89.3% of normal mobility.ConclusionsWe demonstrated that Apple mobility data are useful for short-term prediction of R(t). The results indicate that the number of trips should decrease by 10% until herd immunity is achieved and that higher voluntary restrictions against going out might not be necessary for avoiding a re-emergence of the outbreak.