[Skip to Content]
[Skip to Content Landing]

Association of Mobile Phone Location Data Indications of Travel and Stay-at-Home Mandates With COVID-19 Infection Rates in the US

Educational Objective
To understand what mobile phone location data can reveal about the efficiency of Travel and Stay-at-Home mandates
1 Credit CME
Key Points

Question  Did human mobility patterns change during stay-at-home orders and were the mobility changes associated with the coronavirus disease 2019 (COVID-19) curve?

Findings  This cross-sectional study using anonymous location data from more than 45 million mobile phones found that median travel distance decreased and stay-at-home time increased across the nation, although there was geographic variation. State-specific empirical doubling time of total COVID-19 cases increased (ie, the spread reduced) significantly after stay-at-home orders were put in place.

Meaning  These findings suggest that stay-at-home social distancing mandates were associated with the reduced spread of COVID-19 when they were followed.

Abstract

Importance  A stay-at-home social distancing mandate is a key nonpharmacological measure to reduce the transmission rate of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), but a high rate of adherence is needed.

Objective  To examine the association between the rate of human mobility changes and the rate of confirmed cases of SARS-CoV-2 infection.

Design, Setting, and Participants  This cross-sectional study used daily travel distance and home dwell time derived from millions of anonymous mobile phone location data from March 11 to April 10, 2020, provided by the Descartes Labs and SafeGraph to quantify the degree to which social distancing mandates were followed in the 50 US states and District of Columbia and the association of mobility changes with rates of coronavirus disease 2019 (COVID-19) cases.

Exposure  State-level stay-at-home orders during the COVID-19 pandemic.

Main Outcomes and Measures  The main outcome was the association of state-specific rates of COVID-19 confirmed cases with the change rates of median travel distance and median home dwell time of anonymous mobile phone users. The increase rates are measured by the exponent in curve fitting of the COVID-19 cumulative confirmed cases, while the mobility change (increase or decrease) rates were measured by the slope coefficient in curve fitting of median travel distance and median home dwell time for each state.

Results  Data from more than 45 million anonymous mobile phone devices were analyzed. The correlation between the COVID-19 increase rate and travel distance decrease rate was –0.586 (95% CI, –0.742 to –0.370) and the correlation between COVID-19 increase rate and home dwell time increase rate was 0.526 (95% CI, 0.293 to 0.700). Increases in state-specific doubling time of total cases ranged from 1.0 to 6.9 days (median [interquartile range], 2.7 [2.3-3.3] days) before stay-at-home orders were enacted to 3.7 to 30.3 days (median [interquartile range], 6.0 [4.8-7.1] days) after stay-at-home social distancing orders were put in place, consistent with pandemic modeling results.

Conclusions and Relevance  These findings suggest that stay-at-home social distancing mandates, when they were followed by measurable mobility changes, were associated with reduction in COVID-19 spread. These results come at a particularly critical period when US states are beginning to relax social distancing policies and reopen their economies. These findings support the efficacy of social distancing and could help inform future implementation of social distancing policies should they need to be reinstated during later periods of COVID-19 reemergence.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: July 31, 2020.

Published: September 8, 2020. doi:10.1001/jamanetworkopen.2020.20485

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Gao S et al. JAMA Network Open.

Corresponding Authors: Song Gao, PhD (song.gao@wisc.edu) and Jonathan A. Patz, MD (patz@wisc.edu), University of Wisconsin–Madison, 550 N Park St, Madison, WI 53706.

Author Contributions: Dr Gao had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Gao, Kang, Sethi, Yandell, Patz.

Acquisition, analysis, or interpretation of data: Gao, Rao, Kang, Liang, Kruse, Dopfer, Sethi, Mandujano Reyes.

Drafting of the manuscript: Gao, Rao, Kang, Liang, Kruse, Dopfer, Sethi, Mandujano Reyes, Patz.

Critical revision of the manuscript for important intellectual content: Gao, Rao, Kang, Sethi, Yandell, Patz.

Statistical analysis: Gao, Rao, Kang, Liang, Dopfer, Mandujano Reyes, Yandell.

Obtained funding: Gao.

Administrative, technical, or material support: Gao, Liang, Yandell.

Supervision: Gao.

Conflict of Interest Disclosures: Dr Gao reported receiving grants from National Science Foundation during the conduct of the study. No other disclosures were reported.

Funding/Support: Drs Gao and Patz received funding from grant No. BCS-2027375 from the National Science Foundation.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

References
1.
Centers for Disease Control and Prevention. COVID-19 cases in the U.S. Accessed April 12, 2020. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
2.
Pan  A , Liu  L , Wang  C ,  et al.  Association of public health interventions with the epidemiology of the COVID-19 outbreak in Wuhan, China.   JAMA. 2020;323(19):1915-1923. doi:10.1001/jama.2020.6130 PubMedGoogle ScholarCrossref
3.
Hartley  DM , Perencevich  EN .  Public health interventions for COVID-19: emerging evidence and implications for an evolving public health crisis.   JAMA. 2020;323(19):1908-1909. doi:10.1001/jama.2020.5910 PubMedGoogle ScholarCrossref
4.
Lai  S , Ruktanonchai  NW , Zhou  L ,  et al. Effect of non-pharmaceutical interventions for containing the COVID-19 outbreak: an observational and modelling study. medRxiv. Preprint posted online March 13, 2020. doi:10.1101/2020.03.03.20029843
5.
Chinazzi  M , Davis  JT , Ajelli  M ,  et al.  The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak.   Science. 2020;368(6489):395-400. doi:10.1126/science.aba9757 PubMedGoogle Scholar
6.
Tian  H , Liu  Y , Li  Y ,  et al.  An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China.   Science. 2020;368(6491):638-642. doi:10.1126/science.abb6105 PubMedGoogle ScholarCrossref
7.
Gao  S , Rao  J , Kang  Y , Liang  Y , Kruse  J .  Mapping county-level mobility pattern changes in the United States in response to COVID-19.   SIGSPATIAL Special. 2020;12(1):16-26. doi:10.1145/3404820.3404824Google ScholarCrossref
8.
Warren  MS , Skillman  SW . Mobility changes in response to COVID-19. arXiv. Preprint posted online March 31, 2020.
9.
Zhang  L , Ghader  S , Pack  ML ,  et al. An interactive COVID-19 mobility impact and social distancing analysis platform. medRxiv. Preprint posted online May 5, 2020. doi:10.1101/2020.04.29.20085472
10.
Zhou  C , Su  F , Pei  T ,  et al.  COVID-19: Challenges to GIS with Big Data.   Geogr Sustainability. 2020;1(1):77-87. doi:10.1016/j.geosus.2020.03.005Google ScholarCrossref
11.
Centers for Disease Control and Prevention. Social distancing, quarantine, and isolation. Accessed April 12, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html
12.
Gao  S , Mai  G.  Mobile GIS and location-based services. In: Huang  B , COVA  TJ , Tsou  MH , eds.  Comprehensive Geographic Information Systems. Elsevier; 2017:384-397.
13.
Buckee  CO , Balsari  S , Chan  J ,  et al.  Aggregated mobility data could help fight COVID-19.   Science. 2020;368(6487):145-146. doi:10.1126/science.abb8021PubMedGoogle Scholar
14.
Centers for Disease Control and Prevention. Similarities and differences between flu and COVID-19. Accessed July 10, 2020. https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm
15.
GitHub. Coronadatascraper. Accessed April 12, 2020. https://github.com/covidatlas/coronadatascraper
16.
US Census Bureau. American Community Survey. Accessed April 12, 2020. https://www.census.gov/programs-surveys/acs
17.
US Census Bureau. TIGER/Line Shapefile, 2017, 2010 nation, U.S. Census Urban Area National. Updated October 17, 2019. Accessed April 12, 2020. https://catalog.data.gov/dataset/tiger-line-shapefile-2017-2010-nation-u-s-2010-census-urban-area-national
18.
Cori  A , Ferguson  NM , Fraser  C , Cauchemez  S .  A new framework and software to estimate time-varying reproduction numbers during epidemics.   Am J Epidemiol. 2013;178(9):1505-1512. doi:10.1093/aje/kwt133 PubMedGoogle ScholarCrossref
19.
Thompson  RN , Stockwin  JE , van Gaalen  RD ,  et al.  Improved inference of time-varying reproduction numbers during infectious disease outbreaks.   Epidemics. 2019;29:100356. doi:10.1016/j.epidem.2019.100356 PubMedGoogle Scholar
20.
Vynnycky  E , White  R .  An Introduction to Infectious Disease Modelling. Oxford University Press; 2010.
21.
Lin  J.   Divergence measures based on the Shannon entropy.   IEEE Transactions on Information Theory. 1991;37(1):145-151. doi:10.1109/18.61115Google ScholarCrossref
22.
Maier  BF , Brockmann  D .  Effective containment explains subexponential growth in confirmed cases of recent COVID-19 outbreak in Mainland China.   Science. 2020;368(6492):742-746. doi:10.1126/science.abb4557 PubMedGoogle ScholarCrossref
23.
Sanche  S , Lin  YT , Xu  C , Romero-Severson  E , Hengartner  N , Ke  R .  High contagiousness and rapid spread of severe acute respiratory syndrome coronavirus 2.   Emerg Infect Dis. 2020;26(7):1470-1477. doi:10.3201/eid2607.200282 PubMedGoogle ScholarCrossref
24.
Sen  S , Karaca-Mandic  P , Georgiou  A .  Association of stay-at-home orders with COVID-19 hospitalizations in 4 states.   JAMA. 2020;323(24):2522-2524. doi:10.1001/jama.2020.9176 PubMedGoogle ScholarCrossref
25.
Zhu  J . The ten-hundred plot on COVID-19. Accessed April 12, 2020. http://pages.cs.wisc.edu/~jerryzhu/COVID19/index.html
26.
González  MC , Hidalgo  CA , Barabási  AL .  Understanding individual human mobility patterns.   Nature. 2008;453(7196):779-782. doi:10.1038/nature06958 PubMedGoogle ScholarCrossref
27.
Song  C , Qu  Z , Blumm  N , Barabási  AL .  Limits of predictability in human mobility.   Science. 2010;327(5968):1018-1021. doi:10.1126/science.1177170 PubMedGoogle ScholarCrossref
28.
Kang  C , Ma  X , Tong  D , Liu  Y .  Intra-urban human mobility patterns: an urban morphology perspective.   Physica A. 2012;391(4):1702-1717. doi:10.1016/j.physa.2011.11.005Google ScholarCrossref
29.
Gao  S.   Spatio-temporal analytics for exploring human mobility patterns and urban dynamics in the mobile age.   Spatial Cogn Comp. 2015;15(2):86-114. doi:10.1080/13875868.2014.984300Google ScholarCrossref
30.
Yuan  Y , Raubal  M .  Analyzing the distribution of human activity space from mobile phone usage: an individual and urban-oriented study.   Int J Geogr Inf Sci. 2016;30(8):1594–1621. doi:10.1080/13658816.2016.1143555Google ScholarCrossref
31.
Pullano  G , Valdano  E , Scarpa  N , Rubrichi  S , Colizza  V . Population mobility reductions during COVID-19 epidemic in France under lockdown. medRxiv. Preprint published online June 1, 2020. doi:10.1101/2020.05.29.20097097
32.
Huang  Q , Wong  DW .  Activity patterns, socioeconomic status and urban spatial structure: what can social media data tell us?   Int J Geogr Inf Sci. 2016;30(9):1873-1898. doi:10.1080/13658816.2016.1145225Google ScholarCrossref
33.
Huang  X , Li  Z , Jiang  Y , Li  X , Porter  D . Twitter, human mobility, and COVID-19. arXiv. Preprint published online June 24, 2020.
34.
Prestby  T , App  J , Kang  Y , Gao  S .  Understanding neighborhood isolation through spatial interaction network analysis using location big data.   Environ Plann A. 2020;52(6):1027-1031. doi:10.1177/0308518X19891911Google ScholarCrossref
35.
Liang  Y , Gao  S , Cai  Y , Foutz  NZ , Wu  L .  Calibrating the dynamic Huff model for business analysis using location big data.   Trans GIS. 2020;24(3):681-703. doi:10.1111/tgis.12624Google ScholarCrossref
36.
Wu  L , Zhi  Y , Sui  Z , Liu  Y .  Intra-urban human mobility and activity transition: evidence from social media check-in data.   PLoS One. 2014;9(5):e97010. doi:10.1371/journal.pone.0097010 PubMedGoogle Scholar
37.
Shaw  SL , Tsou  MH , Ye  X .  Human dynamics in the mobile and big data era.   Int J Geogr Inf Sci. 2016;30(9):1687-1693. doi:10.1080/13658816.2016.1164317Google ScholarCrossref
38.
Kang  Y , Zhang  F , Peng  W ,  et al  Understanding house price appreciation using multi-source big geo-data and machine learning.   Land Use Policy. 2020:104919. doi:10.1016/j.landusepol.2020.104919Google Scholar
39.
Ferretti  L , Wymant  C , Kendall  M ,  et al.  Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing.   Science. 2020;368(6491):eabb6936. doi:10.1126/science.abb6936 PubMedGoogle Scholar
40.
Li  R , Pei  S , Chen  B ,  et al.  Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2).   Science. 2020;368(6490):489-493. doi:10.1126/science.abb3221 PubMedGoogle ScholarCrossref
41.
Zhao  Z , Shaw  SL , Xu  Y , Lu  F , Chen  J , Yin  L .  Understanding the bias of call detail records in human mobility research.   Int J Geogr Inf Sci. 2016;30(9):1738-1762. doi:10.1080/13658816.2015.1137298Google ScholarCrossref
42.
Jiang  J , Li  Q , Tu  W , Shaw  SL , Yue  Y .  A simple and direct method to analyse the influences of sampling fractions on modelling intra-city human mobility.   Int J Geogr Inf Sci. 2019;33(3):618–644. doi:10.1080/13658816.2018.1552964Google ScholarCrossref
43.
Xu  Y , Belyi  A , Bojic  I , Ratti  C .  Human mobility and socioeconomic status: analysis of Singapore and Boston.   Comput Environ Urban Syst. 2018;72:51-67. doi:10.1016/j.compenvurbsys.2018.04.001Google ScholarCrossref
44.
Li  M , Gao  S , Lu  F , Zhang  H .  Reconstruction of human movement trajectories from largescale low-frequency mobile phone data.   Comput Environ Urban Syst. 2019;77:101346. doi:10.1016/j.compenvurbsys.2019.101346Google Scholar
45.
de Montjoye  YA , Hidalgo  CA , Verleysen  M , Blondel  VD .  Unique in the crowd: the privacy bounds of human mobility.   Sci Rep. 2013;3:1376. doi:10.1038/srep01376 PubMedGoogle ScholarCrossref
46.
Tsou  MH .  Research challenges and opportunities in mapping social media and Big Data.   Cartography Geogr Inf Sci. 2015;42(supp 1):70-74. doi:10.1080/15230406.2015.1059251Google ScholarCrossref
47.
McKenzie  G , Keßler  C , Andris  C .  Geospatial privacy and security.   J Spatial Inf Sci. 2019;2019(19):53-55. doi:10.5311/JOSIS.2019.19.608Google Scholar
48.
de Montjoye  YA , Gambs  S , Blondel  V ,  et al.  On the privacy-conscientious use of mobile phone data.   Sci Data. 2018;5(1):180286. doi:10.1038/sdata.2018.286 PubMedGoogle Scholar
49.
Jewell  NP , Lewnard  JA , Jewell  BL .  Predictive mathematical models of the COVID-19 pandemic: underlying principles and value of projections.   JAMA. 2020;323(19):1893-1894. doi:10.1001/jama.2020.6585 PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close
Close

Lookup An Activity

or

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close