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Associations of Government-Mandated Closures and Restrictions With Aggregate Mobility Trends and SARS-CoV-2 Infections in Nigeria

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To identify the key insights or developments described in this article
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Key Points

Question  Were coronavirus disease 2019 (COVID-19)–related government-mandated closures and restrictions associated with changes in aggregate mobility and the spread of COVID-19 in Nigeria?

Findings  In this cross-sectional study of data from smartphone users throughout Nigeria, closures and restrictions had significant associations with aggregate mobility trends and may have been associated with averting up 5.8 million severe acute respiratory syndrome coronavirus 2 infections over the study period. Accelerated community spread of COVID-19 was noted in residential areas, transit hubs, and workplaces.

Meaning  These findings suggest that government-mandated closures and restrictions may have slowed the spread of COVID-19 in Nigeria.

Abstract

Importance  To prepare for future coronavirus disease 2019 (COVID-19) waves, Nigerian policy makers need insights into community spread of COVID-19 and changes in rates of infection associated with government-mandated closures and restrictions.

Objectives  To measure the association of closures and restrictions with aggregate mobility and the association of mobility with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and to characterize community spread of COVID-19.

Design, Setting, and Participants  This cross-sectional study used aggregated anonymized mobility data from smartphone users in Nigeria who opted to provide location history (from a pool of up to 40 million individuals) collected between February 27 and July 21, 2020. The analyzed data included daily counts of confirmed SARS-CoV-2 infections and daily changes in aggregate mobility across 6 categories: retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residential. Closures and restrictions were initiated on March 30, 2020, and partially eased on May 4, 2020.

Main Outcomes and Measures  Interrupted time series were used to measure associations of closures and restrictions with aggregate mobility. Negative binomial regression was used to evaluate associations between confirmed SARS-CoV-2 infections and mobility categories. Averted infections were estimated by subtracting cumulative confirmed infections from estimated infections assuming no closures and restrictions.

Results  Closures and restrictions had negative associations with mean change in daily aggregate mobility in retail and recreation (–46.87 [95% CI, –55.98 to –37.76] percentage points; P < .001), grocery and pharmacy (–28.95 [95% CI, –40.12 to –17.77] percentage points; P < .001), parks (–43.59 [95% CI, –49.89 to –37.30] percentage points; P < .001), transit stations (–47.44 [95% CI, –56.70 to –38.19] percentage points; P < .001), and workplaces (–53.07 [95% CI, –67.75 to –38.39] percentage points; P < .001) and a positive association with mobility in residential areas (24.10 [95% CI, 19.14 to 29.05] percentage points; P < .001). Most of these changes reversed after closures and restrictions were partially eased (retail and recreation: 14.63 [95% CI, 10.95 to 18.30] percentage points; P < .001; grocery and pharmacy: 15.29 [95% CI, 10.90 to 19.67] percentage points; P < .001; parks: 6.48 [95% CI, 3.98 to 8.99] percentage points; P < .001; transit stations: 17.93 [95% CI, 14.03 to 21.83] percentage points; P < .001; residential: –5.59 [95% CI, –9.08 to –2.09] percentage points; P = .002). Additionally, every percentage point increase in aggregate mobility was associated with higher incidences of SARS-CoV-2 infection in residential areas (incidence rate ratio [IRR], 1.03 [95% CI, 1.00 to 1.07]; P = .04), transit stations (IRR, 1.02 [95% CI, 1.00 to 1.03]; P = .008), and workplaces (IRR, 1.01 [95% CI, 1.00 to 1.02]; P = .04). Lastly, closures and restrictions may have been associated with averting up to 5.8 million SARS-CoV-2 infections over the study period.

Conclusions and Relevance  In this cross-sectional study, closures and restrictions had significant associations with aggregate mobility and were associated with decreased SARS-CoV-2 infections. These findings suggest that future anticontagion measures need better infection control and contact tracing in residential areas, transit stations, and workplaces.

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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: November 10, 2020.

Published: January 20, 2021. doi:10.1001/jamanetworkopen.2020.32101

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Erim DO et al. JAMA Network Open.

Corresponding Author: Daniel O. Erim, MD, PhD, MSc, Parexel International, Durham, 2520 Meridian Pkwy, No. 200, Durham, NC 27713 (erim.daniel@alumni.harvard.edu).

Author Contributions: Drs Erim and Agaku had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: D. Erim, Oke, Adisa, Odukoya, T. Erim, Tsafa, Meremikwu, Agaku.

Acquisition, analysis, or interpretation of data: D. Erim, Odukoya, Ayo-Yusuf, Tsafa, Agaku.

Drafting of the manuscript: D. Erim, Tsafa, Agaku.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: D. Erim, Odukoya, Agaku.

Administrative, technical, or material support: D. Erim, Oke, Adisa, T. Erim, Tsafa, Agaku.

Supervision: Meremikwu.

Conflict of Interest Disclosures: None reported.

Disclaimer: The views represented in this work are those of the authors and not their institutions.

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