Background: Travel patterns of humans play a major part in the spread of infectious diseases. This was evident in the geographical spread of COVID-19 in the United States. However, the impact of this mobility and the transmission of the virus due to local travel, compared to the population traveling across state boundaries, is unknown. This study evaluates the impact of local vs. visitor mobility in understanding the growth in the number of cases for infectious disease outbreaks.
Methods: We use two different mobility metrics, namely the local risk and visitor risk extracted from trip data generated from anonymized mobile phone data across all 50 states in the United States. We analyzed the impact of just using local trips on infection spread and infection risk potential generated from visitors' trips from various other states. We used the Diebold-Mariano test to compare across three machine learning models. Finally, we compared the performance of models, including visitor mobility for all the three waves in the United States and across all 50 states.
Results: We observe that visitor mobility impacts case growth and that including visitor mobility in forecasting the number of COVID-19 cases improves prediction accuracy by 34. We found the statistical significance with respect to the performance improvement resulting from including visitor mobility using the Diebold-Mariano test. We also observe that the significance was much higher during the first peak March to June 2020.
Conclusion: With presence of cases everywhere (i.e. local and visitor), visitor mobility (even within the country) is shown to have significant impact on growth in number of cases. While it is not possible to account for other factors such as the impact of interventions, and differences in local mobility and visitor mobility, we find that these observations can be used to plan for both reopening and limiting visitors from regions where there are high number of cases.