Effects of Coronavirus Disease (COVID-19) Related Contact Restrictions in Germany, March to May 2020, on the Mobility and Relation to Infection Patterns.

In an effort to contain the spread of COVID-19, Germany has gradually implemented mobility restrictions culminating in a partial lockdown and contact restrictions on 22 March. The easing of the restrictions began 1 month later, on 20 April. Analysis of the consequences of these measures for mobility and infection incidence is of public health interest. A dynamic cohort of about 2,000 individuals in Germany aged 16-89 years provided individual information on demographic variables, and their continuous geolocation via a smartphone app. Using interrupted time series analysis, we investigated mobility by age, sex, and previous mobility habits from 13 January until 17 May 2020, measured as median daily distance traveled before and after restrictions were introduced. Furthermore, we have investigated the association of mobility with the number of new cases and the reproduction number. Median daily distance traveled decreased substantially in total and homogeneously across all subgroups considered. The decrease was strongest in the last week of March followed by a slight increase. Relative reduction of mobility developed parallel with number of new cases and the daily estimated reproduction number in the weeks after contact restrictions were implemented. The increase in mobility from mid-April onwards, however, did not result in increased case numbers but in further decrease. Other behavioral changes, e.g., wearing masks, individual distancing, or general awareness of the COVID-19 hazards may have contributed to the observed further reduction in case numbers and constant reproduction numbers below one until mid-July.