跨区域分析在“与 COVID-19 共存”的过渡阶段东南亚地区人类流动性与 COVID-19 感染之间的关系。

Cross-regional analysis of the association between human mobility and COVID-19 infection in Southeast Asia during the transitional period of "living with COVID-19".

机构信息

GeoSpatialX Lab, Department of Geography, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

GeoSpatialX Lab, Department of Geography, National University of Singapore, Singapore; Department of Urban Planning and Design, Urban Systems Institute, And the Social Infrastructure for Equity and Wellbeing Lab, The University of Hong Kong, Hong Kong Special Administrative Region of China.

出版信息

Health Place. 2023 May;81:103000. doi: 10.1016/j.healthplace.2023.103000. Epub 2023 Mar 13.

Abstract

BACKGROUND

In response to COVID-19, Southeast Asian (SEA) countries had imposed stringent lockdowns and restrictions to mitigate the pandemic ever since 2019. Because of a gradually boosting vaccination rate along with a strong demand for economic recovery, many governments have shifted the intervention strategy from restrictions to "Living with COVID-19" where people gradually resumed their normal activities since the second half of the year 2021. Noticeably, timelines for enacting the loosened strategy varied across Southeast Asian countries, which resulted in different patterns of human mobility across space and time. This thus presents an opportunity to study the relationship between mobility and the number of infection cases across regions, which could provide support for ongoing interventions in terms of effectiveness.

OBJECTIVE

This study aimed to investigate the association between human mobility and COVID-19 infections across space and time during the transition period of shifting strategies from restrictions to normal living in Southeast Asia. Our research results have significant implications for evidence-based policymaking at the present of the COVID-19 pandemic and other public health issues.

METHODS

We aggregated weekly average human mobility data derived from the Facebook origin and destination Movement dataset. and weekly average new cases of COVID-19 at the district level from 01-Jun-2021 to 26-Dec-2021 (a total of 30 weeks). We mapped the spatiotemporal dynamics of human mobility and COVID-19 cases across countries in SEA. We further adopted the Geographically and Temporally Weighted Regression model to identify the spatiotemporal variations of the association between human mobility and COVID-19 infections over 30 weeks. Our model also controls for socioeconomic status, vaccination, and stringency of intervention to better identify the impact of human mobility on COVID-19 spread.

RESULTS

The percentage of districts that presented a statistically significant association between human mobility and COVID-19 infections generally decreased from 96.15% in week 1 to 90.38% in week 30, indicating a gradual disconnection between human mobility and COVID-19 spread. Over the study period, the average coefficients in 7 SEA countries increased, decreased, and finally kept stable. The association between human mobility and COVID-19 spread also presents spatial heterogeneity where higher coefficients were mainly concentrated in districts of Indonesia from week 1 to week 10 (ranging from 0.336 to 0.826), while lower coefficients were mainly located in districts of Vietnam (ranging from 0.044 to 0.130). From week 10 to week 25, higher coefficients were mainly observed in Singapore, Malaysia, Brunei, north Indonesia, and several districts of the Philippines. Despite the association showing a general weakening trend over time, significant positive coefficients were observed in Singapore, Malaysia, western Indonesia, and the Philippines, with the relatively highest coefficients observed in the Philippines in week 30 (ranging from 0.101 to 0.139).

CONCLUSIONS

The loosening interventions in response to COVID-19 in SEA countries during the second half of 2021 led to diverse changes in human mobility over time, which may result in the COVID-19 infection dynamics. This study investigated the association between mobility and infections at the regional level during the special transitional period. Our study has important implications for public policy interventions, especially at the later stage of a public health crisis.

摘要

背景

自 2019 年以来,东南亚(SEA)国家为了减轻疫情影响,一直实施严格的封锁和限制措施。由于疫苗接种率逐渐提高,以及对经济复苏的强烈需求,许多政府已将干预策略从限制转向“与新冠共存”,自 2021 年下半年以来,人们逐渐恢复正常活动。值得注意的是,东南亚各国实施宽松策略的时间表各不相同,这导致了不同的人口流动模式在空间和时间上的差异。这为研究人口流动与区域内感染病例数量之间的关系提供了机会,这可以为当前的疫情干预措施提供支持。

目的

本研究旨在调查在东南亚国家从限制措施向正常生活过渡期间,人口流动与时空新冠感染之间的关系。我们的研究结果对当前新冠疫情和其他公共卫生问题的循证决策具有重要意义。

方法

我们汇总了 2021 年 6 月 1 日至 2021 年 12 月 26 日(共 30 周)期间每周平均来自 Facebook 源和目的地移动数据集的人口流动数据,以及每个区每周平均新增新冠病例数。我们绘制了东南亚各国人口流动和新冠病例的时空动态图。我们进一步采用地理和时间加权回归模型,以确定 30 周内人口流动与新冠感染之间的时空变化关系。我们的模型还控制了社会经济地位、疫苗接种和干预措施的严格程度,以更好地确定人口流动对新冠传播的影响。

结果

在第 1 周到第 30 周,与人口流动和新冠感染之间存在统计学显著关联的区的百分比总体上从 96.15%下降到 90.38%,表明人口流动和新冠传播之间的联系逐渐减弱。在整个研究期间,7 个 SEA 国家的平均系数先增加后减少,最后保持稳定。人口流动与新冠传播之间的关联也存在空间异质性,较高的系数主要集中在印度尼西亚的区,从第 1 周到第 10 周(范围从 0.336 到 0.826),而较低的系数主要位于越南的区(范围从 0.044 到 0.130)。从第 10 周到第 25 周,较高的系数主要出现在新加坡、马来西亚、文莱、印度尼西亚北部和菲律宾的几个区。尽管随着时间的推移,关联呈现出总体减弱的趋势,但在新加坡、马来西亚、印度尼西亚西部和菲律宾仍观察到显著的正系数,在第 30 周,菲律宾的系数相对较高(范围从 0.101 到 0.139)。

结论

东南亚国家在 2021 年下半年放宽了对新冠的干预措施,导致人口流动随时间发生了多样化的变化,这可能导致新冠感染动态的变化。本研究在特殊过渡时期调查了区域层面上的流动和感染之间的关系。本研究对公共政策干预具有重要意义,特别是在公共卫生危机的后期阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8788/10008814/e0673f78c721/gr1_lrg.jpg

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