Impact assessment of mobility restrictions, testing, and vaccination on the COVID-19 pandemic in India

  1. Jeonghyun Shin
  2. Quynh Long Khuong
  3. Kaja Abbas
  4. Juhwan Oh

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Abstract

Background

Before the availability of vaccines, countries largely relied on mobility restriction and testing to mitigate the COVID-19 pandemic. Our aim is to assess the combined impact of mobility restriction, testing, and vaccination on the COVID-19 pandemic in India.

Methods

We conducted a multiple regression analysis to assess the impact of mobility, testing, and vaccination on COVID-19 incidence between April 28, 2021 to November 24, 2021 using data from Our World in Data and Google Mobility Report. The 7-day moving average was applied to offset the daily fluctuations in the mobility and testing. Each independent variable was lagged to construct a temporal relationship, and waning vaccination efficacy was taken into consideration. We performed additional analysis for three time periods between March 28, 2020 to November 24, 2021 (1 st : March 28, 2020 ∼ October 7, 2020, 2 nd : October 8, 2020 ∼ April 27, 2021, 3 rd : April 28, 2021 ∼ November 24, 2021) to examine potential heterogeneity over time.

Results

Mobility (0.041, 95% CI: 0.033 to 0.048), testing (-0.008, 95% CI: -0.015 to -0.001), and vaccination (quadratic term: 0.004, 95% CI: 0.003 to 0.005, linear term: -0.130, 95% CI: -0.161 to -0.099) were all associated with COVID-19 incidence. For vaccination rate, the decrease of number of cases demonstrated a U-shaped curve, while mobility showed a positive association and testing showed an inverse association with COVID-19 incidence. Mobility restriction was effective during all three periods – March 28, 2020 to November 24, 2021 (0.009, 0.048, and 0.026 respectively). Testing was effective during the second and third period – October 8, 2020 to November 24, 2021 (-0.036, and -0.006 respectively).

Conclusion

Mobility restriction and testing were effective even in the presence of vaccination. This shows the positive value of mobility restrictions, testing, and vaccination from the health system perspective on COVID-19 prevention and control, especially with continual emergence of variants in India and globally. At the same time, this health system gain must be balanced with the challenges in the delivery of non-COVID health services and broader socio-economic impact in deciding the prolonged continuance of mobility restriction.

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  1. ScreenIT

    SciScore for 10.1101/2022.03.24.22272864: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    We have limitations in this analysis. Although the analysis was constructed to ensure a temporal relationship between the independent variables and dependent variable by a week, it is hard to conclude a causal relationship yet. We used daily statistics based on testing and were thus unable to analyze the number of quarantined people per case directly, which is an important element of the tracing-testing-isolation and quarantine policy. This may underestimate the impact of tracing-testing-isolation and quarantine when tests are conveniently done decoupled with trace and quarantine. Additionally, we conducted the analysis on a national level. So, the heterogeneity between states in the COVID-19 prevention and control policies and practices is not taken into account in this analysis. The emergence of new variants, waning vaccination effectivity, and continued breakthrough infections are possible contributing factors to the persistent effectiveness of mobility restrictions and testing. The emergence of highly contagious variant viruses, such as the Delta and Omicron continue to threaten the health system15,16. Also, studies show that the effect of currently available vaccinations wane over time, both in serology-based laboratory studies and in empirical studies17,18. Studies have also reported breakthrough infections that occur among fully vaccinated population (those who have completed their 2nd dose)19. In the presence of such circumstances, high vaccination rates alone do not ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2022.03.24.22272864 on medRxiv