key: cord-0971579-rkole2uo
authors: Kurian, Shyam J.; Bhatti, Atiq ur Rehman; Ting, Henry H.; Storlie, Curtis; Shah, Nilay; Bydon, Mohamad
title: Utilization of Mobility Data in The Fight Against COVID-19
date: 2020-10-27
journal: Mayo Clin Proc Innov Qual Outcomes
DOI: 10.1016/j.mayocpiqo.2020.10.003
sha: ded77bd68b564a3de97d67ddb0c417a2f747f597
doc_id: 971579
cord_uid: rkole2uo

nan

As the coronavirus 2019 (COVID-19) pandemic continues to evolve, evaluating the impact of stay-at-home executive orders and individual social behaviors are paramount. Although stay-athome orders and social distancing have successfully "flattened the curve", states are relaxing these executive orders and businesses are beginning to reopen. 1 The impact of businesses reopening on social mobility and COVID-19 infection spread are uncertain, and there is a possibility a second spike in COVID-19 cases will occur. With less than 5% of our population with a positive serology indicating prior infection and deployment of an effective vaccine 12-18 months away, individual behaviors including social distancing, facemasks, and hand hygiene remain the pillars for prevention of spread of infection. By analyzing social mobility data, researchers can evaluate if changing social mobility in outdoor or indoor settings influence COVID-19 infection spread in realtime.

Social mobility data has been made publicly available by a number of groups to enable research on the impact of changes in social mobility. Four major organizations currently sharing their mobility data are Google, Apple, Facebook, and Unacast. 2-5 Google collects mobility information through its Google Maps app, and then aggregates and reports the information with no identifiable information. They break down mobility based on the type of environment; this includes retail and recreation, grocery, pharmacy, parks, transit stations, workplaces, and residential. 2 Apple follows a similar pattern of reporting data collected through Apple Maps. They, however, report mobility data based on transportation modality; this includes walking, driving, and transit. 3 Facebook has partnered with other organizations via the COVID-19 Mobility Data Network and allows collaborators in this network to utilize their mobility data. Facebook reports movement trends based on baselines from February and informs researchers how often people in specific J o u r n a l P r e -p r o o f regions choose to either stay-at-home or travel based on their original population baselines. 4 Unacast, on the other hand, is unique in that they provide compiled mobility data from various partner applications. Their partnered apps have GPS functions that consumers opt into when using the app, and the mobility data from these various sources is compiled and analyzed to create one generalized data set. Another unique feature Unacast offers is proximity data, which reports close encounters between two devices per square kilometer. This is reported as a fraction of precoronavirus baseline. 5 As outlined, all four of these organizations provide different variations of mobility data that could potentially be combined and used as a powerful tool to track the efficacy of COVID-19 interventions and detect new hotspots.

Researchers have already started to analyze mobility data and the impact movement has on COVID-19 spread. Chang et al. analyzed Facebook data and developed a metro population model to assess the risk of viral spread in high-risk areas based on human mobility and the impact of travel restrictions. 6, 7 They found that intracity travel reductions had a higher impact on overall infection numbers, while intercity travel reductions narrowed the scope of the outbreak. Furthermore, they were able to pinpoint areas that were more highly connected and would consequently serve as higher risk zones during an outbreak. Jia and colleagues looked into spatiotemporal datasets obtained from cell phones and developed a "risk source" model to observe the spread of disease from the epicenter in Wuhan based on the geographical flow of the public to and from Wuhan, indexing the community transmission risk over time. 8 Their model was able to estimate the location, intensity, and timing of outbreaks as the coronavirus spread throughout China. There were certainly deviations from their model when compared to actual cases, but nevertheless they showed that population mobility data can serve as a powerful tool during a pandemic.

As the pandemic progresses, innovations such as geospatial data tracking applications will be key for identifying new cases of COVID-19. Apps that can detect other users who have come into close proximity of a COVID-19 positive individual could change management in the midst of this pandemic by alerting exposed individuals and recommending testing options. Google and Apple believe this could be accomplished by enabling Bluetooth on smartphones, and this functionality has already been demonstrated by a novel Singaporean app called TraceTogether, which is an optional download for the public. If a user does contract COVID-19, the country's Ministry of Health can look at the information stored on the device to "identify a list of other app users who were in close contact with the infected person during the previous 14 days." 9 There are certainly privacy concerns that come along with this approach. 10 Applications could also be used to regulate appropriate distancing between individuals by alerting users that they are too close to one another via their smartphones. An application in China with a similar aim has been used to record proximity events between COVID negative individuals and positive individuals, but has taken things one step further. Individuals in China are required to use the app which alerts them whether they are cleared to be mobilizing or whether they need to go home based on certain individual criteria. If the app states that they need to quarantine, they must stay at home or risk being penalized by law enforcement, who have access to the status of everyone using the app. 11 China is a country known to have loose laws protecting consumer privacy, and an app like this could not exist in the United States. However, it does emphasize the scope of how impactful mobility data could potentially be.

Implementing consumer location tracking specifically for disease surveillance does risk consumers' digital privacy. Consumer mobility is already tracked, and data is gathered by J o u r n a l P r e -p r o o f telecommunication companies and other applications using geospatial information. Many insurance companies even provide significant discounts on car insurance premiums if you agree to install a GPS tracking device in your car. 12 However, privacy concerns should be strongly considered and balanced with public health benefits prior to the implementation of new laws and policies that give researchers open access to mobility databases. There are certainly measures that can be taken to avoid substantial intrusion to privacy.

The COVID-19 Mobility Data Network was created with the aim of gathering and analyzing confidential data from technology companies to guide officials involved in formulating public health policies. The approach of this network is to respect consumer privacy while providing highquality data for research. By anonymizing and aggregating their data, organizations such as Google, Apple, Facebook, and Unacast have introduced a safe way to disseminate critical information while guarding against unauthorized access to identifiable consumer information. Furthermore, individuals using applications from these organization have opted into GPS tracking, although sometimes unknowingly. Apps will often ask for GPS access when you open them for the first time, and state it will improve the apps functionality. Most people just click "accept" without giving the agreement much thought. Importantly, this is still an opt in situation, and users can opt out at any time; the default is an opt out. Giving the consumer control of this function is paramount, and organizations need to clearly state how to opt in and out rather than giving vague messages about application improvement. Also, there is a distinction to be drawn here for making data publicly available for research versus using the data to serve the consumer directly. With regard to the collection process, Apple's mobility system has random and rotating identifiers that are continuously reset to prevent consumer profile tracing. 13 Google and Facebook have adopted a J o u r n a l P r e -p r o o f differential privacy system which integrates artificial noise to collect user data without compromising consumer privacy. 14 Certain countries with aggressive surveillance systems using identifiable data in response to COVID-19 have undermined public privacy and have been criticized for this; these countries include China, South Korea, and Israel. During times like this, it is important that international rules and regulations be implemented for organizations tracking and providing public mobility data to ensure appropriate protection of personal identifiable information (PII) and ethical use of data. 15

Analysis of mobility data from various sources can undoubtedly be beneficial to better understand how changes in mobility in outdoor and indoor settings may impact COVID-19 infection spread, and this data can help inform prediction models. Internal auditing of data by stakeholders involved in data mining and analysis is critical for validating the quality of data to ensure we do not misinform policymakers or the public. Importantly, we must remember to respect the privacy of individuals in our communities as we use this powerful data to inform public policy decisions.

J o u r n a l P r e -p r o o f

Only one state has yet to begin reopening and it will do so this week

Unacast Social Distancing Dataset

Modeling the impact of human mobility and travel restrictions on the potential spread of SARS-CoV-2 in Taiwan. medRxiv

Mobile phone data for informing public health actions across the COVID-19 pandemic life cycle

Population flow drives spatio-temporal distribution of COVID-19 in China

looks to Singapore for insights on contact tracing apps in fight against COVID-19

Apple and Google are teaming up to create a way for your smartphone to alert you if you've come into contact with someone infected with the coronavirus

Coronavirus Fight, China Gives Citizens a Color Code

How GPS Vehicle Tracking Can Lower Your Insurance Premiums

Google Starts To Publish Coronavirus Mobility Reports. 2020. 15. Rules and Policies -Protecting PII -Privacy Act