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Impact Assessment of Mobility Restriction, Testing, and Vaccination on the COVID-19 Pandemic in India
16 Pages Posted: 30 Mar 2022
More...Abstract
Background: Before the availability of vaccines to control the COVID-19 pandemic, countries largely relied on mobility restriction and testing policies to mitigate the pandemic. There is uncertainty in the combined impact of mobility restriction, testing policies, and vaccination on the pandemic in different countries. Our aim is to assess the impact of mobility restriction, testing, and vaccination on the COVID-19 pandemic in India.
Methods: We collected data on COVID-19 incidence, testing, and vaccination in India from Our World in Data, and mobility data from Google Mobility Report. To assess the combined effects of mobility restriction, testing policies, and vaccination on COVID-19 incidence, we conducted multiple regression analysis for the time period between April 28, 2021 to November 24, 2021. 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 (1st period: March 28, 2020 ~ October 7, 2020, 2nd period: October 8, 2020 ~ April 27, 2021, 3rd period: April 28, 2021 ~ November 24, 2021) to examine potential heterogeneity of the results 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 positive association and testing showed 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).
Implications: We infer that mobility restriction and testing were effective interventions even in the presence of vaccination, while the effects changed over time. While 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 of concern in India and globally, this health system gain must be balanced with the challenges in the delivery of non-COVID health services and broader socio-economic impact on the society to decide for or against sustaining the mobility restrictions for a prolonged period of time.
Funding Information: Korea Ministry of Foreign Affairs
Declaration of Interests: None to declare.
Keywords: India, COVID-19, test, trace, quarantine, vaccine, mobility restriction
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