BACKGROUND
On January 30, 2020, World Health Organization (WHO) declared the current novel coronavirus disease 2019 (COVID-19) as a public health emergency of international concern and later characterized it as a pandemic. Since then the virus has also rapidly spread among Latin American, Caribbean and African countries.
OBJECTIVE
The first aim of this study was to identify new emerging COVID-19 clusters over time and in space in Latin American, Caribbean, and African regions [mostly low and middle-income countries (LMICs)], using a prospective space-time scan measurement approach. The second aim was to assess the impact of real-time population mobility patterns between January 21st to May 18th, under the implemented government interventions, measurements and policy restrictions, on COVID-19 spread, among those regions and globally.
METHODS
We created a global COVID-19 database merging WHO daily case reports (of 218 countries, regions and territories) with other measures such as population density, country income levels for January 21st to May 15th, 2020. A score of government policy interventions was created ranging from “light”, “intermediate”, and “high”, to “very high” interventions. Prospective space-time scan statistic methods were applied in five time periods between January to May 2020 and a stepped-wedged regression mixed model analysis was used.
RESULTS
We found that COVID-19 emerging clusters within these five periods of time grew from 7 emerging clusters to 28 by mid-May. We also detected various increasing and decreasing relative risk estimates of COVID-19 spread among Latin American, Caribbean and African countries within the period of analysis. Globally, as well as regionally (Latin American, Caribbean and Africa), population mobility to parks and similar leisure areas during all the implemented control policies were related with accelerated COVID-19 spread. For countries in Africa, population mobility for work reasons during high and very high levels of implemented control policies were related with increased virus spread.
CONCLUSIONS
Prospective space-time scan is a measurement approach that LMICs countries could easily use to detect emerging clusters in a timely manner and implement specific control policies and interventions to slow down COVID-19 transmission. In addition, real time population mobility obtained from crowdsourced digital data could be useful for current and future targeted public health and mitigation policies among Latin American, Caribbean and African countries as well as globally.