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Background: The impact of individual non-pharmaceutical interventions (NPI)such as state-wide stay-at-home orders, school closures and gathering sizelimitations, on the COVID-19 epidemic is unknown. Understanding the impact thatabove listed NPI have on disease transmission is critical for policy makers,particularly as case counts increase again in some areas.  Methods: Using a Bayesian framework, we reconstructed the incidence andtime-varying reproductive number (Rt) curves to investigate the relationshipbetween Rt, individual mobility as measured by Google Community MobilityReports, and NPI.  Results: We found a strong relationship between reproductive number andmobility, with each 10% drop in mobility being associated with an expected10.2% reduction in Rt compared to baseline. The effects of limitations on thesize of gatherings, school and business closures, and stay-at-home orders weredominated by the trend over time, which was associated with a 48% decrease inthe reproductive number, adjusting for the NPI.  Conclusions: We found that the decrease in mobility associated with time maybe due to individuals changing their behavior in response to perceived risk orexternal factors.

The COVID-19 Pandemic, Community Mobility and the Effectiveness of  Non-pharmaceutical Interventions: The United States of America, February to  May 2020