Characterizing collective physical distancing in the U.S. during the first nine months of the COVID-19 pandemic.

The COVID-19 pandemic offers an unprecedented natural experiment providing insights into the emergence of collective behavioral changes of both exogenous (government mandated) and endogenous (spontaneous reaction to infection risks) origin. Here, we characterize collective physical distancing-mobility reductions, minimization of contacts, shortening of contact duration-in response to the COVID-19 pandemic in the pre-vaccine era by analyzing de-identified, privacy-preserving location data for a panel of over 5.5 million anonymized, opted-in U.S. devices. We define five indicators of users' mobility and proximity to investigate how the emerging collective behavior deviates from typical pre-pandemic patterns during the first nine months of the COVID-19 pandemic. We analyze both the dramatic changes due to the government mandated mitigation policies and the more spontaneous societal adaptation into a new (physically distanced) normal in the fall 2020. Using the indicators here defined we show that: a) during the COVID-19 pandemic, collective physical distancing displayed different phases and was heterogeneous across geographies, b) metropolitan areas displayed stronger reductions in mobility and contacts than rural areas; c) stronger reductions in commuting patterns are observed in geographical areas with a higher share of teleworkable jobs; d) commuting volumes during and after the lockdown period negatively correlate with unemployment rates; and e) increases in contact indicators correlate with future values of new deaths at a lag consistent with epidemiological parameters and surveillance reporting delays. In conclusion, this study demonstrates that the framework and indicators here presented can be used to analyze large-scale social distancing phenomena, paving the way for their use in future pandemics to analyze and monitor the effects of pandemic mitigation plans at the national and international levels.

COVID-19 is linked to changes in the time-space dimension of human mobility.

Socio-economic constructs and urban topology are crucial drivers of human mobility patterns. During the coronavirus disease 2019 pandemic, these patterns were reshaped in their components: the spatial dimension represented by the daily travelled distance, and the temporal dimension expressed as the synchronization time of commuting routines. Here, leveraging location-based data from de-identified mobile phone users, we observed that, during lockdowns restrictions, the decrease of spatial mobility is interwoven with the emergence of asynchronous mobility dynamics. The lifting of restriction in urban mobility allowed a faster recovery of the spatial dimension compared with the temporal one. Moreover, the recovery in mobility was different depending on urbanization levels and economic stratification. In rural and low-income areas, the spatial mobility dimension suffered a more considerable disruption when compared with urbanized and high-income areas. In contrast, the temporal dimension was more affected in urbanized and high-income areas than in rural and low-income areas.

Spatial immunization to abate disease spreading in transportation hubs.

Proximity social interactions are crucial for infectious diseases transmission. Crowded agglomerations pose serious risk of triggering superspreading events. Locations like transportation hubs (airports and stations) are designed to optimize logistic efficiency, not to reduce crowding, and are characterized by a constant in and out flow of people. Here, we analyze the paradigmatic example of London Heathrow, one of the busiest European airports. Thanks to a dataset of anonymized individuals' trajectories, we can model the spreading of different diseases to localize the contagion hotspots and to propose a spatial immunization policy targeting them to reduce disease spreading risk. We also detect the most vulnerable destinations to contagions produced at the airport and quantify the benefits of the spatial immunization technique to prevent regional and global disease diffusion. This method is immediately generalizable to train, metro and bus stations and to other facilities such as commercial or convention centers.

Living in a pandemic: changes in mobility routines, social activity and adherence to COVID-19 protective measures.

Non-Pharmaceutical Interventions (NPIs), aimed at reducing the diffusion of the COVID-19 pandemic, have dramatically influenced our everyday behaviour. In this work, we study how individuals adapted their daily movements and person-to-person contact patterns over time in response to the NPIs. We leverage longitudinal GPS mobility data of hundreds of thousands of anonymous individuals to empirically show and quantify the dramatic disruption in people's mobility habits and social behaviour. We find that local interventions did not just impact the number of visits to different venues but also how people experience them. Individuals spend less time in venues, preferring simpler and more predictable routines, also reducing person-to-person contacts. Moreover, we find that the individual patterns of visits are influenced by the strength of the NPIs policies, the local severity of the pandemic and a risk adaptation factor, which increases the people's mobility regardless of the stringency of interventions. Finally, despite the gradual recovery in visit patterns, we find that individuals continue to keep person-to-person contacts low. This apparent conflict hints that the evolution of policy adherence should be carefully addressed by policymakers, epidemiologists and mobility experts.

Socio-economic determinants of mobility responses during the first wave of COVID-19 in Italy: from provinces to neighbourhoods.

After more than 1 year into the COVID-19 pandemic, governments worldwide still face the challenge of adopting non-pharmaceutical interventions to mitigate the risks posed by the emergence of new SARS-CoV-2 variants and the lack of a worldwide equitable vaccine allocation. Thus, it becomes crucial to identify the drivers of mobility responses to mitigation efforts during different restriction regimes, for planning interventions that are both economically and socially sustainable while effective in controlling an outbreak. Here, using anonymous and privacy-enhanced cell phone data from Italy, we investigate the determinants of spatial variations of reductions in mobility and co-location in response to the adoption and the lift of restrictions, considering both provinces and city neighbourhoods. In large urban areas, our analysis uncovers the desertification of historic city centres, which persisted after the end of the lockdown. Such centre-periphery gradient was mainly associated with differences in educational attainment. At the province level, the local structure of the labour market mainly explained the variations in mobility responses, together with other demographic factors, such as the population's age and sex composition. In the future, targeted interventions should take into account how the ability to comply with restrictions varies across geographical areas and socio-demographic groups.

COVID-19 outbreak response, a dataset to assess mobility changes in Italy following national lockdown.

Italy has been severely affected by the COVID-19 pandemic, reporting the highest death toll in Europe as of April 2020. Following the identification of the first infections, on February 21, 2020, national authorities have put in place an increasing number of restrictions aimed at containing the outbreak and delaying the epidemic peak. On March 12, the government imposed a national lockdown. To aid the evaluation of the impact of interventions, we present daily time-series of three different aggregated mobility metrics: the origin-destination movements between Italian provinces, the radius of gyration, and the average degree of a spatial proximity network. All metrics were computed by processing a large-scale dataset of anonymously shared positions of about 170,000 de-identified smartphone users before and during the outbreak, at the sub-national scale. This dataset can help to monitor the impact of the lockdown on the epidemic trajectory and inform future public health decision making.

A severe myopathy case in aged patient treated with high statin dosage.

Statins (S) are widely used drugs for cardiovascular prevention however their utilization may cause a various grade of muscle toxicity. Sometime S discontinuation alone is not sufficient to revert muscle injury and this can evolve in serious inflammatory muscle disease. In this case immunosuppressive medications are required to achieve remission. This case report describes a patient who developed rhabdomyolysis after recent S treatment initiation and the diagnostic work up have lead to the diagnosis of necrotizing autoimmune myopathy (NAM). We believe that the clinical case described here is a useful report of this rare toxicity and we aim to highlight the importance of its prompt recognition and treatment.

The relationship between inhibitors of the Wnt signalling pathway (sclerostin and Dickkopf-1) and carotid intima-media thickness in postmenopausal women with type 2 diabetes mellitus.

The aim of the study was to investigate the association of the extracellular inhibitors of Wnt/ß-catenin signalling sclerostin and Dickkopf-1 (Dkk-1) with carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM). We performed a cross-sectional study including 40 T2DM postmenopausal women and 40 healthy controls. CIMT was measured by B-mode ultrasound. Serum sclerostin and Dkk-1 were measured by solid-phase enzyme-linked immunosorbent assay (ELISA). Serum sclerostin and Dkk-1 concentrations were significantly higher in T2DM group than in controls. There was a significant negative correlation between sclerostin and Dkk-1 and CIMT in T2DM (p = 0.0063 and p = 0.0017, respectively). After adjustment for potential confounders, associations remained significant only for sclerostin. These data suggest that sclerostin, an established modulator of the canonical Wnt signalling, may protect against progression of vascular complications in diabetic patients, possibly by attenuating upregulation of ß-catenin activity in the vascular cells.

Sclerostin levels associated with inhibition of the Wnt/ß-catenin signaling and reduced bone turnover in type 2 diabetes mellitus.

CONTEXT: Patients with type 2 diabetes (T2DM) have low bone turnover, poor bone quality, and circulating levels of sclerostin significantly higher than non-T2DM controls. There are no data on the possible association of sclerostin with ß-catenin, a key component of the Wnt/ß-catenin canonical signaling. OBJECTIVES: The aim of the study was to evaluate the circulating ß-catenin levels in T2DM patients and to analyze their relationship with sclerostin and bone turnover markers. DESIGN: This was a cross-sectional study. SETTING AND PATIENTS: The study was conducted at a clinical research center. Forty T2DM postmenopausal women were studied and compared with 40 healthy controls. Bone status was assessed by dual-energy x-ray absorptiometry measurements (bone mineral density) and by measuring bone alkaline phosphatase and carboxy-terminal telopeptide of type 1 collagen. Sclerostin and ß-catenin were evaluated by an immunoenzymetric assay. RESULTS: Consistent with previous reports in T2DM subjects, we found sclerostin levels higher and bone turnover markers lower than controls. In our cohort of T2DM patients, ß-catenin levels are significantly lower than in controls (median 1.22 pg/ml, 25th to 75th percentiles 0.50-2.80; and median 4.25 pg/ml, 25th to 75th percentiles 2.20-7.62, respectively; P=0.0002). ß-Catenin correlated negatively with sclerostin (P<0.0001) and positively with bone alkaline phosphatase (P=0.0030) only in T2DM patients and negatively with age in both groups. Eight of the 40 T2DM patients had vertebral fractures. CONCLUSIONS: These results show for the first time that T2DM patients have serum concentrations of ß-catenin lower than controls. The negative association of ß-catenin with sclerostin suggests a biological effect of increased sclerostin on the Wnt signaling, which appears impaired in T2DM.