The Role of Location in the Spread of SARS-CoV-2: Examination of Cases and Exposed Contacts in South Texas, Using Social Network Analysis.

OBJECTIVE: This study sought to better understand the types of locations that serve as hubs for the transmission of COVID-19. METHODS: Contact tracers interviewed individuals who tested positive for SARS-CoV-2 between November 2020 and March 2021, as well as the people with whom those individuals had contact. We conducted a 2-mode social network analysis of people by the types of places they visited, focusing on the forms of centrality exhibited by place types. RESULTS: The most exposed locations were grocery stores, commercial stores, restaurants, commercial services, and schools. These types of locations also have the highest "betweenness," meaning that they tend to serve as hubs between other kinds of locations since people would usually visit more than 1 location in a day or when infected. The highest pairs of locations were grocery store/retail store, restaurant/retail store, and restaurant/grocery store. Schools are not at the top but are 3 times in the top 7 pairs of locations and connected to the 3 types of locations in those top pairs. CONCLUSIONS: As the pandemic progressed, location hotspots shifted between businesses, schools, and homes. In this social network analysis, certain types of locations appeared to be potential hubs of transmission.