Human mobility impacts the transmission of common respiratory viruses: A modeling study of the Seattle metropolitan area

Many studies have used mobile device location data to model SARS-CoV-2 dynamics, yet relationships between mobility behavior and endemic respiratory pathogens are less understood. We studied the impacts of human mobility on the transmission of SARS-CoV-2 and 16 endemic viruses in Seattle over a 4-year period, 2018-2022. Before 2020, school-related foot traffic and large-scale population movements preceded seasonal outbreaks of endemic viruses. Pathogen circulation dropped substantially after the initiation of stay-at-home orders in March 2020. During this period, mobility was a positive, leading indicator of transmission of all endemic viruses and lagged SARS-CoV-2 activity. Mobility was briefly predictive of SARS-CoV-2 transmission when restrictions relaxed in summer 2020 but associations weakened in subsequent waves. The rebound of endemic viruses was heterogeneously timed but exhibited stronger relationships with mobility than SARS-CoV-2. Mobility is most predictive of respiratory virus transmission during periods of dramatic behavioral change, and, to a lesser extent, at the beginning of epidemic waves. Teaser: Human mobility patterns predict the transmission dynamics of common respiratory viruses in pre- and post-pandemic years. ### Competing Interest Statement CH received personal fees from Sanofi outside the submitted work. MLJ received funding as a contractor to Merck & Co. AW received clinical trial support to their institution from Pfizer, Ansun Biopharma, Allovir, and GlaxoSmithKline/Vir, personal fees from Vir, and grants from Amazon outside the submitted work. JAE received grants from Pfizer, AstraZeneca, Merck, and GlaxoSmithKline and personal fees from Pfizer, AstraZeneca, Meissa Vaccines, Moderna, and Sanofi Pasteur outside the submitted work. HYC received personal fees from Ellume, the Bill and Melinda Gates Foundation, Vindico, Abbvie, Merck, and Pfizer, research funding from Gates Ventures and Sanofi Pasteur, and support and reagents from Ellume and Cepheid outside the submitted work. CV received honoraria from Elsevier outside the submitted work. All other authors declare they have no competing interests. ### Funding Statement Funding for the Seattle Flu Study and Greater Seattle Coronavirus Assessment Network (SCAN) was provided by Gates Ventures and the Howard Hughes Medical Institute. SCAN samples collected in Pierce County were funded by the Tacoma-Pierce County Health Department. ACP, CH, SB, RP, CM, DR, BC, KSF, KK, BP, ZA, EM, LRS, JSt, LG, PDH, AW, JSh, TB, HYC, and LMS received third-party support from Gates Ventures through the Brotman Baty Institute during the conduct of the study. ACP, LMS, and TB are supported by CDC contract 75D30122C14368. RB and MF are employees of the Institute for Disease Modeling, a research group within, and solely funded by, the Bill and Melinda Gates Foundation. JSh and TB are supported by the Howard Hughes Medical Institute. CV is supported by the in-house research division of the Fogarty International Center, US National Institutes of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Institutional Review Board of the University of Washington gave ethical approval of this work (protocol #00006181). All participants who contributed specimens to the Seattle Flu Study or Greater Seattle Coronavirus Assessment Network provided informed consent at enrollment. Informed consent for residual sample and clinical data collection was waived, as these samples were already collected as part of routine clinical care, and it was not possible to re-contact these individuals. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Aggregated epidemiological and mobility data and code to reproduce analyses and figures will be made available in a GitHub repository and Dryad at the time of publication acceptance. Access to deidentified study participant data requires a signed data access agreement with the Seattle Flu Alliance and can be made available to researchers whose proposed use of the data is approved by study investigators. Requests for data access should be submitted to data{at}seattleflu.org. Mobility metrics were generated using SafeGraph Weekly Patterns and Social Distancing datasets and Meta Data for Good Movement Range Maps, which were originally made freely available to academics in response to the COVID-19 pandemic. The SafeGraph Weekly Patterns dataset is currently available to academics for non-commercial use through an institutional university subscription or individual subscription to Dewey (). The data access agreement with Dewey does not permit sharing of the raw data. Meta Data for Good Movement Range Maps are publicly accessible through the Humanitarian Data Exchange ().