Lifting mobility restrictions and the induced short-term dynamics of COVID-19

SARS-CoV-2 has now infected 15 million people and produced more than six hundred thousand deaths around the world. Due to high transmission levels, many governments implemented social-distancing measures and confinement with different levels of required compliance to mitigate the COVID-19 epidemic. In several countries, these measures were effective, and it was possible to flatten the epidemic curve and control it. In others, this objective was not or has not been achieved. In far to many cities around the world rebounds of the epidemic are occurring or, in others, plateau-like states have appeared where high incidence rates remain constant for relatively long periods of time. Nonetheless, faced with the challenge of urgent social need to reactivate their economies, many countries have decided to lift mitigation measures at times of high incidence. In this paper, we use a mathematical model to characterize the impact of short duration transmission events within the confinement period previous but close to the epidemic peak. The model describes too, the possible consequences on the disease dynamics after mitigation measures are lifted. We use Mexico City as a case study. The results show that events of high mobility may produce either a later higher peak, a long plateau with relatively constant but high incidence or the same peak as in the original baseline epidemic curve, but with a post-peak interval of slower decay. Finally, we also show the importance of carefully timing the lifting of mitigation measures. If this occurs during a period of high incidence, then the disease transmission will rapidly increase, unless the effective contact rate keeps decreasing, which will be very difficult to achieve once the population is released.