Following the emergence of SARS-CoV-2, early outbreak response relied on behavioural interventions. In the USA, local governments implemented restrictions aimed at reducing movements and contacts to limit viral transmission. In Pennsylvania, restrictions closed schools and businesses in the spring of 2020 and interventions eased later through the summer. Here we use passive monitoring of vehicular traffic volume and mobile device-derived visits to points of interest as proxies for movements and contacts in a rural Pennsylvania county. Rural areas have limited health care resources, which magnifies the importance of disease prevention. These data show the lowest levels of movement occurred during the strictest phase of restrictions, indicating high levels of compliance with behavioural intervention. We find that increases in movement correlated with increases in reported SARS-CoV-2 cases 9–18 days later. The methodology used in this study can be adapted to inform outbreak management strategies for other locations and future outbreaks that use behavioural interventions to reduce pathogen transmission.


© The Author(s), 2021. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

Cite as

Faust, C., Lambert, B., Kochenour, C., Robinson, A. & Bharti, N. 2021, 'Passive surveillance assesses compliance with COVID-19 behavioural restrictions in a rural US county', Epidemiology and Infection, 149, pp. 1-8, article no: e211. https://doi.org/10.1017/S0950268821002107

Downloadable citations

Download HTML citationHTML Download BIB citationBIB Download RIS citationRIS
Last updated: 16 June 2022
Was this page helpful?