Crowding and the shape of COVID-19 epidemics

Benjamin Rader, Samuel V. Scarpino, Anjalika Nande, Alison L. Hill, Ben Adlam, Robert C. Reiner, David M. Pigott, Bernardo Gutierrez, Alexander E. Zarebski, Munik Shrestha, John S. Brownstein, Marcia C. Castro, Christopher Dye, Huaiyu Tian, Oliver G. Pybus, Moritz U.G. Kraemer

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


The coronavirus disease 2019 (COVID-19) pandemic is straining public health systems worldwide, and major non-pharmaceutical interventions have been implemented to slow its spread1–4. During the initial phase of the outbreak, dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was primarily determined by human mobility from Wuhan, China5,6. Yet empirical evidence on the effect of key geographic factors on local epidemic transmission is lacking7. In this study, we analyzed highly resolved spatial variables in cities, together with case count data, to investigate the role of climate, urbanization and variation in interventions. We show that the degree to which cases of COVID-19 are compressed into a short period of time (peakedness of the epidemic) is strongly shaped by population aggregation and heterogeneity, such that epidemics in crowded cities are more spread over time, and crowded cities have larger total attack rates than less populated cities. Observed differences in the peakedness of epidemics are consistent with a meta-population model of COVID-19 that explicitly accounts for spatial hierarchies. We paired our estimates with globally comprehensive data on human mobility and predict that crowded cities worldwide could experience more prolonged epidemics.

Original languageEnglish (US)
Pages (from-to)1829-1834
Number of pages6
JournalNature medicine
Issue number12
StatePublished - Dec 2020

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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