AbstractBackgroundMobile phone-derived human mobility data are a proxy for disease transmission risk and have proven useful during the COVID-19 pandemic for forecasting cases and evaluating interventions. We propose a novel metric using mobility data to characterize responsiveness to rising case rates.MethodsWe examined weekly reported COVID-19 incidence and retail and recreation mobility from Google Community Mobility Reports for 50 U.S. states and nine Canadian provinces from December 2020 to November 2021. For each jurisdiction, we calculated the responsiveness of mobility to COVID-19 incidence when cases were rising. Responsiveness across countries was summarized using subgroup meta-analysis. We also calculated the correlation between the responsiveness metric and the reported COVID-19 death rate during the study period.FindingsResponsiveness in Canadian provinces (β= -1·45; 95% CI: -2·45, -0·44) was approximately five times greater than in U.S. states (β= -0·30; 95% CI: -0·38, -0·21). Greater responsiveness was moderately correlated with a lower reported COVID-19 death rate during the study period (Spearman’sρ= 0·51), whereas average mobility was only weakly correlated the COVID-19 death rate (Spearman’sρ= 0·20).InterpretationOur study used a novel mobility-derived metric to reveal a near-universal phenomenon of reductions in mobility subsequent to rising COVID-19 incidence across 59 states and provinces of the U.S. and Canada, while also highlighting the different public health approaches taken by the two countries.FundingThis study received no funding.Research in contextEvidence before the studyThere exists a wide body of literature establishing the usefulness of mobile phone-derived human mobility data for forecasting cases and other metrics during the COVID-19 pandemic. We performed a literature search to identify studies examining the opposite relationship, attempting to quantify the responsiveness of human mobility to changes in COVID-19 incidence. We searched PubMed on October 21, 2022 using the keywords “COVID-19”, “2019-nCoV”, or “SARS-CoV-2” in combination with “responsiveness” and one or more of “mobility”, “distancing”, “lockdown”, and “non-pharmaceutical interventions”. We scanned 46 published studies and found one that used a mobile phone data-derived index to measure the intensity of social distancing in U.S. counties from January 2020 to January 2021. The authors of this study found that an increase in cases in the last 7 days was associated with an increase in the intensity of social distancing, and that this effect was larger during periods of lockdown/shop closures.Added value of the studyOur study developed a metric of the responsiveness of mobility to rising case rates for COVID-19 and calculated it for 59 subnational jurisdictions in the United States and Canada. While nearly all jurisdictions displayed some degree of responsiveness, average responsiveness in Canada was nearly five times greater than in the United States. Responsiveness was moderately associated with the reported COVID-19 death rate during the study period, such that jurisdictions with greater responsiveness had lower death rates, and was more strongly associated with death rates than average mobility in a jurisdiction.Implications of all the available evidenceMobile phone-derived human mobility data has proven useful in the context of infectious disease surveillance during the COVID-19 pandemic, such as for forecasting cases and evaluating non-pharmaceutical interventions. In our study, we derived a metric of responsiveness to show that mobility data may be used to track the efficiency of public health responses as the pandemic evolves. This responsiveness metric was also correlated with reported COVID-19 death rates during the study period. Together, these results demonstrate the usefulness of mobility data for making broad characterizations of public health responses across jurisdictions during the COVID-19 pandemic and reinforce the value of mobility data as an infectious disease surveillance tool for answering present and future threats.