Associations among IT, PHSM, and pandemic dynamics. (A-C) Association between IT and pandemic dynamics for Shannon's index, evenness, and richness of lineage diversity and the GR of cases. (D-F) Association between PHSM and pandemic dynamics for Shannon's index, evenness, and richness of lineage diversity (Box 1 and Methods) and the GR of cases. In A-F, blue, red, green, and yellow lines represent the effect of IT or PHSM on the GR of cases, Shannon's index, evenness, and richness of lineage diversity, respectively. Estimations of effects are based on DLNMs. Due to a significant number of missing values in the calculation of Shannon's index (evenness or richness) of lineage diversity in September 2022 (Box 1 and SI Appendix, Fig. S3), the data for that month were excluded from the DLNMs. Therefore, all of the analyses were based on the genome dataset from subsampling strategy 1 (Box 1 and SI Appendix, Fig. S3) across 63 countries worldwide between March 2020 and August 2022. Shaded regions represent 95% CIs.

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... emerging VOCs have led to repeated COVID-19 waves globally, reflected by the GR of cases ( Fig. 1 A and B). The GR, with its peaks and troughs, mirrors the upsurge and decline of waves of monthly new confirmed infections (SI Appendix, Fig. S2). To investigate the lineage diversity during the COVID-19 pandemic, we used three diversity metrics: richness (the number of lineages), evenness (the relative abundance of lineages), and Shannon's index [a larger value of the diversity index indicates a larger number and more evenly distributed frequencies of lineages (24)]. These ...

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... role in facilitating the global dissemination of SARS-COV-2 during the COVID-19 pandemic (7,26). We found that an additional monthly increase of 10,000 passengers traveling between different countries would lead to a 5.5% (95% CI: 2.9 to 8.2%) increase in Shannon's index of lineage diversity during the period from March 2020 to September 2022 ( Fig. 2A). Moreover, we found a positive association between richness and IT but found no association for evenness (Fig. 2 B and C). To ensure the robustness of our results, we addressed potential missing data in the IT indexes for May 2022 by using the average values of each country in April 2022 and June 2022, which yielded consistent findings ...

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... association between IT and the GR of cases showed insignificant negative trends in the models considering Shannon's index and evenness of lineage diversity ( Fig. 2 A and B). However, a positive trend was observed for the richness (Fig. 2C), which can be attributed to the collinearity between richness and the monthly number of new cases resulting from the subsampling based on strategy 1. In sensitivity analyses using two other subsampling strategies (Box 1 and SI Appendix, Fig. S3), we consistently found a ...

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... association between IT and the GR of cases showed insignificant negative trends in the models considering Shannon's index and evenness of lineage diversity ( Fig. 2 A and B). However, a positive trend was observed for the richness (Fig. 2C), which can be attributed to the collinearity between richness and the monthly number of new cases resulting from the subsampling based on strategy 1. In sensitivity analyses using two other subsampling strategies (Box 1 and SI Appendix, Fig. S3), we consistently found a significant negative association between IT and the case GR when ...

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... statistical analysis suggested that PHSM played a crucial role in suppressing the COVID-19 pandemic. We found that Shannon's index of SARS-CoV-2 lineage diversity and the monthly GR of new confirmed cases were both negatively associated with the implementation of PHSM (Fig. 2D). Moreover, a significant negative association was observed between PHSM and lineage diversity of evenness and richness ( Fig. 2 E and F). This finding is in line with other observations, such as the decline in the diversity of cocirculating lineages during the first wave of the COVID-19 pandemic in the United Kingdom after the ...

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... role in suppressing the COVID-19 pandemic. We found that Shannon's index of SARS-CoV-2 lineage diversity and the monthly GR of new confirmed cases were both negatively associated with the implementation of PHSM (Fig. 2D). Moreover, a significant negative association was observed between PHSM and lineage diversity of evenness and richness ( Fig. 2 E and F). This finding is in line with other observations, such as the decline in the diversity of cocirculating lineages during the first wave of the COVID-19 pandemic in the United Kingdom after the implementation of national lockdown ...