Cell phone data show Americans hit the road for July 4, even as coronavirus surged

(CNN) — After Memorial Day, as the United States began to reopen, coronavirus cases began to rise. The number of hospitalizations had risen in at least a dozen states some two weeks after the holiday weekend.

For the Fourth of July weekend, a new analysis of cell phone data suggests even more people hit the road among 10 coronavirus hotspots, despite warnings from health experts.

Mobility, experts say, is one driver of transmission of the novel coronavirus.

The analysis comes from data shared with CNN byCuebiq, one of the private companies that the US Centers for Disease Control and Prevention uses to track general movement in the United States. Cuebiq gets its data when people download apps on their phones and opt into anonymous location data tracking. The company’s full data set includes 15 million phones nationwide.

For the Fourth of July holiday weekend, the data show that the numbers of people travelingwere generally higher overall than Memorial Day weekend. The July 4 weekend was generally recognized as Friday, Saturday and Sunday, while Memorial Day weekend in May was Saturday, Sunday and Monday.

Cuebiq focused on the number of visitors to and from 10 metro area hotspots from a weekprior to the July 4 weekend.

The metropolitan areas had been ranked by the percent positive COVID-19 tests the week prior in a presentation by the White House Coronavirus Task Force. The analysis included the Houston; Austin, Texas; Phoenix; Dallas; San Antonio; Orlando; Tampa, Florida; Charleston, South Carolina; Miami; and Atlanta areas.

Local leaders were concerned that gatherings over the July 4 holiday could spread the virus. States put an end to some celebrations. California Gov. Gavin Newsom urged cities struggling with the virus to cancel fireworks. Beaches and parks in Miami were closed over the holiday. Some beaches in South Carolina canceled their fireworks shows. In Texas, tubing was canceled on some rivers. Some places celebrated with livestreamed events.

Still, the draw of a three-day summer weekend with long-awaited get-togethers and newly reopened attractions worried health experts.

“It’s set up a perfect storm: the combination of travel, the combination of reopening — perhaps in some cases, too early — and the combination of people not necessarily following some of these preventive guidelines,” Dr. Joshua Barocas, an infectious disease physician at Boston Medical Center, said before the holiday.

Metro areas with the most movement

Despite the warnings, nearly all of the metro areas Cuebiq analyzed saw an increase in the proportion of visitors over the Fourth of July weekend, when compared to either Memorial Day weekend or the two-week prior average. The sole exception was the Phoenix area, which saw a slightly higher percentage of visitors during Memorial Day weekend, but whose locals traveled elsewhere in greater numbers over Fourth of July weekend.

Among them, two hotspot cities saw the highest proportions of vacationers: Orlando saw the largest increase in visitors compared to the weeks leading up to the holiday weekend and Charleston saw the highest percentage of visitors among the 10 metro areas. In both areas, roughly 1 in 5 devices was determined to be a visitor, according to Cuebiq’s analysis. Visits have been steadily increasing in Charleston through June, the company’s data showed.

Travelers tended to visit cities in their own state or region, but some traveled further. About 3.7% of visitors to the Miami area came from New York, and another 3.9% came from the Atlanta area. Of the people who visited Phoenix, 16.3% came from just three metro areas in Southern California — those including Los Angeles, Riverside and San Diego. Others came from areas around Chicago and Dallas — about 2% of Phoenix visitors in each case.

Of these 10 areas, Atlanta area residents were the most likely to travel. About 20% of the resident devices the company tracked had left the state and traveled to another city during the July 4 weekend. Many went to Florida.

‘When we see social mobility going up … we see a rise in cases’

As more states open up, people have generally been on the move more, even as the number of COVID-19 cases continues to rise in the United States. CDC’s aggregate mobility data, which includes Cuebiq, shows steadily increasing mobility trends since mid-April, especially to retail and recreation locations.

Mobility doesn’t equal infection; maintaining physical distance and wearing masks can reduce the risk of the coronavirus spreading. It could be weeks before states notice an increase in cases linked to holiday getaways, if they happen. But with travel, there are a lot more opportunities for people to come into contact with someone who can make them sick.

Health experts predict that there will be an uptick in cases the more people are mobile. Dr. Cassandra Salgado, the infectious diseases medical director at the Medical University of South Carolina, has been watching the crowds grow in Charleston. To prepare the medical system to be ready for additional patients, her group has been following a number of social mobility models during the pandemic, including Cuebiq’s, and the models line up with the uptick in cases.

“When we see social mobility going up, in seven to ten days later, we see a rise in cases, and then we see a bigger rise, as we are starting from a higher starting point. These models are really useful to help us prepare,” Salgado said.

She said Charleston is a beautiful tourist destination and she understands why so many people would want to visit. Plus, it is “pretty much wide open,” as far as restaurants and bars. People are asked to wear a mask when they can’t social distance.

“Some people are being very responsible, but some aren’t unfortunately,” she said. “I have always sort of said, human beings, if things are open for them, they will go do them.”

Salgado said there have been moments in the pandemic when she has been proud of people for staying home, but she has also felt some disappointment and frustration.

“I worry mostly about the vulnerable population who don’t have a choice and are somewhat victims of what other people decide to do,” Salgado said.

She said she can see why sometimes people will see that more is reopening and start to think it is safe to go out or to travel, especially in the summer vacation season. But she said they definitely have seen mini outbreaks tied to travel.

“We sure will keep a close eye on it every day,” Salgado said. Typically, hospitalizations won’t spike for another few weeks.

“It’s still quite early, but we’ll prepare and be ready for it.”

• March 6: Indiana State Department of Health (ISDH) confirms the first case in Indiana. Officials say the Marion County resident had recently traveled to Boston to attend a BioGen conference as a contractor.
• March 8: ISDH confirms a second case. An adult in Hendricks County who had also traveled to the BioGen conference was placed in isolation. Noblesville Schools announces that a parent and that parent’s children will be self-quarantining after attending an out-of-state event where someone else tested positive.
• March 9: ISDH’s total of positive cases rises to 4. Avon Community School Corp. had announced on March 8 that a student tested positive; that case, along with another in Noble County, was confirmed by state health officials at a news conference.
• March 10: ISDH’s total of positive cases rises to 6 as the state launches an online tracker. Purdue and Indiana universities suspend classes for two weeks beyond their spring breaks. Ball State University basketball fans learn the Mid-American Conference tourney will have no fans in the stands. Three businesses operating nursing homes in Indiana announce they will no longer allow visitors.
• March 11: ISDH confirms four more positive cases in Indiana. The University of Indianapolis announces it will extend its ongoing spring break through March 22. The Indianapolis-based NCAA announces the men’s and women’s Final Four basketball tournaments will be conducted with essential staff and limited family attendance. The Big Ten announces all sports events, including the men’s basketball tournament at Bankers Life Fieldhouse, will have no fans starting March 12. Ball State University announces classes are suspended for the rest of the spring semester. NBA suspends all games, including the Indiana Pacers, until further notice. Butler University extends its spring break, after which it will go to virtual classes.
• March 12: ISDH’s total of positive cases rises 12. Taylor University cancels international and domestic spring break trips for students and faculty sponsors. Indianapolis’ annual St. Patrick’s Day Parade is canceled. Gov. Eric Holcomb announces new protections that led to extended public school closings and the cancellation of large events across the state. The league including the Indy Fuel hockey team suspends its season. Indy Eleven says it will reschedule four matches, including its April 4 home opener. The NCAA cancels the men’s and women’s basketball tournaments. The Big Ten suspends all sporting events through the winter and spring seasons.
• March 13: Gov. Holcomb announces additional actions — they included eliminating Medicaid co-pays for COVID-19 testing and lifting regulations limiting the number of work hours per day for drivers of commercial vehicles — to help stop the coronavirus. Wayzata Home Products, a Connersville cabinet maker, shut down and lays off its entire workforce due to market uncertainty associated with the coronavirus. The Indiana High School Athletic Association postpones the boys basketball tournament. Franklin College says it will have no in-person classes March 16 and 17, start online classes March 18 through at least April 5 and empty residence halls of students by 5 p.m. March 15. The Children’s Museum of Indianapolis says it will be closed March 14-28. The Indianapolis Public Library joins other libraries across Indiana and says it will close all facilities until further notice beginning at 5 p.m. March 14.
• March 14: ISDH’s total number of positive cases rises to 15. The Indiana Gaming Commission says all licensed gaming and racing operations will close 14 days starting March 16.
• March 15: ISDH’s total number of positive cases rises to 19, with 121 tested. St. Vincent Hospital in Indianapolis announces all elective, non-urgent surgeries are canceled as of Tuesday.
• March 16: Gov. Eric Holcomb announces the first Hoosier death. ISDH’s total number of positive cases rises to 24. Holcomb closes bars, restaurants and nightlubs to in-person patrons, while carryout and delivery services will still be allowed.
• March 17: ISDH announces the second Hoosier death. Indiana’s Catholic bishops announce the cancellation of Sunday and weekday public masses. Gov. Holcomb activates the National Guard to assist as needed with the virus response. Purdue, Butler and Indiana State universities cancel May commencement ceremonies.
• March 18: ISDH’s total number of positive cases rises to 39. Eli Lilly and Co. says it will use its labs to speed up testing in Indiana for SARS-CoV-2, the virus that causes COVID-19. The 500 Festival announces suspends all planned, in-person events scheduled through May 9. Simon Property Group closes all malls and retail properties until March 29.
• March 19: ISDH’s total number of positive cases rises to 56. Gov. Holcomb extends Indiana’s state of emergency into May. Holcomb says all K-12 public schools will be closed until May 1 and nonpublic schools also are to close. Standardized testing was canceled. The state’s income-tax and corporate-tax payment deadline was extended to July 15. Holcomb says the state will waive job search requirements for people applying for Temporary Assistance to Needy Families. The IHSAA Boys Basketball State Tournament was canceled. The Marion County Emergency Operations Center upgrades to Level 1 status.
• March 20: ISDH reports the third Hoosier death and 23 new cases for a total of 79. Gov. Holcomb moves the state’s primary election to June 2. Indiana University says it is postponing May commencement ceremonies on all campuses. Indiana University Health says it can do limited virus testing.
• March 21: ISDH reports the fourth Hoosier death, and 47 new cases positive for a total of 126. A total of 833 people have been tested for the virus. Indiana National Guard details how it’s working with the Department of Transportation on distribution of medical supplies to hospitals.
• March 22: Indiana’s death toll rises to 7. ISDH reports 75 more positive cases.
• March 23: ISDH reports 259 cases of COVID-19, up from 201 a day earlier. Gov. Holcomb orders Hoosiers deemed nonessential to “stay at home” from March 24-April 7. Eli Lilly & Co. begins drive-thru testing for the coronavirus for health care workers with a doctor’s order. Ball State University cancels the May commencement.
• March 24: Indiana’s death toll rises to 13. Fred Payne of Indiana Workforce Development says any Hoosiers out of work, including temporary layoffs, are eligible to apply for unemployment benefits.
• March 25: Indiana’s death toll rises 17. Indianapolis Motor Speedway announces the Indianapolis 500 is moved to Aug. 23. IndyGo suspends fares and changes its ride schedules.
• March 27: Indiana’s death toll rises to 25. Marion County adds 192 new positive COVID-19 cases, the most of any county in the state for the day, for a total of 484. Indiana has 981 confirmed cases.
• March 28: Indiana’s death toll rises to 31. Marion County adds 100 new cases, the most of any county in the state, for a total of 584. Indiana has 1,232 confirmed cases.
• March 29: Indiana’s death toll rises to 32. Marion County adds 92 new positive cases, the most of any county in the state, for a total 676. Indiana has 1,514 confirmed cases. President Donald Trump announces in a press conference that the national social distancing recommendation will be extended by 30 days, to end April 30.
• March 30: Indiana’s death toll rises to 35. Marion County had the most new cases in the state with 135, for a total of 804. Indiana health commissioner Dr. Kris Box predicted the arrival of the surge in cases and deaths could come in mid-April to late April, but could be as late as mid-May, “but we don’t know.”
• March 31: Indiana’s death toll rises to 49. Gov. Holcomb extends the limits of bars and restaurants to offer only “to go” and “carry out” through April 6. Health commissioner Box, asked about when Indiana will be in a surge of COVID-19 cases, says she thinks the surge is starting.
• April 1: Indiana’s death toll rises to 65. Officials extend Marion County’s “stay at home” order through May 1. Marion County health officials say they will start COVID-19 testing services for frontline employees.The Children’s Museum of Indianapolis says it will remain closed until further notice. Gov. Holcomb announces the #InThisTogether campaign.
• April 2: Indiana’s death toll rises to 78. The state announces K-12 schools will be closed for the rest of the school year. The Indiana High School Athletic Association cancels spring sports seasons.
• April 3: Indiana’s death toll rises to 102. Gov. Holcomb extends the “stay at home” order through April 20. Indiana officials say the state has received a federal Major Disaster Declaration for all 92 counties. The Indiana National Guard says it, the Army Corps of Engineers and state health officials will begin on Saturday to assess sites for alternate health care facilities.
• April 4: ISDH reports 14 more deaths, bringing the state’s total to 116. 3,953 Hoosiers have tested positive, with 116 deaths and 19,800 total tests conducted. 
• April 5: ISDH reports 11 more deaths in Indiana.
• April 6: Indiana’s death toll rises to 139. The state reports one Madison County nursing home has had 11 deaths. Gov. extends the “stay at home” order through April 20. He also limits additional businesses to carry-out only.
• April 7: Indiana’s death toll rises to 173. A total of 5,507 Hoosiers have tested positive. Indiana health commissioner Box notes four long-term care facilities have 22 deaths that appear to be related to COVID-19.
• April 8: Indiana surpasses 200 deaths. Indiana now has 203 deaths and 5,943 confirmed cases. A total of 30,869 Hoosiers have been tested.
• April 9: ISDH says 6,351 Hoosiers have been tested positive, resulting in 245 deaths. A total of 32,133 Hoosiers have been tested.
• April 10: ISDH says 6,907 Hoosiers have tested positive for COVID-19, resulting in 300 deaths. A total of 35,040 Hoosiers have been tested. ISDH said 24 residents of a long-term care facility in Madison County have died from COVID-related illness.
• April 11: 30 more deaths are announced, bringing Indiana’s total to 330.
• April 12: A total of 343 Hoosiers have now died due to COVID-19, according to ISDH. Just under 8,000 cases have been confirmed in Indiana.
• April 13: Indiana stands at 350 deaths and 8,236 positive coronavirus cases, according to ISDH.
• April 14: ISDH announces 313 more cases and 37 more deaths, bringing the totals to 8,527 positive cases and 387 deaths.
• April 15: ISDH announces 49 more deaths for a total of 463. The total of positive cases grows to 8,955.
• April 16: Indiana reports 477 deaths and 9,542 positive cases. The governor says he expects Indiana to experience a reopening in early May.
• April 17: ISDH reports 519 deaths and 10,154 positive cases. The governor says that he will be extending the stay-at-home order through May 1, although some restrictions may be lifted in the new order.
• April 18: ISDH reports 26 more deaths. ISDH says there are now 10,641 positive cases and 545 Hoosiers have died as a result of the virus.
• April 19: 17 more Hoosiers have died according to ISDH, bringing Indiana’s total to 562.
• April 20: ISDH reports seven new deaths. ISDH says there are now 11,686 positive cases and 569 deaths related to the virus. Holcomb extended the “stay at home” order to May 1. The governor also said, if the medical supply chain is in good shape, other elective medical procedures can resume April 27.
• April 21: Indiana reports more than 12,000 positive cases and more than 600 deaths.
• April 22: Indiana reports 12,438 COVID-19 cases and 661 deaths. The Tyson facility in Logansport voluntarily closes so 2,200 employees can be tested for COVID-19.
• April 23: Indiana reports 13,039 COVID-19 cases and 709 deaths.
• April 24: Indiana reports 13,680 COVID-19 cases and 741 deaths. The Indianapolis City-County Council unanimously approved $25 million in an emergency meeting to help small businesses. Fishers City Council creates a city health department with a plan to test every resident.
• April 25: Indiana reports 14,395 COVID-19 cases and 785 deaths. ISDH launched an antibody testing study for Hoosiers on Saturday. Thousands of residents were randomly selected to participate in the study.
• April 26: Indiana reports 15,012 positive COVID-19 cases and 813 total deaths.
• April 27: Indiana reports 15,961 positive COVID-19 cases and 844 total deaths.
• April 28: Indiana reports 16,588 positive COVID-19 cases and 901 total deaths. Indiana officials say they are opening up COVID-19 testing to more Hoosiers, with expanded criteria and new testing services at 20 sites around the state.
• April 29: Indiana reports 17,182 positive COVID-19 cases and 964 total deaths. The state said it will spent $43 million on contact tracing.
• April 30: Indiana reports 17,835 positive COVID-19 cases and 1,007 total deaths. Indianapolis extends its stay-at-home order through May 15.
• May 1: Indiana reports 18,630 positive COVID-19 cases and 1,062 deaths. Gov. Eric Holcomb announces a phased reopening plan for the state of Indiana. He also extends the stay-at-home order to May 4.
• May 2: Indiana reports 19,295 positive COVID-19 cases and 1,115 deaths.
• May 3: Indiana reports 19,993 positive COVID-19 cases and 1,132 deaths.
• May 4: Indiana reports 583 more COVID-19 cases and 19 additional deaths. The stay-at-home order ends for most of Indiana. That order will end May 11 in Lake and Marion counties, and May 18 in Cass County.
• May 5: Indiana reports 21,033 positive COVID-19 cases and 1,213 deaths.
• May 6: Indiana reports 21,870 positive COVID-19 cases and 1,264 deaths. Ivy Tech Community College says it will continue virtual classes when summer courses begin in June.
• May 7: Indiana reports 22,503 positive COVID-19 cases and 1,295 deaths.
• May 8: Indiana reports 23,146 positive COVID-19 cases and 1,328 deaths. Cris Johnston, director of the Office of Budget and Management, said the state missed out on nearly $1 billion in anticipated April revenues. All state agencies will be given budget-cutting goals.
• May 9: Indiana reports 23,732 positive COVID-19 cases and 1,362 deaths.
• May 10: Indiana reports 24,126 COVID-19 cases in Indiana and 1,379 deaths.
• May 11: Indiana reports 24,627 COVID-19 cases in Indiana and 1,411 deaths.
• May 12: Indiana reports 25,127 COVID-19 cases in Indiana and 1,444 deaths.
• May 13: Indiana reports 25,473 COVID-19 cases in Indiana and 1,482 deaths. The first phase of a state-sponsored study of the coronavirus estimated about 186,000 Hoosiers had COVID-19 or the antibodies for the novel virus by May 1. Indianapolis Mayor Joe Hogsett announced plans for limited reopenings of worship services, retail establishments, the libraries and restaurants.