Causal analysis of COVID-19 observational data in German districts reveals effects of mobility, awareness, and temperature

Mobility, awareness, and weather are suspected to be causal drivers for new cases of COVID-19 infection. Correcting for possible confounders, we estimated their causal effects on reported case numbers. To this end, we used a directed acyclic graph (DAG) as a graphical representation of the hypothesized causal effects of the aforementioned determinants on new reported cases of COVID-19. Based on this, we computed valid adjustment sets of the possible confounding factors. We collected data for Germany from publicly available sources (e.g. Robert Koch Institute, Germany’s National Meteorological Service, Google) for 401 German districts over the period of 15 February to 8 July 2020, and estimated total causal effects based on our DAG analysis by negative binomial regression. Our analysis revealed favorable causal effects of increasing temperature, increased public mobility for essential shopping (grocery and pharmacy), and awareness measured by COVID-19 burden, all of them reducing the outcome of newly reported COVID-19 cases. Conversely, we saw adverse effects of public mobility in retail and recreational areas, awareness measured by searches for “corona” in Google, and higher rainfall, leading to an increase in new COVID-19 cases. This comprehensive causal analysis of a variety of determinants affecting COVID-19 progression gives strong evidence for the driving forces of mobility, public awareness, and temperature, whose implications need to be taken into account for future decisions regarding pandemic management.