Time to address the spatiotemporal uncertainties in COVID-19 research: Concerns and challenges

Abstract

In this correspondence, we emphasize methodological caveats of ecological studies assessing associations between COVID-19 and its physical and social environmental determinants. First, we stress that inference is error-prone due to the modifiable areal unit problem and the modifiable temporal unit problem. The possibility of confounding from using aggregated data is substantial due to the neglect of person-level factors. Second, studying the viral transmission of COVID-19 solely on people's residential neighborhoods is problematic because people are also exposed to nonhome locations and environments en-route along their daily mobility path. We caution against an uncritical application of aggregated data and reiterate the importance of stronger research designs (e.g., case-control studies) on an individual level. To address environmental contextual uncertainties due to people's day-to-day mobility, we call for people-centered studies with mobile phone data.