At the request of the Province of Limburg (also on behalf of Gelderland and Overijssel), the Staatskanzlei of the Land North Rhine-Westphalia (NRW) and the Dutch Ministry of the Interior and Kingdom Relations, we conducted both a qualitative and a quantitative study to gain insight into whether significant differences exist in the distribution of COVID-19 in the Netherlands, North Rhine-Westphalia and Belgium. Attention was paid to how these differences relate to the different policy measures. We, euPrevent, GGD Zuid Limburg, Gesundheitsamt Düren and Maastricht University, also investigated the question of whether the virus distribution in the border region differs from the distribution within these three countries.