Tag: lockdown

Effect of timing of implementation of the lockdown on the number of deaths for COVID-19 in four European countries

Publication date: 20/10/2020 – E&P Code: repo.epiprev.it/1984
Authors: Raffaele Palladino1,2,3, Jordy Bollon4, Luca Ragazzoni4,5, Francesco Barone-Adesi4,5

Abstract: Background: Lockdown in France, Italy, Spain and United Kingdom, the four European countries which have been impacted the most by the COVID-19 emergency, was enforced 13 to 16 days after the one in Hubei, when normalizing for the time when the outbreak hit 50 cases in all countries. This prompts the question on how many deaths for COVID-19 could have been avoided during the early phase of the pandemic, had containment measures in European countries aligned in timing with those adopted in China.
Methods: We modeled the daily number of COVID-19 deaths in France, Italy, Spain, United Kingdom and we estimated the effect of the national lockdown implementing an interrupted time series analysis. Then, we created four separate counterfactual scenario by predicting the daily number of deaths that would have been observed in the four countries if the lockdown had been implemented at the same time as in Hubei. Finally, we estimated the relative change in the number of total deaths in the counterfactual scenario, compared to the observed one.
Results: If an early lockdown had been implemented, the death toll would have been 2461, 6769, 6792 and 4071, corresponding to a 92% (95%CI: 86% to 95%), 81% (95%CI: 77% to 84%), 78% (95%CI: 62% to 86%) and 90% (95%CI: 88% to 92%) relative reduction, as compared with observed data.
Conclusions: We found that a more rapid and homogeneous response would have avoided a substantial number of deaths. Our results underline the need of strengthening public health emergency preparedness at national and global level.

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Excess deaths and hospital admissions for COVID-19 due to a late implementation of the lockdown in Italy

Publication date: 05/06/2020 – E&P Code: repo.epiprev.it/1735
Authors: Raffaele Palladino1,2, Jordy Bollon3, Luca Ragazzoni3,4, Francesco Barone-Adesi3,4

Abstract: Background: In Italy, the COVID-19 pandemic led to the implementation of containment measures to the highest level, with a national lockdown enforced on March 9th, 2020. Despite this, by the time the epidemic curve started to flatten the health system already exceeded its capacity in different areas of the country, raising concerns that the public health response was indeed delayed. Aim of this study was to evaluate the health effects of late implementation of the lockdown in Italy.
Methods: Using national data on daily number of COVID-19 cases we first estimated the effect of the lockdown, employing an interrupted time series analysis. Second, we evaluated the effect of an early lockdown on the trend of new cases, creating a counterfactual scenario where the intervention was implemented one week in advance. We then predicted the corresponding number of intensive care unit (ICU) admissions, non-ICU admissions, and deaths. Finally, we compared the number of hospital admissions and deaths under the actual and counterfactual scenarios.
Results: an early implementation of the lockdown would have avoided about 126,000 COVID-19 cases, 54,700 non-ICU admissions, 15,600 ICU admissions, and 12,800 deaths. On the relative scale, this corresponds to a reduction of 60% (95%CI: 55% to 64%), 52% (95%CI: 46% to 57%), 48% (95%CI: 42% to 53%), and 44% (95%CI: 38% to 50%), respectively.
Conclusions: We found that the late implementation of the lockdown in Italy was responsible for a substantial proportion of hospital admissions and deaths associated with the COVID-19 pandemic. Understanding the factors contributing to a delayed response is necessary to strengthen public health preparedness in case of a second wave of infections.

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