Lockdowns and restrictions across Europe ‘averted 3 million deaths’

Lockdowns and restrictions on daily life prevented around 3.1 million deaths in 11 European countries, according to a new modelling study published Monday, as most nations tiptoe out of the strict measures to halt the spread of the new coronavirus.

Lockdowns and restrictions across Europe 'averted 3 million deaths'
Members of the Catalan regional police force Mossos d'Esquadra inform tourists about the lockdown in Barcelona on March 15, 2020

Research by Imperial College London, whose scientists are advising the British government on the virus, found that restrictions such as stay-at-home orders had worked to bring the epidemic under control. 

Using European Centre of Disease Control data on deaths in 11 nations in the period up to May 4, they compared the number of observed deaths in the countries against those predicted by their model if no restrictions had been 

They estimated that approximately 3.1 million deaths had been averted by the policies.

The 11 nations were: Germany, France, Italy, Britain, Spain, Belgium, Austria, Denmark, Norway, Switzerland and Sweden, which did not impose a strict lockdown as seen in other countries.

Researchers also calculated that the interventions had caused the reproduction number — how many people someone with the virus infects — to drop by an average of 82 percent, to below 1.0.

“Our results show that major non-pharmaceutical interventions, and lockdown in particular, have had a large effect on reducing transmission,” the authors said in the study, published in Nature Research.

“Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.”

The researchers estimated that cumulatively between 12 and 15 million people had been infected in the period — or between 3.2 and four percent of the population of the 11 nations.

This fluctuated significantly between countries, with only 710,000 people in Germany thought to have caught the virus, or 0.85 percent of the population. 

That compares with Belgium, with the highest infection rate of the countries at eight percent, and Spain, where some 5.5 percent of the population, or 2.6 million people, were estimated to have been infected. 

'Large health benefits'
The authors said that since interventions such as restrictions on public events and school closures were imposed in quick succession, it is difficult to tease out the effect of each one separately. 
But they found that lockdown measures taken as a whole did have an identifiable and “substantial” effect, reducing transmission by an estimated 81 percent.  
The authors acknowledged that one limitation of their model was that it assumes each measure had the same effect on all countries, whereas in reality “there was variation in how effective lockdown was in different countries”.
In a separate study, also published in Nature, researchers from UC Berkeley used a different method — econometric modelling used to assess how policies affect economic growth — to evaluate containment policies in China, South 
Korea, Italy, Iran, France and the United States. 
Researchers used data on daily infection rates and the timings of hundreds of localised interventions up until April 6. They then compared infection growth rates before and after those policies were implemented. 
By comparing this to a scenario in which no policies had been put in place, they estimated that the interventions may have prevented or delayed around 62 million confirmed cases of COVID-19 across the six countries.
They said this corresponded to averting around 530 million total infections.

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Italy to keep quarantine rules in place as Covid cases rise

Italy will not scrap its mandatory Covid isolation period, the health minister has said, with the government split over whether to follow the ‘English model’ of managing the pandemic.

Italy to keep quarantine rules in place as Covid cases rise

The Italian health minister said he’s not considering scrapping the country’s existing Covid isolation requirements, following weeks of disagreement within government and among health experts over whether the rule should remain in place.

Health Minister Roberto Speranza said “no” when asked by Italian newspaper La Repubblica on Saturday if he’ll end the isolation requirement for positive cases “as requested by various politicians and experts”.

“At the moment such a thing is not in question,” he added. “Anyone who is infected must stay at home.”

“There are 650,000 people in solitary confinement right now, and it is unimaginable to tell them they can move around.”

Though Italy has now scrapped almost all other Covid-related health measures – including all entry requirements for travellers – the country still requires anyone who tests positive while in the country to self-isolate for between one and three weeks (see the bottom of the article for more details).

READ ALSO: How tourists and visitors can get a coronavirus test in Italy

Speranza, who is known for taking a cautious line when it comes to managing the pandemic, also decided in mid-June to the keep the requirement to wear masks on public transport in place throughout the summer.

The minister’s clarification came after weeks of debate over whether the isolation rule should also now be dropped or not, with the government reportedly split over the issue.

One of Speranza’s two deputy health ministers, Andrea Costa, has spoken out in favour of scrapping the rule, while the other, Pierpaolo Sileri, said the government should keep it in place.

Several prominent politicians within Italy’s broad coalition government, as well as health experts, have been calling for an end to all restrictions amid a debate over the adoption of a ‘modello inglese‘ or ‘English model’ of managing the pandemic: in England, isolation when infected is only a recommendation, not a requirement. 

Others, including epidemiologist Carlo La Vecchia, meanwhile suggested Italy move towards adopting a ‘Swiss model’: one week of isolation when positive, and no testing requirement at the end of that period.

But as the Covid infection and hospitalisation rates rise again – with the latest official health data showing a 60 percent rise in new infections in just seven days – Speranza doesn’t appear keen to try out either idea in Italy.

READ ALSO:  Why are so many Italians still wearing face masks in shops?

While Speranza told Repubblica “the challenge now is to focus on individual responsibility”, he said certain situations called for rules to remain in place.

“We mustn’t forget what we’ve been through,” he said.

“The most vulnerable must be protected. If they encounter the virus, their lives are still at risk. Their protection does not depend only on their own behavior, but on all of us … for example by putting on a mask in risky places.

“When circulation was very low, I said [the pandemic] was not over, and now I ask everyone once again to be cautious.”

Photo by Miguel MEDINA / AFP

What are Italy’s isolation rules?

In Italy and beyond, any type of Covid isolation period is commonly referred to as ‘quarantine’ (quarantena); though it should be noted that Italy’s health authorities define quarantine as an isolation period “carried out when a healthy person has been exposed to a Covid-19 case, with the aim of monitoring symptoms and providing for the early identification of cases”.

This is as opposed to isolation (isolamento), which is used “to separate people suffering from Covid-19 from healthy ones in order to prevent the spread of infection”.

The health ministry’s existing rules state that anyone who tests positive while in Italy is required to immediately self-isolate for a minimum of seven days – if they’re fully vaccinated or recently recovered from Covid.

Italy’s health ministry defines this as either being vaccinated and boosted (at any time – there’s no time limit or expiry period for those who’ve had a booster shot); or as having completed the primary vaccination cycle or recovered from Covid within the past 120 days (and being able to show certification proving this).

For anyone who is not classed as fully vaccinated or recently recovered, the isolation period is extended to 10 days.

In either case, the infected person must have been symptomless for at least three days in order to exit quarantine (with the exception of symptoms relating to a lost sense of taste or smell).

Reader question: How do Italy’s Covid quarantine rules work for travellers?

The patient must also test negative for the virus via either a molecular (PCR) or rapid antigen test on the final day of the quarantine in order to be allowed out.

Read more about getting tested while in Italy in a separate article here.

Quarantined people who keep testing positive for the virus can be kept in self-isolation for a maximum of 21 days, at which point they will be automatically released.

The prospect of potentially having to spend up to three weeks in isolation is obviously concerning for people visiting Italy on holiday this summer – with a number of The Local’s readers saying they wouldn’t be coming on holiday to Italy this summer if the rules remain in place.

As some countries require people travelling from Italy to test negative before their departure, visitors at the tail end of their journey could also be hit with the unpleasant surprise of finding out they need to quarantine for another week in Italy instead of heading home as planned.

Italy does not currently require visitors from any country to test negative in order to enter the country, as long as they are fully boosted or were recently vaccinated/have recently recovered from Covid.

For more information about how Italy’s health regulations may apply to you, see the Italian health ministry’s website or consult the Italian embassy in your country.