Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

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Title: Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe
Authors: Flaxman, S
Mishra, S
Gandy, A
Unwin, HJT
Mellan, TA
Coupland, H
Whittaker, C
Zhu, H
Berah, T
Eaton, JW
Monod, M
Perez Guzman, PN
Schmit, N
Cilloni, L
Ainslie, K
Baguelin, M
Boonyasiri, A
Boyd, O
Cattarino, L
Cucunuba Perez, Z
Cuomo-Dannenburg, G
Dighe, A
Djaafara, A
Dorigatti, I
Van Elsland, S
Fitzjohn, R
Gaythorpe, K
Geidelberg, L
Grassly, N
Green, W
Hallett, T
Hamlet, A
Hinsley, W
Jeffrey, B
Knock, E
Laydon, D
Nedjati Gilani, G
Nouvellet, P
Parag, K
Siveroni, I
Thompson, H
Verity, R
Volz, E
Walters, C
Wang, H
Watson, O
Winskill, P
Xi, X
Walker, P
Ghani, AC
Donnelly, CA
Riley, SM
Vollmer, MAC
Ferguson, NM
Okell, LC
Bhatt, S
Item Type: Journal Article
Abstract: Following the emergence of a novel coronavirus1 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics. In response, many European countries have implemented unprecedented non-pharmaceutical interventions such as closure of schools and national lockdowns. We study the impact of major interventions across 11 European countries for the period from the start of COVID-19 until the 4th of May 2020 when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks prior, allowing for the time lag between infection and death. We use partial pooling of information between countries with both individual and shared effects on the reproduction number. Pooling allows more information to be used, helps overcome data idiosyncrasies, and enables more timely estimates. Our model relies on fixed estimates of some epidemiological parameters such as the infection fatality rate, does not include importation or subnational variation and assumes that changes in the reproduction number are an immediate response to interventions rather than gradual changes in behavior. Amidst the ongoing pandemic, we rely on death data that is incomplete, with systematic biases in reporting, and subject to future consolidation. We estimate that, for all the countries we consider, current interventions have been sufficient to drive the reproduction number Rt below 1 (probability Rt< 1.0 is 99.9%) and achieve epidemic control. We estimate that, across all 11 countries, between 12 and 15 million individuals have been infected with SARS-CoV-2 up to 4th May, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions and lockdown in particular have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.
Issue Date: 8-Jun-2020
Date of Acceptance: 22-May-2020
DOI: 10.1038/s41586-020-2405-7
ISSN: 0028-0836
Publisher: Springer Science and Business Media LLC
Journal / Book Title: Nature
Copyright Statement: © 2020 Springer-Verlag. The final publication is available at Springer via [insert hyperlinked DOI]
Sponsor/Funder: Medical Research Council (MRC)
Wellcome Trust
Funder's Grant Number: MR/R015600/1
Keywords: Imperial College COVID-19 Response Team
General Science & Technology
Publication Status: Published online
Embargo Date: 2020-12-08
Open Access location:
Online Publication Date: 2020-06-08
Appears in Collections:Mathematics
Department of Infectious Diseases
Faculty of Medicine
Faculty of Natural Sciences
School of Public Health
Grantham Institute for Climate Change
Imperial College London COVID-19