Effectiveness of Localized Lockdowns in the COVID-19 Pandemic
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
- Evaluated articles (NCRC)
Abstract
Nonpharmaceutical interventions, such as social distancing and lockdowns, have been essential to control of the coronavirus disease 2019 (COVID-19) pandemic. In particular, localized lockdowns in small geographic areas have become an important policy intervention for preventing viral spread in cases of resurgence. These localized lockdowns can result in lower social and economic costs compared with larger-scale suppression strategies. Using an integrated data set from Chile (March 3–June 15, 2020) and a novel synthetic control approach, we estimated the effect of localized lockdowns, disentangling its direct and indirect causal effects on transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our results showed that the effects of localized lockdowns are strongly modulated by their duration and are influenced by indirect effects from neighboring geographic areas. Our estimates suggest that extending localized lockdowns can slow down SARS-CoV-2 transmission; however, localized lockdowns on their own are insufficient to control pandemic growth in the presence of indirect effects from contiguous neighboring areas that do not have lockdowns. These results provide critical empirical evidence about the effectiveness of localized lockdowns in interconnected geographic areas.
Article activity feed
-
-
-
-
SciScore for 10.1101/2020.08.25.20182071: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Th…
SciScore for 10.1101/2020.08.25.20182071: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code.
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- No funding statement was detected.
- No protocol registration statement was detected.
-
Our take
This study, available as a preprint and thus not yet peer-reviewed, demonstrated that the effectiveness of local lockdowns on COVID-19 transmission are dependent on the duration of intervention and the spillover effects from neighboring municipalities using municipalities in Chile as a case study. Due to spillover events, local control by itself may not be sufficient to control epidemic growth. Greatest reductions in transmission and case numbers could be achieved by extending the lockdown period of the target and neighboring municipalities.
Study design
modeling-simulation
Study population and setting
Authors used the daily time series of COVID-19 cases reported by the Ministry of Health of Chile between March 1 and mid-July, 2020 and adjusted this by the delay from symptom onset to report to …
Our take
This study, available as a preprint and thus not yet peer-reviewed, demonstrated that the effectiveness of local lockdowns on COVID-19 transmission are dependent on the duration of intervention and the spillover effects from neighboring municipalities using municipalities in Chile as a case study. Due to spillover events, local control by itself may not be sufficient to control epidemic growth. Greatest reductions in transmission and case numbers could be achieved by extending the lockdown period of the target and neighboring municipalities.
Study design
modeling-simulation
Study population and setting
Authors used the daily time series of COVID-19 cases reported by the Ministry of Health of Chile between March 1 and mid-July, 2020 and adjusted this by the delay from symptom onset to report to reconstruct the epidemic curve by date of onset. Census data and household survey data were also incorporated. Transmission in each municipality was characterized by the instantaneous reproduction number allowing for interactions between neighboring municipalities as different municipalities were subject to different localized lockdown policies. Demographic and economic factors that differed by municipality and could affect transmission such as age, sex, sanitation infrastructure, overcrowding, and monthly income were accounted for. The authors used a causal inference framework to explore the impact of counterfactual lockdown policies of different durations.
Summary of main findings
Authors found that the effectiveness of local lockdowns are highly affected by the duration of the local lockdown and the level of spillover from neighboring municipalities that may have different levels of transmission and under different control measures. In three municipalities of Greater Santiago a local lockdown lasting 3-weeks longer would have decreased the reproduction number further, preventing 143 per 100,000; 59 per 100,000; and 267 per 100,000 population in Lo Barnechea, Providencia, and Santiago respectively, representing a 33-62% reduction in reported cases in that time period. Authors estimate that these reductions would have been even greater had the neighboring municipalities also extended their local lockdowns.
Study strengths
Authors used an integrated dataset of daily reported COVID-19 cases adjusted for reporting delays, household survey, and census data to reconstruct the epidemic course in Chile. The natural variation in local lockdowns implemented in each municipality with varying durations were used to explore their effectiveness in reducing transmission. Authors also accounted for the interconnected nature of neighboring municipalities and explored varying counterfactuals and their effect on the epidemic.
Limitations
As data by date of symptom onset were not available, authors had to reconstruct the epidemic curve accounting for the onset to reporting delay to estimate the reproduction number over time. Information on testing efforts are not provided so it is difficult to determine whether the increase in case numbers, particularly early in the epidemic are a true increase in transmission, or an increase in case finding.
Value added
This study provides insights into the effectiveness of local lockdowns and the importance of considering the spatial interconnectedness of neighbouring municipalities and their local interventions.
-
-