Impact of small-area lockdowns for the control of the COVID-19 pandemic
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Abstract
Background
Countries confronting the COVID-19 pandemic are implementing different social distancing strategies. We evaluated the impact of small-area lockdowns in Chile, aimed to reduce viral transmission while minimizing the population disrupted. The effectiveness of this intervention on the outbreak control is unknown.
Methods
A natural experiment assessing the impact of small-area lockdowns between February 15th and April 25th, 2020. We used mobility data and official governmental reports to compare regions with small-area lockdowns versus regions without. The primary outcome was the mean difference in the effective reproductive number (Re) of COVID-19. Secondary outcomes were changes in mobility indicators. We used quasi-experimental methods for the analysis and examined the impact of other concurrent public health interventions to disentangle their effects.
Results
Small-area lockdown produced a sizable reduction in human mobility, equivalent to an 11.4% reduction (95%CI −14.4% to −8.38%) in public transport and similar effects in other mobility indicators. Ten days after implementation, the small-area lockdown produced a reduction of the effective reproductive number (Re) of 0.86 (95%CI −1.70 to −0.02). School and university closures, implemented earlier, led to a 40% reduction in urban mobility. Closure of educational institutions resulted in an even greater Re reduction compared with small-area lockdowns.
Conclusions
Small-area lockdowns produced a reduction in mobility and viral transmission, but the effects were smaller than the early closures of schools and universities. Small-area lockdowns may have a relevant supporting role in reducing SARS-CoV-2 transmission and could be useful for countries considering scaling-down stricter social distancing interventions.
Article activity feed
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SciScore for 10.1101/2020.05.05.20092106: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Based on mobility data, our results show that the closure of schools and the limitation of the attendance of teachers, workers, and students to educational centers had an impact on the reduction of disease transmission. We …
SciScore for 10.1101/2020.05.05.20092106: (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: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Based on mobility data, our results show that the closure of schools and the limitation of the attendance of teachers, workers, and students to educational centers had an impact on the reduction of disease transmission. We hypothesize that this probably occurs because the closure is associated with other social processes that affect mobility within cities and caused the acceleration in the adoption of other measures such as the installation of work from home, as seen by other authors (35), and other individual actions of voluntary confinement. Individual voluntary quarantine decisions resulting from the increasing awareness are likely to have an effect on this outcome, but probably varying substantially depending on material circumstances and other socioeconomic considerations. However, due to the magnitude and evident temporal relationship with the closure of schools and universities, the effect of this measure seems evident. Our study has a number of limitations. First, the lockdowns are implemented at a small-area level, but our analysis was aggregated at the regional level. While this can dilute the intervention effect, it seems adequate given that mobility in major cities occurs between different municipalities. Moreover, policy effects are expected to impact disease transmission on a larger scale and not only in the small area directly affected by the lockdown. Secondly, our main outcome (Re) is subject to biases due to underreporting or different testing capacity betwe...
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.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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