Quantifying the efficiency of non-pharmaceutical interventions against SARS-COV-2 transmission in Europe

  1. Andres garchitorena
  2. Hugo Gruson
  3. Bernard Cazelles
  4. Benjamin Roche

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Abstract

Since the emergence of SARS-CoV-2, governments around the World have implemented a combination of public health responses based on non-pharmaceutical interventions (NPIs), with significant social and economic consequences. Though most European countries have overcome the first epidemic wave, it remains of high priority to quantify the efficiency of different NPIs to inform preparedness for an impending second wave. In this study, combining capture-recapture methods with Bayesian inference in an age-structured mathematical model, we use a unique European dataset compiled by the European Centre for Disease Control (ECDC) to quantify the efficiency of 24 NPIs and their combinations (referred to as public health responses, PHR) in reducing SARS-Cov-2 transmission rates in 32 European countries. Of 166 unique PHR tested, we found that median decrease in viral transmission was 74%, which is enough to suppress the epidemic. PHR efficiency was positively associated with the number of NPIs implemented. We found that bans on mass gatherings had the largest effect among NPIs, followed by school closures, teleworking, and stay home orders. Partial implementation of most NPIs resulted in lower than average response efficiency. This first large-scale estimation of NPI and PHR efficiency against SARS-COV-2 transmission in Europe suggests that a combination of NPIs targeting different population groups should be favored to control future epidemic waves.

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  1. Version published to 10.1101/2020.08.17.20174821v2 on medRxiv
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    SciScore for 10.1101/2020.08.17.20174821: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

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    Table 2: Resources

    No key resources detected.

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    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study had several limitations. First, we used an age-structured model where each age class has the same susceptibility to the virus, and we assume that detected and non-detected cases have the same transmissibility capacity because non-detected cases can be both asymptomatic and symptomatic cases. However, it is still unclear whether asymptomatic cases and children have similar or lower SARS-COV-2 transmissibility capacity compared to other population groups, which could affect our results. Second, although our mathematical model allowed us to accurately quantify PHR efficiency, responses were comprised of 13 different NPIs that frequently overlapped over space and time. We estimated the added efficiency provided by each NPI via statistical time-series analyses controlling for relevant factors, but these should not be interpreted as NPI independent efficiencies because we could not control for the implementation of other NPIs in our multivariate framework. Given the substantial overlap in NPI implementation, this could also lead to biases in the estimated efficiency of certain NPIs, which could explain for instance the small effect of lockdowns as compared with stay at home recommendations for at-risk groups. Third, we use a comprehensive database on NPI implementation compiled by the ECDC from country reports, but other interventions such as travel restrictions could have impacted epidemic progression at European level [8,30]. This could have biased the estimates for th...

    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.

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    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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    • No protocol registration statement was detected.

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  3. Version published to 10.1101/2020.08.17.20174821v1 on medRxiv