TY - JOUR

T1 - Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

AU - Flaxman, Seth

AU - Mishra, Swapnil

AU - Gandy, Axel

AU - Unwin, H. Juliette T.

AU - Mellan, Thomas A.

AU - Coupland, Helen

AU - Whittaker, Charles

AU - Zhu, Harrison

AU - Berah, Tresnia

AU - Eaton, Jeffrey W.

AU - Monod, Mélodie

AU - Perez-Guzman, Pablo N.

AU - Schmit, Nora

AU - Cilloni, Lucia

AU - Ainslie, Kylie E.C.

AU - Baguelin, Marc

AU - Boonyasiri, Adhiratha

AU - Boyd, Olivia

AU - Cattarino, Lorenzo

AU - Cooper, Laura V.

AU - Cucunubá, Zulma

AU - Cuomo-Dannenburg, Gina

AU - Dighe, Amy

AU - Djaafara, Bimandra

AU - Dorigatti, Ilaria

AU - van Elsland, Sabine L.

AU - FitzJohn, Richard G.

AU - Gaythorpe, Katy A.M.

AU - Geidelberg, Lily

AU - Grassly, Nicholas C.

AU - Green, William D.

AU - Hallett, Timothy

AU - Hamlet, Arran

AU - Hinsley, Wes

AU - Jeffrey, Ben

AU - Knock, Edward

AU - Laydon, Daniel J.

AU - Nedjati-Gilani, Gemma

AU - Nouvellet, Pierre

AU - Parag, Kris V.

AU - Siveroni, Igor

AU - Thompson, Hayley A.

AU - Verity, Robert

AU - Volz, Erik

AU - Walters, Caroline E.

AU - Wang, Haowei

AU - Wang, Yuanrong

AU - Watson, Oliver J.

AU - Winskill, Peter

AU - Bhatt, Samir

AU - Imperial College COVID-19 Response Team

N1 - Publisher Copyright: © 2020, The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2020

Y1 - 2020

N2 - Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, 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 time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data 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 Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that—for all of the countries we consider here—current interventions have been sufficient to drive Rt below 1 (probability Rt < 1.0 is greater than 99%) and achieve control of the epidemic. We estimate that across all 11 countries combined, between 12 and 15 million individuals were infected with SARS-CoV-2 up to 4 May 2020, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions—and lockdowns in particular—have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.

AB - Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, 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 time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data 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 Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that—for all of the countries we consider here—current interventions have been sufficient to drive Rt below 1 (probability Rt < 1.0 is greater than 99%) and achieve control of the epidemic. We estimate that across all 11 countries combined, between 12 and 15 million individuals were infected with SARS-CoV-2 up to 4 May 2020, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions—and lockdowns in particular—have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.

U2 - 10.1038/s41586-020-2405-7

DO - 10.1038/s41586-020-2405-7

M3 - Journal article

C2 - 32512579

AN - SCOPUS:85086040332

VL - 584

SP - 257

EP - 261

JO - Nature

JF - Nature

SN - 0028-0836

IS - 7820

ER -