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Espenhain L, Ethelberg S, Mortensen LH, Christiansen LE. Automated local lockdowns for SARS-CoV-2 epidemic control-assessment of effect by controlled interrupted time series analysis. IJID REGIONS 2024; 12:100380. [PMID: 38911235 PMCID: PMC11186853 DOI: 10.1016/j.ijregi.2024.100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/22/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024]
Abstract
Objectives During the COVID-19 pandemic, broad non-pharmaceutical interventions such as national lockdowns were effective but had significant drawbacks, prompting targeted approaches, such as Denmark's localized lockdowns, based on specific epidemiological criteria. This study evaluates the effect of Denmark's automated local lockdown strategy on epidemic control to inform future response. Methods This was a register-based controlled interrupted time series analysis, examining SARS-CoV-2 infection rates in Danish parishes from March to September 2021. The matching of control parishes was based on location, time, and pre-lockdown infection trends, with the lockdown's start defined as the day after a parish exceeded the lockdown criteria. Follow-up included 3-week pre-lockdown and 2-week post-lockdown. Results A total of 30 parishes were mandated to lockdown, approximately 3.5% of the population of Denmark. A total of 94 control parishes were used as 109 controls. The decrease in the incidence during the 2-week follow-up period after the initiation of the lockdown was 13% points higher in case parishes: in case parishes, the incidence was reduced by 78% compared with 65% in control parishes. Conclusions Our findings demonstrate that local lockdowns did have a positive effect in mitigating the spread of the SARS-CoV-2 virus, making them valuable in the fight against the COVID-19 pandemic and an important alternative to national lockdowns.
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Affiliation(s)
- Laura Espenhain
- Department of Infectious Disease epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust Hvas Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Statistics Denmark, Copenhagen, Denmark
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Lattanzio S. Schools and the transmission of Sars-Cov-2: Evidence from Italy. ECONOMICS AND HUMAN BIOLOGY 2024; 52:101342. [PMID: 38104359 DOI: 10.1016/j.ehb.2023.101342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/25/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023]
Abstract
This paper studies the effect on the spread of Sars-Cov-2 in Italy of schools' re-openings and closures. Exploiting different re-opening dates across regions after the summer break of 2020, I show that early-opening regions experienced more cases in the 40 days following school re-openings compared with late-opening ones. However, there is great uncertainty around the estimates, and this suggests a wide dispersion in the effects of school re-openings on Sars-Cov-2 transmission. I also study the effect of school closures in Campania, one of the biggest regions in Southern Italy. Using a synthetic control approach, I show that school closures are associated with lower numbers of cases relative to the counterfactual group, particularly in younger age groups. In contrast, I find no significant effects on older age groups, which are more likely to require hospitalization. Finally, by exploiting survey data, I provide descriptive evidence on the increased incidence rate among teachers and students relative to the general population, following school re-openings.
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Murphy C, Lim WW, Mills C, Wong JY, Chen D, Xie Y, Li M, Gould S, Xin H, Cheung JK, Bhatt S, Cowling BJ, Donnelly CA. Effectiveness of social distancing measures and lockdowns for reducing transmission of COVID-19 in non-healthcare, community-based settings. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230132. [PMID: 37611629 PMCID: PMC10446910 DOI: 10.1098/rsta.2023.0132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
Social distancing measures (SDMs) are community-level interventions that aim to reduce person-to-person contacts in the community. SDMs were a major part of the responses first to contain, then to mitigate, the spread of SARS-CoV-2 in the community. Common SDMs included limiting the size of gatherings, closing schools and/or workplaces, implementing work-from-home arrangements, or more stringent restrictions such as lockdowns. This systematic review summarized the evidence for the effectiveness of nine SDMs. Almost all of the studies included were observational in nature, which meant that there were intrinsic risks of bias that could have been avoided were conditions randomly assigned to study participants. There were no instances where only one form of SDM had been in place in a particular setting during the study period, making it challenging to estimate the separate effect of each intervention. The more stringent SDMs such as stay-at-home orders, restrictions on mass gatherings and closures were estimated to be most effective at reducing SARS-CoV-2 transmission. Most studies included in this review suggested that combinations of SDMs successfully slowed or even stopped SARS-CoV-2 transmission in the community. However, individual effects and optimal combinations of interventions, as well as the optimal timing for particular measures, require further investigation. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Caitriona Murphy
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Wey Wen Lim
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Cathal Mills
- Department of Statistics, University of Oxford, Oxford, UK
| | - Jessica Y. Wong
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Dongxuan Chen
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Yanmy Xie
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Mingwei Li
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Susan Gould
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Hualei Xin
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Justin K. Cheung
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Samir Bhatt
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Benjamin J. Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People's Republic of China
- Laboratory of Data Discovery for Health, Hong Kong Science and Technology Park, New Territories, Hong Kong, People's Republic of China
| | - Christl A. Donnelly
- Department of Statistics, University of Oxford, Oxford, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
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Alfano V, Capasso S, Limosani M. On the determinants of anti-COVID restriction and anti-vaccine movements: the case of IoApro in Italy. Sci Rep 2023; 13:16784. [PMID: 37798271 PMCID: PMC10556032 DOI: 10.1038/s41598-023-42133-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 09/05/2023] [Indexed: 10/07/2023] Open
Abstract
Following restrictions to control the spread of COVID-19, and subsequent vaccination campaigns, sentiments against such policies were quick to arise. While individual-level determinants that led to such attitudes have drawn much attention, there are also reasons to believe that the macro context in which these movements arose may contribute to their evolution. In this study, exploiting data on business activities which supported a major Italian anti-restriction and anti-vaccine movement, IoApro, using quantitative analysis that employs both a fractional response probit and logit model and a beta regression model, we investigate the relationship between socio-economic characteristics, institutional quality, and the flourishing of this movement. Our results suggest a U-shaped relationship between income and the proliferation of the movement, meaning that support for these movements increases the greater the degree of economic decline. Our results further indicate that the share of the population between 40 and 60 years old is positively related to support for such movements, as is institutional corruption.
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Affiliation(s)
- Vincenzo Alfano
- DiSEGIM, University of Napoli Parthenope, Naples, Italy.
- Center for Economic Studies - CES-Ifo, Munich, Germany.
| | - Salvatore Capasso
- Department of Human and Social Sciences, Italian National Research Council, Rome, Italy
- University of Napoli Parthenope, Naples, Italy
- CSEF, University of Naples Federico II, Naples, Italy
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Alfano V, Cicatiello L, Ercolano S. Assessing the effectiveness of mandatory outdoor mask policy: The natural experiment of Campania. ECONOMICS AND HUMAN BIOLOGY 2023; 50:101265. [PMID: 37348287 PMCID: PMC10259108 DOI: 10.1016/j.ehb.2023.101265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/13/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
Face masks are possibly the main symbol of the COVID-19 pandemic. Once rarely used in Western countries, in the last two years they have become an object it is impossible to leave one's home without. Italy made their use a legal requirement, even outdoors, from late 2020 to early 2022. The effectiveness of this policy in reducing COVID-19 cases has been widely debated. The recent cancellation of their mandatory use in Italy offers an interesting setting in which to test its impact, since one Italian region (Campania) extended the restriction for a further three weeks. We aim to shed some light on the real-world impact of mandatory use of face masks outdoors, identifying the effect of this policy on the spread of COVID-19. By means of a quantitative analysis, employing a synthetic control method approach, we find that Campania had statistically the same number of cases as its synthetic counterfactual, built from a donor pool formed from the other Italian provinces. Hence, results suggest that while it imposes a burden on the public, the use of face masks outdoors is not correlated with a decrease in the number of COVID-19 cases.
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Affiliation(s)
- Vincenzo Alfano
- DiGESIM, University of Napoli Parthenope, Napoli, Italy; Center for Economic Studies - CESifo, Italy.
| | - Lorenzo Cicatiello
- Department of Human and Social Science, University of Napoli L'Orientale, Napoli, Italy
| | - Salvatore Ercolano
- Department of Mathematics, Information Sciences and Economics, University of Basilicata, Potenza, Italy; National University Centre for Applied Economic Studies - CMET 05, Italy
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The effect of self-esteem on the spread of a pandemic. A cross-country analysis of the role played by self-esteem in the spread of the COVID-19 pandemic. Soc Sci Med 2023; 324:115866. [PMID: 37015169 PMCID: PMC10030268 DOI: 10.1016/j.socscimed.2023.115866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/23/2023] [Accepted: 03/20/2023] [Indexed: 03/24/2023]
Abstract
Extant research on COVID-19 suggests that many socio-economic determinants, by affecting personal behavior, have influenced the evolution of the pandemic. In this paper we study the role played in this regard by average levels of self-esteem in the public. There are reasons to believe that both low and very levels of self-esteem may have an effect on the spread of COVID-19, for opposite reasons. On the one hand, people with low self-esteem may not worry enough to behave in the way recommended (and prescribed, through non-pharmaceutical interventions) by the authorities; people with very high self-esteem, on the other hand, may be over-confident and fail to follow the prescriptions, believing that they do not need them. In this study we test this hypothesis by means of a quantitative cross-country analysis, using a hybrid model and the Rosenberg self-esteem scale. Our results suggest the existence of a U-shaped relationship between the trend of COVID-19 and average levels of self-esteem in a country.
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