Evidence that coronavirus blocks work to save lives worldwide

• Overwhelming evidence suggests that blockages help contain coronavirus outbreaks and prevent further deaths.
• Italy’s blockade prevented around 200,000 hospitalizations, according to a recent study.
• Another study found that Wuhan restrictions prevent tens of thousands of infections across Hubei province.
• While it is possible to reduce transmission only through social distancing, blockades ensure that citizens comply with these guidelines.
• Visit the Business Insider home page for more stories.

More than a third of the world population is under some restriction in the movement related to the coronavirus pandemic. But after several weeks of closure measures, small groups have started to protest and businessmen like Elon Musk have argued that countries should reopen.

“Give people back their freedom!” Musk tweeted on Wednesday, linking to an opinion piece in the Wall Street Journal by TJ Rodgers, the founder of the manufacturing company Cypress Semiconductor.

Rodgers recently described two arguments as to why the US blockades. USA They were a mistake: The first is that their own analysis found a minimal correlation between states that closed businesses early and their overall death count (adjusted for population size). The second is that Sweden, where many schools and companies remain open, has a lower death rate than some European nations that imposed complete blockades, such as Italy, Spain, and the United Kingdom.

But overwhelmingly, the evidence suggests that locks help contain outbreaks and save lives.

China, Germany and Spain saw their number of daily infections decrease after the blockades were put in place.

In Italy, a team of researchers recently simulated what could have happened if the country’s restrictions had been relaxed in March, or not imposed at all. The results showed that the country’s blockade prevented around 200,000 hospitalizations between February 21 (when Italy’s first case was reported) and March 25. It also reduced transmission of the virus in Italy by about 45%, according to the study.

Another group of scientists found that Chinese cities that implemented restrictions before discovering any case of COVID-19 saw a third fewer cases during their first week of infections than cities with late outbreak responses.

“The social distancing provided by the blocks has clearly slowed the spread of the virus,” Jeffrey Morris, director of the biostatistics division at the University of Pennsylvania, told Business Insider.

Morris estimated that most places in the US USA They have reduced their normal activity levels by 70% due to blockages and social distancing. That means fewer opportunities for the spread of infection.

Cities that closed in China and Italy saw fewer infections

Now that the outbreak in China appears to be contained and the outbreak in Italy appears to be declining, the data from both countries provides a retrospective on why the blockades work.

A recent study of restrictions in Wuhan, China, where the virus was first identified, found that the closure of the city on January 23 prevented tens of thousands of infections across Hubei province. Without the blockage, the cases in Hubei would have been 65% higher, the study found. International researchers also recently determined that general social distancing in China reduced the number of daily interactions by at least seven times, thereby decreasing transmission.

In Italy, cities with closure measures also fared better than cities that did not.

Associated Press

The nation reported its first case of coronavirus, a man in Lodi, a province in the northern region of Lombardy, on February 21. However, epidemiologists determined that the virus was likely circulating in the region as early as January.

Lodi closed for sale on February 23. That same day, Bergamo, another province of Lombardy that was not under closure, reported its first case.

But it took until March 8 for Bergamo to close, despite a recommendation by the Italian Higher Institute of Health that the province be closed on March 2. At the time, the virus was rapidly spreading throughout the area.

The total number of cases in Bergamo tripled from March 9 to 16, according to a WSJ analysis. Meanwhile, the number of cases in Lodi increased by less than 50%. By March 16, Bergamo reported more than 3,700 coronavirus cases compared to less than 1,400 in Lodi.

“Clearly, with the benefit of hindsight, we should have done a full shutdown in Lombardy, everyone at home and no one is moving,” Andrea Crisanti, professor of microbiology at the University of Padua, told ABC News. “Probably for political reasons, it was not done.”

As of April 6, Bergamo represented around two thirds of the total number of cases in Italy. Tens of thousands of people have signed a petition demanding to know why the province was not closed.

Sweden’s lax approach may not work in other countries

While many countries closed schools and nonessential businesses in response to the pandemic, Sweden has chosen to keep its primary schools, restaurants, bars and gyms open.

The decision has drawn criticism from public health authorities who fear that the lack of restrictions will result in unnecessary deaths. In a joint article in the Swedish daily Dagens Nyheter, Bo Lundback, a professor of epidemiology at the University of Gothenburg, called for “quick and radical measures” to contain the Swedish outbreak.

At the time of writing, the country has nearly 12 times more COVID-19-related deaths than two other Nordic nations that imposed blockades: Finland and Sweden. Charts published by Pantheon Macroeconomics also show that the number of new cases of coronavirus in Sweden continues to rise.

TT / Anders Wiklund news agency via Reuters

A recent analysis by Politico also found that Sweden has a shorter doubling time, the number of days it takes for doubling coronavirus cases, compared to many other European countries, including France, Germany, Austria and Spain. When the doubling time is low, the virus spreads more quickly.

As of Monday, the number of coronavirus cases in Sweden doubled every 18 days compared to every 53 days in Spain and Germany and every 151 days in Austria. That means the Swedish outbreak could end up being much more fatal than its death rate currently suggests.

Furthermore, the country has not completely circumvented the restrictive measures. High schools and universities are closed and Sweden has banned gatherings of more than 50 people. Residents are asked to maintain social distance in public and stay home if they are sick or elderly.

The strategy assumes that citizens will exercise their personal responsibility, something that has been more difficult to enforce in other larger countries.

In Italy, by contrast, hundreds of thousands of citizens received police subpoenas for ignoring the country’s blockade restrictions in the days following its entry into force. People continued to organize events, breaking the curfew and wandering outside, CNN reported. In Australia, similarly, Bondi Beach was crowded with visitors in March despite social distance patterns, forcing the government to close the beach. And in London, people continued to crowd the subway even after access to the train was limited to essential workers.

“While Sweden never instituted outright blockades, many people followed the same patterns of social distancing that people followed during the blockades,” Morris said. “If Sweden or anywhere else were to try to deny the severity of COVID-19 and live life ‘as usual,’ the incidence and death rates are likely to have skyrocketed.”

There are different ways to enforce a blockade, but social distancing is key

Rodgers’ analysis suggested that closing a state quickly did not save many lives in the United States, but Morris pointed to several problems with the argument.

For one thing, Morris said, there is no consistent definition of a blockade in all 50 states. Some states have allowed restaurants to remain open, while others only issued partial orders to stay home. New York is also an outlier, accounting for more than a third of the nation’s coronavirus deaths, far more than any other individual state. That means you can skew the results.

“I think the analysis they did is simplistic and clearly not the best way to answer the question,” said Morris. Additional factors such as population density could also influence a state’s death rates, he added.

REUTERS / Lucas Jackson

In an opinion piece for the Philadelphia Inquirer, Morris suggested that restrictive measures could be tailored to communities based on their density and demographics. Higher-density areas may require tighter locks than most, he wrote, as they create more opportunities for people to interact. Places with a higher proportion of older residents, who are especially vulnerable to the virus, could also benefit from tighter closings.

Countries and cities can also adjust the severity of their blockades depending on the state of the outbreak. Wuhan, for example, resumed transportation in and out of the city after 76 days, but schools still remain closed and local authorities ask people to stay home as much as possible.

A recent NBER article found that the optimal blocking policy involves severe blocking two weeks after an outbreak is detected, which is then gradually withdrawn after three months.

“Clearly, we need society to practice new levels of precaution in terms of social distancing, hygiene, and wearing masks,” Morris said. “Lockdowns accomplished this, but at great cost.”