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

Imperial College COVID-19 Response Team

Research output: Contribution to journalArticlepeer-review

755 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)257-261
Number of pages5
JournalNature
Volume584
Issue number7820
DOIs
Publication statusPublished - 13 Aug 2020
Externally publishedYes

Bibliographical note

Funding Information:
Acknowledgements S.B. acknowledges the NIHR BRC Imperial College NHS Trust Infection and COVID themes, the Academy of Medical Sciences Springboard award and the Bill and Melinda Gates Foundation. L.C.O. acknowledges funding from a UK Royal Society fellowship. Initial research on covariates in Supplementary Table 2 was crowdsourced; we thank a number of people across the world for help with this. This work was supported by Centre funding from the UK Medical Research Council under a concordat with the UK Department for International Development, the NIHR Health Protection Research Unit in Modelling Methodology and Community Jameel. We thank F. Valka for creating our website, and A. Gelman and the Stan team for helpful discussions. We acknowledge the resources provided by Cirrus UK National Tier-2 HPC Service at EPCC (http://www.cirrus.ac.uk) funded by the University of Edinburgh and EPSRC (EP/P020267/1), and cloud compute time donated by Microsoft and Amazon.

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

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