Lockdown as a last resort option in case of COVID-19 epidemic rebound: a modelling study

Kiem, Cécile Tran; Crépey, Pascal; Bosetti, Paolo; Bruhl, Daniel Levy; Yazdanpanah, Yazdan; Salje, Henrik; Boëlle, Pierre‐Yves; Cauchemez, Simon

doi:10.2807/1560-7917.es.2021.26.22.2001536

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…FTTIS measures and the rapid expansion of vaccine coverage will reduce the susceptible population and reduce the contact frequency and contact probability between infected and susceptible people. This should reduce cases and deaths in the long run [ 30 ]. A study in France found that most COVID-19 cases were undetected, especially when the incidence was high.…”

Section: Discussionmentioning

confidence: 99%

Predicted Impact of the Lockdown Measure in Response to Coronavirus Disease 2019 (COVID-19) in Greater Bangkok, Thailand, 2021

Uansri

Tuangratananon

Phaiyarom

et al. 2021

IJERPH

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In mid-2021, Thailand faced a fourth wave of Coronavirus Disease 2019 (COVID-19) predominantly fueled by the Delta and Alpha variants. The number of cases and deaths rose exponentially, alongside a sharp increase in hospitalizations and intubated patients. The Thai Government then implemented a lockdown to mitigate the outbreak magnitude and prevent cases from overwhelming the healthcare system. This study aimed to model the severity of the outbreak over the following months by different levels of lockdown effectiveness. Secondary analysis was performed on data primarily obtained from the Ministry of Health; the data were analyzed using both the deterministic compartmental model and the system dynamics model. The model was calibrated against the number of daily cases in Greater Bangkok during June–July 2021. We then assessed the outcomes (daily cases, daily deaths, and intubated patients) according to hypothetical lockdowns of varying effectiveness and duration. The findings revealed that lockdown measures could reduce and delay the peak of COVID-19 cases and deaths. A two-month lockdown with 60% effectiveness in the reduction in reproduction number caused the lowest number of cases, deaths, and intubated patients, with a peak about one-fifth of the size of a no-lockdown peak. The two-month lockdown policy also delayed the peak until after December, while in the context of a one-month lockdown, cases peaked during the end of September to early December (depending on the varying degrees of lockdown effectiveness in the reduction in reproduction number). In other words, the implementation of a lockdown policy did not mean the end of the outbreak, but it helped delay the peak. In this sense, implementing a lockdown helped to buy time for the healthcare system to recover and better prepare for any future outbreaks. We recommend further studies that explore the impact of lockdown measures at a sub-provincial level, and examine the impact of lockdowns on parameters not directly related to the spread of disease, such as quality of life and economic implications for individuals and society.

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Section: Discussionmentioning

confidence: 99%

Predicted Impact of the Lockdown Measure in Response to Coronavirus Disease 2019 (COVID-19) in Greater Bangkok, Thailand, 2021

Uansri

Tuangratananon

Phaiyarom

et al. 2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…Variants of concern (VOC) of SARS-CoV-2 with increased transmissibility, such as the Delta (B.1.617.2) and, more recently, the Omicron (B.1.1.529) variants, have led to a substantial surge in the incidence rate of severe COVID-19 cases, particularly in the context of low vaccine coverage and especially in lower-middle and low-income countries. As a result, in many countries the saturation of intensive care units (ICU) has driven political decisions, including containment and segregation measures [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Doxycycline for the prevention of progression of COVID-19 to severe disease requiring intensive care unit (ICU) admission: A randomized, controlled, open-label, parallel group trial (DOXPREVENT.ICU)

Dhar

Kirkpatrick²,

Gilbert³

et al. 2023

PLoS ONE

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Background After admission to hospital, COVID-19 progresses in a substantial proportion of patients to critical disease that requires intensive care unit (ICU) admission. Methods In a pragmatic, non-blinded trial, 387 patients aged 40–90 years were randomised to receive treatment with SoC plus doxycycline (n = 192) or SoC only (n = 195). The primary outcome was the need for ICU admission as judged by the attending physicians. Three types of analyses were carried out for the primary outcome: “Intention to treat” (ITT) based on randomisation; “Per protocol” (PP), excluding patients not treated according to randomisation; and “As treated” (AT), based on actual treatment received. The trial was undertaken in six hospitals in India with high-quality ICU facilities. An online application serving as the electronic case report form was developed to enable screening, randomisation and collection of outcomes data. Results Adherence to treatment per protocol was 95.1%. Among all 387 participants, 77 (19.9%) developed critical disease needing ICU admission. In all three primary outcome analyses, doxycycline was associated with a relative risk reduction (RRR) and absolute risk reduction (ARR): ITT 31.6% RRR, 7.4% ARR (P = 0.063); PP 40.7% RRR, 9.6% ARR (P = 0.017); AT 43.2% RRR, 10.8% ARR (P = 0.007), with numbers needed to treat (NTT) of 13.4 (ITT), 10.4 (PP), and 9.3 (AT), respectively. Doxycycline was well tolerated with not a single patient stopping treatment due to adverse events. Conclusions In hospitalized COVID-19 patients, doxycycline, a safe, inexpensive, and widely available antibiotic with anti-inflammatory properties, reduces the need for ICU admission when added to SoC.

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“…As a result, in many countries the saturation of intensive care units (ICU) has driven political decisions, including containment and segregation measures. 2–3…”

Section: Introductionmentioning

confidence: 99%

Doxycycline for the prevention of progression of COVID-19 to severe disease requiring intensive care unit (ICU) admission: a randomized, controlled, open-label, parallel group trial (DOXPREVENT.ICU)

Dhar

Kirkpatrick²,

Gilbert

et al. 2022

Preprint

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BackgroundAfter admission to hospital, COVID-19 progresses in a substantial proportion of patients to critical disease that requires intensive care unit (ICU) admission.MethodsIn a pragmatic, non-blinded trial, 387 patients aged 40-90 years were randomised to receive treatment with SoC plus doxycycline (n=192) or SoC only (n=195). The primary outcome was the need for ICU admission as judged by the attending physicians. Three types of analyses were carried out for the primary outcome: “Intention to treat” (ITT) based on randomisation; “Per protocol” (PP), excluding patients not treated according to randomisation; and “As treated” (AT), based on actual treatment received. The trial was undertaken in six hospitals in India with high-quality ICU facilities. An online application serving as the electronic case report form was developed to enable screening, randomisation and collection of outcomes data.ResultsAdherence to treatment per protocol was 95.1%. Among all 387 participants, 77 (19.9%) developed critical disease needing ICU admission. In all three primary outcome analyses, doxycycline was associated with a relative risk reduction (RRR) and absolute risk reduction (ARR): ITT 31.6% RRR, 7.4% ARR (P=0.063); PP 40.7% RRR, 9.6% ARR (P=0.017); AT 43.2% RRR, 10.8% ARR (P=0.007), with numbers needed to treat (NTT) of 13.4 (ITT), 10.4 (PP), and 9.3 (AT), respectively. Doxycycline was well tolerated with not a single patient stopping treatment due to adverse events.ConclusionsIn hospitalized COVID-19 patients, doxycycline, a safe, inexpensive, and widely available antibiotic with anti-inflammatory properties, reduces the need for ICU admission when added to SoC.

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Lockdown as a last resort option in case of COVID-19 epidemic rebound: a modelling study

Cited by 4 publications

References 18 publications

Predicted Impact of the Lockdown Measure in Response to Coronavirus Disease 2019 (COVID-19) in Greater Bangkok, Thailand, 2021

Predicted Impact of the Lockdown Measure in Response to Coronavirus Disease 2019 (COVID-19) in Greater Bangkok, Thailand, 2021

Doxycycline for the prevention of progression of COVID-19 to severe disease requiring intensive care unit (ICU) admission: A randomized, controlled, open-label, parallel group trial (DOXPREVENT.ICU)

Doxycycline for the prevention of progression of COVID-19 to severe disease requiring intensive care unit (ICU) admission: a randomized, controlled, open-label, parallel group trial (DOXPREVENT.ICU)

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