Retrospective analysis of the Italian exit strategy from COVID-19 lockdown

Abstract

After the national lockdown imposed on March 11, 2020, the Italian government has gradually resumed the suspended economic and social activities since May 4, while maintaining the closure of schools until September 14. We use a model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission to estimate the health impact of different exit strategies. The strategy adopted in Italy kept the reproduction number Rt at values close to one until the end of September, with marginal regional differences. Based on the estimated postlockdown transmissibility, reopening of workplaces in selected industrial activities might have had a minor impact on the transmissibility. Reopening educational levels in May up to secondary schools might have influenced SARS-CoV-2 transmissibility only marginally; however, including high schools might have resulted in a marked increase of the disease burden. Earlier reopening would have resulted in disproportionately higher hospitalization incidence. Given community contacts in September, we project a large second wave associated with school reopening in the fall.

Psychological Distress, Fear of COVID-19, and Resilient Coping Abilities among Healthcare Workers in a Tertiary First-Line Hospital during the Coronavirus Pandemic

“…Moreover, since social support has been demonstrated to bolster coping abilities and to positively influence the resilience of healthcare workers during the pandemic, we can hypothesize that the sense of gratitude conveyed by both media and society during the first phases of the COVID-19 outbreak may have been helpful in determining a sense of effectiveness in the healthcare teams [34]. However, given the notable changes that pandemic control measures have over time [35], coupled with the ambiguity inherent in some media-conveyed messages [36], further and longitudinal evaluations of the influence of social support on coping abilities of HCWs are needed. The observation that physicians have shown superior coping skills compared to nurses and other health professionals confirms that HCWs should not be considered a homogeneous population in the psychological impact they have as a result of the pandemic.…”

A data-driven model of the COVID-19 spread among interconnected populations: epidemiological and mobility aspects following the lockdown in Italy

“…that is the same condition as (36) providing the stability of the endemic equilibrium (as well as the instability of the disease-free equilibrium). On the other hand, when R i < 1 the epidemics reduces and tends to vanish.…”

“…At the same time, being ( 30) not satisfied, the epidemicfree equilibrium is unstable. The opposite situation arises when (36), and then (21), are not satisfied: the only admissible equilibrium point is the epidemic-free one, and it is locally asymptotically stable.…”

“…Moreover, among the most recent (and actually huge) literature on the COVID-19 modeling, we also mention some papers proposing interesting variants of the classical SIR model and using different approaches: the age-structured SIR model [36], the stochastic, discrete, age-structured compartmental model [1] in which distributed time delays related to the periods of incubation, infection, and quarantine are considered as in [35]. Another aspect common to these latter works that matters in relation to our study is that they analyze the first epidemic period (until October 2020) in order to highlight how different strategies implemented in that peculiar time interval can affect the future epidemic trajectory.…”

Association of public health interventions and COVID-19 incidence in Vietnam, January to December 2020

“…These findings confirmed results from a modelling study in eleven European countries showing how Rt began to drop after school closure and other NPIs, even before complete national lockdown ( Flaxman et al, 2020 ). In Vietnam, after social distancing was lifted in Period 4, a peak of Rt was observed, which eventually led to the biggest outbreak in Period 5, which can be explained through the reintroduction of imported cases into high-risk areas ( Yeoh et al, 2021 ), and/or the resumption of previous social mixing patterns as observed in several countries following lockdowns ( Santamaría and Hortal, 2021 , Marziano et al, 2021 ). In Period 5, a wide-scale lockdown of two affected cities (Da Nang and Hai Duong), coupled with extensive testing and quarantine policies (see Supplement 1 ), resulted in a substantial reduction of Rt after only two weeks, and in the containment of outbreaks two months later.…”