The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China

Abstract

Background With its epicenter in Wuhan, China, the COVID-19 outbreak was declared a Public Health Emergency of International Concern by the World Health Organization (WHO). Consequently, many countries have implemented flight restrictions to China. China itself has imposed a lockdown of the population of Wuhan as well as the entire Hubei province. However, whether these two enormous measures have led to significant changes in the spread of COVID-19 cases remains unclear. Methods We analyzed the available data on the development of confirmed domestic and international COVID-19 cases before and after lockdown measures. We evaluated the correlation of domestic air traffic to the number of confirmed COVID-19 cases and determined the growth curves of COVID-19 cases within China before and after lockdown as well as after changes in COVID-19 diagnostic criteria. Results Our findings indicate a significant increase in doubling time from 2 days (95% CI: 1.9–2.6) to 4 days (95% CI: 3.5–4.3), after imposing lockdown. A further increase is detected after changing diagnostic and testing methodology to 19.3 (95% CI: 15.1–26.3), respectively. Moreover, the correlation between domestic air traffic and COVID-19 spread became weaker following lockdown (before lockdown: r = 0.98, P < 0.05 vs after lockdown: r = 0.91, P = NS). Conclusions A significantly decreased growth rate and increased doubling time of cases was observed, which is most likely due to Chinese lockdown measures. A more stringent confinement of people in high risk areas seems to have a potential to slow down the spread of COVID-19.

Only strict quarantine measures can curb the coronavirus disease (COVID-19) outbreak in Italy, 2020

“…The lockdown in China with government enforced movement restriction outdoors combined with facility-based case isolation, rigorous contact tracing and quarantine of all contacts, had a substantial impact on interrupting the chain of human-to-human transmission in Wuhan, thus effectively containing the outbreak [16]. While the outbreak in Wuhan involved a highly urbanised setting, the current lockdown in Italy involves small villages with a different social culture and behaviour, and different mechanisms of quarantine enforcement.…”

“…Less strict quarantine adherence would imply even longer lockdown periods, and longer lockdown periods will likely present even greater socioeconomic challenges. By implementing the world's largest lockdown combined with prompt case isolation, contact tracing of contacts and with strict enforcement of physical distancing [16], containment of COVID-19 in China was shown to be feasible. Remarkably, in South Korea, the control of the outbreak, which had been temporarily lost, was regained without lockdown but with rigorous active case finding, by liberal testing, prompt isolation, and by using novel digital technologies to maximise contact tracing and quarantine of all contacts [18].…”

Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19)

“…Overall, it can hence be estimated that over one-third of humanity is subjected to some form of restrictive measures [13]. This strategy has been proven effective for containing the COVID-19 outbreak in China, also limiting the exportation of infected cases outside the country [14,15]. Nevertheless, stay-athome orders may also be associated with numerous side effects, especially when the lockdown is protracted for months, thereby disrupting social habits and jeopardizing personal health.…”

Impact of non-pharmaceutical interventions on documented cases of COVID-19

“…NPIs have been linked to the spread of SARS-CoV-2 primarily within or from a single country [8][9][10][11][12][13][14][15][16][17][18][19] , mostly focusing on the novel coronavirus outbreak in China. The majority of findings are based on transmission models where epidemiological parameters are informed by previous studies or corroborated via simulation.…”