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Inferring the effective start dates of non-pharmaceutical interventions during COVID-19 outbreaks

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Background. During Feb-Apr. 2020, many countries implemented non-pharmaceutical interventions (NPIs), such as school closures and lockdowns, to control the COVID-19 pandemic caused by the SARS-CoV-2 virus. Overall, these interventions seem… Click to show full abstract

Background. During Feb-Apr. 2020, many countries implemented non-pharmaceutical interventions (NPIs), such as school closures and lockdowns, to control the COVID-19 pandemic caused by the SARS-CoV-2 virus. Overall, these interventions seem to have reduced the spread of the pandemic. We hypothesized that the official and effective start date of NPIs can be noticeably different, e.g. due to slow adoption by the population, and that these differences can lead to errors in the estimation of the impact of NPIs. Methods. SEIR models were fitted to case data from 12 regions to infer the effective start dates of interventions and contrast them with the official dates. The impact of NPIs was estimated from the inferred model parameters. Results. We infer mostly late effective start dates of interventions. For example, Italy implemented a lockdown on Mar 11, but we infer the effective start date on Mar 17 ( + 3.05 − 2.01  days 95% CI). Moreover, we find that the impact of NPIs can be under-estimated if assuming they start at their official date. Conclusions. Differences between the official and effective start of NPIs are likely. Neglecting such differences can lead to under-estimation of the impact of NPIs, which could cause decision-makers to escalate interventions and guidelines.

Keywords: effective start; pharmaceutical interventions; start dates; start; non pharmaceutical; impact npis

Journal Title: International Journal of Infectious Diseases
Year Published: 2022

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