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. 2020 Aug 5;17(16):5644.
doi: 10.3390/ijerph17165644.

Excess Deaths and Hospital Admissions for COVID-19 Due to a Late Implementation of the Lockdown in Italy

Raffaele Palladino  1   2   3 , Jordy Bollon  4 , Luca Ragazzoni  4   5 , Francesco Barone-Adesi  4   5
Affiliations

Excess Deaths and Hospital Admissions for COVID-19 Due to a Late Implementation of the Lockdown in Italy

Raffaele Palladino et al. Int J Environ Res Public Health. .

Abstract

In Italy, the COVID-19 epidemic curve started to flatten when the health system had already exceeded its capacity, raising concerns that the lockdown was indeed delayed. The aim of this study was to evaluate the health effects of late implementation of the lockdown in Italy. Using national data on the daily number of COVID-19 cases, we first estimated the effect of the lockdown, employing an interrupted time series analysis. Second, we evaluated the effect of an early lockdown on the trend of new cases, creating a counterfactual scenario where the intervention was implemented one week in advance. We then predicted the corresponding number of intensive care unit (ICU) admissions, non-ICU admissions, and deaths. Finally, we compared results under the actual and counterfactual scenarios. An early implementation of the lockdown would have avoided about 126,000 COVID-19 cases, 54,700 non-ICU admissions, 15,600 ICU admissions, and 12,800 deaths, corresponding to 60% (95%CI: 55% to 64%), 52% (95%CI: 46% to 57%), 48% (95%CI: 42% to 53%), and 44% (95%CI: 38% to 50%) reduction, respectively. We found that the late implementation of the lockdown in Italy was responsible for a substantial proportion of hospital admissions and deaths associated with the COVID-19 pandemic.

Keywords: COVID-19; evaluation; health; healthcare; late implementation; lockdown.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Predicted number of new cases of COVID-19 under different scenarios. Solid line represents the actual scenario (lockdown implemented on March 9th), and dashed line the counterfactual scenario (lockdown implemented on March 2nd).
Figure 2
Figure 2
Total number of cases of COVID-19, non-ICU admissions, ICU admissions, and deaths under different scenarios. Solid line represents the actual scenario (lockdown implemented on March 9th) and dashed line the counterfactual scenario (lockdown implemented on March 2nd). ICU = intensive care unit.
See this image and copyright information in PMC

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