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Initial Assessment of the Impact of the Emergency State Lockdown Measures on the 1st Wave of the COVID-19 Epidemic in Portugal.
Acta Med Port. 2020 Nov 02; 33(11):733-741.AM

Abstract

INTRODUCTION

Portugal took early action to control the COVID-19 epidemic, initiating lockdown measures on March 16th when it recorded only 62 cases of COVID-19 per million inhabitants and reported no deaths. The Portuguese public complied quickly, reducing their overall mobility by 80%. The aim of this study was to estimate the initial impact of the lockdown in Portugal in terms of the reduction of the burden on the healthcare system.

MATERIAL AND METHODS

We forecasted epidemic curves for: Cases, hospital inpatients (overall and in intensive care), and deaths without lockdown, assuming that the impact of containment measures would start 14 days after initial lockdown was implemented. We used exponential smoothing models for deaths, intensive care and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data up to the 31st March 2020. We then compared observed (with intervention) and forecasted curves (without intervention).

RESULTS

Between April 1st and April 15th, there were 146 fewer deaths (-25%), 5568 fewer cases (-23%) and, as of April 15th, there were 519 fewer intensive care inpatients (-69%) than forecasted without the lockdown. On April 15th, the number of intensive care inpatients could have reached 748, three times higher than the observed value (229) if the intervention had been delayed.

DISCUSSION

If the lockdown had not been implemented in mid-March, Portugal intensive care capacity (528 beds) would have likely been breached during the first half of April. The lockdown seems to have been effective in reducing transmission of SARS-CoV-2, serious COVID-19 disease, and associated mortality, thus decreasing demand on health services.

CONCLUSION

An early lockdown allowed time for the National Health Service to mobilize resources and acquire personal protective equipment, increase testing, contact tracing and hospital and intensive care capacity and to promote broad prevention and control measures. When lifting more stringent measures, strong surveillance and communication strategies that mobilize individual prevention efforts are necessary.

Authors+Show Affiliations

Public Health Research Centre. NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Public Health Unit. North Lisbon Health Centers. Lisbon; European Programme for Intervention Epidemiology Training (EPIET). European Centre for Disease Prevention and Control (ECDC). Stockholm. Sweden. Portugal.Public Health Research Centre. NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisboa. Portugal.Public Health Research Centre. NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisboa. Portugal.Unit for Multidisciplinary Research in Biomedicine. Abel Salazar Institute of Biomedical Sciences. Universidade do Porto. Porto. Communicable Disease Surveillance Centre. Public Health Wales. Cardiff. United Kingdom. Portugal.European Programme for Intervention Epidemiology Training (EPIET). European Centre for Disease Prevention and Control (ECDC). Stockholm. Communicable Disease Surveillance Centre. Public Health Wales. Cardiff. United Kingdom. Sweden.Public Health Research Centre. NOVA National School of Public Health. Universidade NOVA de Lisboa. Lisboa. Portugal.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33160423

Citation

Ricoca Peixoto, Vasco, et al. "Initial Assessment of the Impact of the Emergency State Lockdown Measures On the 1st Wave of the COVID-19 Epidemic in Portugal." Acta Medica Portuguesa, vol. 33, no. 11, 2020, pp. 733-741.
Ricoca Peixoto V, Vieira A, Aguiar P, et al. Initial Assessment of the Impact of the Emergency State Lockdown Measures on the 1st Wave of the COVID-19 Epidemic in Portugal. Acta Med Port. 2020;33(11):733-741.
Ricoca Peixoto, V., Vieira, A., Aguiar, P., Carvalho, C., Rhys Thomas, D., & Abrantes, A. (2020). Initial Assessment of the Impact of the Emergency State Lockdown Measures on the 1st Wave of the COVID-19 Epidemic in Portugal. Acta Medica Portuguesa, 33(11), 733-741. https://doi.org/10.20344/amp.14129
Ricoca Peixoto V, et al. Initial Assessment of the Impact of the Emergency State Lockdown Measures On the 1st Wave of the COVID-19 Epidemic in Portugal. Acta Med Port. 2020 Nov 2;33(11):733-741. PubMed PMID: 33160423.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Initial Assessment of the Impact of the Emergency State Lockdown Measures on the 1st Wave of the COVID-19 Epidemic in Portugal. AU - Ricoca Peixoto,Vasco, AU - Vieira,André, AU - Aguiar,Pedro, AU - Carvalho,Carlos, AU - Rhys Thomas,Daniel, AU - Abrantes,Alexandre, Y1 - 2020/11/02/ PY - 2020/05/13/received PY - 2020/07/31/accepted PY - 2020/11/8/entrez PY - 2020/11/9/pubmed PY - 2020/11/20/medline KW - COVID-19 KW - Coronavirus Infections KW - Pandemics KW - Portugal KW - Quarantine KW - SARS-CoV-2 SP - 733 EP - 741 JF - Acta medica portuguesa JO - Acta Med Port VL - 33 IS - 11 N2 - INTRODUCTION: Portugal took early action to control the COVID-19 epidemic, initiating lockdown measures on March 16th when it recorded only 62 cases of COVID-19 per million inhabitants and reported no deaths. The Portuguese public complied quickly, reducing their overall mobility by 80%. The aim of this study was to estimate the initial impact of the lockdown in Portugal in terms of the reduction of the burden on the healthcare system. MATERIAL AND METHODS: We forecasted epidemic curves for: Cases, hospital inpatients (overall and in intensive care), and deaths without lockdown, assuming that the impact of containment measures would start 14 days after initial lockdown was implemented. We used exponential smoothing models for deaths, intensive care and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data up to the 31st March 2020. We then compared observed (with intervention) and forecasted curves (without intervention). RESULTS: Between April 1st and April 15th, there were 146 fewer deaths (-25%), 5568 fewer cases (-23%) and, as of April 15th, there were 519 fewer intensive care inpatients (-69%) than forecasted without the lockdown. On April 15th, the number of intensive care inpatients could have reached 748, three times higher than the observed value (229) if the intervention had been delayed. DISCUSSION: If the lockdown had not been implemented in mid-March, Portugal intensive care capacity (528 beds) would have likely been breached during the first half of April. The lockdown seems to have been effective in reducing transmission of SARS-CoV-2, serious COVID-19 disease, and associated mortality, thus decreasing demand on health services. CONCLUSION: An early lockdown allowed time for the National Health Service to mobilize resources and acquire personal protective equipment, increase testing, contact tracing and hospital and intensive care capacity and to promote broad prevention and control measures. When lifting more stringent measures, strong surveillance and communication strategies that mobilize individual prevention efforts are necessary. SN - 1646-0758 UR - https://www.unboundmedicine.com/medline/citation/33160423/Initial_Assessment_of_the_Impact_of_the_Emergency_State_Lockdown_Measures_on_the_1st_Wave_of_the_COVID_19_Epidemic_in_Portugal_ L2 - http://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14129 DB - PRIME DP - Unbound Medicine ER -