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Although it is still a long way from the end of the coronavirus epidemic, Italy – like other European countries – is trying to gradually ease restrictions. Scientists are already considering a scenario in which the increase in the mobility of Italians will lead to a second wave of the disease, even more tragic than the first.
What will happen when the lockdown ends in Italy?
A team of researchers from Imperial College London, the University of Oxford, MRC Center for Global Infectious Disease Analytics and WHO analyzed the likely impact of easing restrictions in force in Italy on the spread of the coronavirus. At the beginning of May, the first restrictions were withdrawn there.
The researchers published a report warning thatreducing blocking measures in some regions could lead to an increase in deaths from COVID-19. According to the authors, if the country returns to just 20 percent. pre-lock mobility levels (and mobility includes people commuting to work, shopping, visiting family and friends), the death rate could increase again in just three weeks.
Lead author of the study, Dr.Samir Bhatt, emphasizes:
– The impact of COVID-19 on Italy has been tragic, but the response to reduce the impact of the disease has been successful and disease control has been substantially achieved. Unfortunately, further social distancing and other measures are needed to prevent this success from rapidly reversing, and our work is a warning against underestimating the importance of such a sacrifice.
Isolation worked, but the Italians have no herd immunity
In the analysis, scientists estimate that the average number of reproductions (referred to as R) is now below one for all Italian regions. This means that someone infected with COVID-19 in these regions infects less than one person on average. According to the authors, such an indicator is not enough to deal with the epidemic for good. Despite the high number of deaths (almost 30 according to data as of May 6), the current percentage of people who contracted COVID-19 does not ensure herd immunity. It is not even found in Lombardy, the region with the highest infection rate.
Herd immunity (in other words: population immunity, group immunity, community immunity) is the protection of people who are not immune as a result of acquiring immunity by a large percentage of the society. Such immunity can be obtained, for example, by vaccination.
In modeling, scientists used data on the number of people going outside and the time spent in places such as grocery stores, pharmacies, parks, gas stations, and workplaces. They described changes in the number of people going out and the time spent outside (expressed as a percentage increase in mobility). They compared the data with analogous data collected before the lockdown.
Dr Michaela Vollmer:
Our analysis clearly shows that the drastic measures implemented by the Italian government had a huge impact on the movement of their citizens and thus limiting the portability of SARS-CoV-2. At the same time, however, we see that the lifting of the intervention must be closely monitored and compensated for by other surveillance measures. Even small changes in mobility are likely to lead to an increase in the number of deaths and a second wave, which may be even greater than what Italy has experienced.
The second wave of the epidemic and three possible scenarios
The authors of the report call for close monitoring of transmission and mobility in the coming weeks and even months. They emphasize the importance of performing tests and tracing the contact path.
Based on their own modeling, they describe three possible scenarios for the course of the epidemic in Italy after the blockade was lifted. In the first, mobility remains at the current level for 8 weeks, in the second, there is a return to pre-lock mobility at the level of 20%, and in the third, 40% returns. mobility. In the case of constant mobility, scientists predict a further decline in the number of deaths, but when it comes to scenarios, 20%. and 40%, modeling indicates that deaths may continue to decline initially, but the epidemic will eventually return.
Graphs: The black bars show the deaths in the seven regions with the highest mortality in Italy. The forecast in which mobility remains at the block level is marked in blue, and the scenario in which mobility returns to 20% is marked in red. pre-lock level. / Source: Report 20: Using mobility to estimate the transmissionintensity of COVID-19 in Italy: A subnational analysiswith future scenarios
Graphs: Black bars – deaths. The forecast in which the mobility remains on the current one is marked in blue, and the scenario in which the mobility returns to 40% is marked in red. pre-lock level. / Source: Report 20: Using mobility to estimate the transmissionintensity of COVID-19 in Italy: A subnational analysiswith future scenarios
In the 20 percent scenario Epidemiologists estimate that the increase in the number of deaths will be from 3 to 5, and in the case of the scenario, 40%. expect an increase in the number of deaths by 10–23 thousand.
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