The Italian government has announced that it is extending it’s quarantine measures to the entire country.
Dr Elisabetta Groppelli, lecturer in Global Health at St George’s, University of London, said:
“Viruses start outbreaks, but it is people who sustain them and therefore can stop them.
“The lockdown in Italy was likely motivated by the Government needing to take a stronger approach to encourage people to abide by the restrictions, and because of increasing numbers of cases outside Lombardy and an increasing strain on healthcare facilities in the area.
“Until viral genetic analysis sheds more light on the situation, it’s hard to say exactly why Italy has been so badly affected. Northern Italy is the economic hub of the country as well as a tourist hotspot, and therefore has lots of travel in and out of the region. With more people moving constantly and interacting with each other, this could provide a greater context for spread of the disease.
“Social distancing measures have had a major effect in Wuhan, and in previous outbreaks such as the recent Ebola Outbreak in West Africa and Spanish Flu in 1918. The lockdown in Italy could therefore have success in containing and slowing the number of new cases, which could also reduce the strain on healthcare facilities in the country.”
Prof Andrew Tatem, Professor within Geography and Environmental Science, University of Southampton, said:
“The measures introduced in Italy are not too surprising – we now have a growing number of examples that such aggressive and widespread intervention tactics can be successful. Mainland China outside of Hubei province have now reported zero new cases for three consecutive days, while South Korea reported fewer than 150 new cases yesterday. Both were previously in a similar situation to Italy with thousands of new cases each day at one stage and health systems overwhelmed, so the new interventions put in place in Italy that are similar to those used in China and South Korea are understandable. A question now remains on whether these will be enough to contain the spread to other countries, or if we will see more major outbreaks like this – hopefully governments around the world are watching and learning from all of these examples to be fully prepared, willing to implement similar measures if needed, and able to act quickly.”
Prof Francois Balloux, Professor of Computational Systems Biology and Director of UCL Genetics Institute, University College London (UCL), said:
“This is not that surprising. The Italian government may have reached the conclusion that given they had to burden the huge economic costs of a lockdown of the North of the country, they might as well go the whole way and maximise their chances to control the epidemic nationwide. The decision to extend the lockdown to the whole country might also in part have been triggered by the exodus of thousands of people from northern Italy after the plans for a lockdown on Lombardy were leaked to the media.
“The objective of these measures is to control the epidemic and ensure hospitals can cope with the number of patients they have to treat. The potential benefits are obvious. Though such measures will come at a great cost to individuals, communities and the economy. It is also not sustainable to maintain such a nationwide lockdown for very long. China implemented comparable measures in the Wuhan province where the covid-19 epidemic started, which were effective at controlling the epidemic, for now. Though, these came at a considerable cost to the population.
“The covid-19 epidemic in the UK is about two weeks behind the situation in Italy. Otherwise, the trajectories of the early stages of the epidemics look fairly comparable between the two countries. One factor that might play a slight difference in the burden of a covid-19 epidemic is the age distribution of the population in the two countries. The UK’s population is on average five year younger than Italy’s, which may marginally reduce the proportion of serious cases and deaths.”
Prof John Edmunds, Professor in the Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, said:
“These extraordinary measures are unprecedented and almost certainly unsustainable. This will be a long epidemic and the appropriate measures need to be taken at the right time to maximise their impact, help ensure compliance and minimise economic and social costs. These measures will probably have a short-term impact. However, if they can’t be sustained for the long term, all they are likely to do is delay the epidemic for a while.”
Prof Paul Hunter, Professor in Medicine, University of East Anglia (UEA), said:
“The recent extension of COVID-19 controls in Italy represent one of the most rigorous country wide control measures implemented in the last 50 years. It comes after one of the more dramatic increases in new reports each day and especially new deaths so far seen in this epidemic.
“Whilst we have seen in Wuhan that such intensive social distancing can bring the epidemic under control it is far from clear how long this may need to be maintained in the Italian context. Unlike the situation in Wuhan where there was the possibility that the global epidemic could be prevented, COVID-19 is already spreading globally. So when the restrictions in Italy are eased there may still be a large number of cases in nearby countries that could lead to spread back into Italy.
“So will the country-wide implementation of controls reduce the eventual number of people to be infected in Italy? Probably not, as the epidemic is still spreading globally and many European countries have cases that can be traced back to Italy and these could easily lead to the infection being re-introduced.
“Will the new controls delay the spread of the outbreak? Probably and if the epidemic can be delayed into Spring it is possible, but not certain, that this could lead to a more gradual epidemic that would be easier to manage.
“Would this degree of restriction be appropriate for the UK? Probably not as we are currently seeing a much more gradual increase in numbers and these are already distributed throughout the UK unlike the situation in Italy where cases were concentrated in a single region. More rigorous social distancing measures are likely to be implemented in the UK over coming days or weeks as case numbers increase. But the timing of their introduction will be chosen to hopefully maximise the benefit whilst minimising the harm to British society.”
Prof Rowland Kao, Professor of Veterinary Epidemiology and Data Science, University of Edinburgh, said:
“The Italian authorities may believe that such extensive measures will serve to protect areas with still only a few cases; existing measures were not sufficient to prevent the current crisis In the north but these measures may be sufficient in the south. Another reason for doing so is because of logistics – the restrictions may slow down the epidemic enough to allow the health care system to adequately protect the most vulnerable. An important point to remember is that such restrictions have the potential to place an enormous economic burden on the country and if it goes on too long, creates the risk of a kind of restriction fatigue. It may be therefore that the Italians have decided that the country could withstand these restrictions until spring, when there is hope that the spread will be naturally alleviated in the same way that seasonal flu is (however there is at this point no proof that such seasonal effects are important for this virus).
“The situation in Britain thus far is different because the case load remains relatively low. This means that the burden on the healthcare system is thus far lower, and so the balancing act between the disruption and cost caused by extreme measures and the benefit in terms of slowing the epidemic and giving the health care system room to breathe, is at a very different point. This does not mean of course that later on, the same calculation may lead to Britain adopting a similar strategy to Italy – such decisions must be updated at this stage almost daily.”
All our previous output on this subject can be seen at this weblink:
The SMC also produced a Factsheet on COVID-19 which is available here:
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