March 8, 2020

expert reaction to news that Northern Italy has quarantined 16 million people

Italy has begun the quarantine of 16 million people in the north of the country for 4 weeks, in an effort to help contain the COVID-19 outbreak localised there.

On Monday 9^th March

Prof Paul Hunter, Professor in Medicine, University of East Anglia (UEA), said:

“Lockdowns can work if implemented soon enough but mostly they can only really delay the epidemic. Given the fact that a large proportion of currently known cases across Europe can trace their spread back to Italy it is clear that the opportunity to contain the outbreak or even delay it substantially has passed. 

“It is difficult to answer why Italy has seen more cases than other European countries, but it could possibly be because the spread of the virus was not identified and contained earlier. So early cases were not identified as quickly as in other European countries. The higher death rate may also be a reflection of this and indicate lower detection rates in those not quite as severely ill.

“Personally, I do not think that such a large-scale lockdown would be appropriate in the UK. Compared to Italy and indeed China, cases in the UK seem to be spread throughout the country with no real concentration in one or two areas, so banning movement from one area to another would not necessarily achieve anything useful in the UK. However, some of the other social distancing advice may be of value in slowing the spread of infection and thereby reduce the intensity of the pressure on the NHS and British business.”

Prof Francois Balloux, Professor of Computational Systems Biology and Director of UCL Genetics Institute, University College London (UCL), said:

“The COVID-19 epidemic represents an extremely challenging situation in Northern Italy, which prompted the Italian government to in effect quarantine 16 million people. The measure is primarily intended to limit the spread of the virus to other regions of the world and comes at a great cost to individuals, communities and the economy. It is also not sustainable in the long term.

“The benefits of such a lock down may primarily be felt in regions of the world that do not currently have local ongoing epidemic. There is evidence for sustained local transmission in the UK and the importation of COVID-19 cases from abroad might play only a relatively minor role in the evolution of the situation in the UK. The trajectory of the epidemic in the UK is so far roughly comparable to the one in Northern Italy, but with the epidemic in Northern Italy 2-3 weeks ahead of the situation in the UK.

“It is possible that a lock down strategy similar to the one imposed in Northern Italy may be adopted by the UK and other countries at some point in the future. The COVID-19 epidemic cannot be contained anymore. Though, a desirable objective may be to delay the increase in the number of cases to avoid healthcare capacity being overrun. In this context, social distancing measures aimed at reducing local transmission would likely be far more effective in slowing down the epidemic in the UK than a ban on international travel.”

On Sunday 8^th March

Prof Mark Woolhouse, Professor of Infectious Disease Epidemiology, University of Edinburgh, said: 

“The movement restrictions announced by Italy today are designed to slow the spread of COVID-19 to other parts of Italy and beyond. According to the Italian authorities the measures will be in place until April 3rd. This raises several questions. 

“First of all, what is the evidence that 4 weeks is the right duration? What happens if the epidemiological situation inside and/or outside the restriction zone has not improved by April 3rd? Will the restrictions be extended? For how long is Italy willing to keep these restrictions in place?

“Next, what happens if it becomes apparent in the coming days that the virus has already spread to the rest of Italy? Will the same restrictions be imposed on one region after another until they apply across the country?

“There is an important message here for any country considering imposing travel or movement restrictions in an attempt to slow the spread of COVID-19: what is your exit strategy? What are you expecting to see in the epidemiological data that indicates it is safe to lift the restrictions? And if the epidemic does not behave as hoped, what then?”

Declared interests

None to declare