Impact of the lockdown on COVID-19 epidemics in regions of mainland France

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Locks have been used by most European countries in response to the COVID-19 pandemic. In France, a nationwide lockdown was put in place on March 17, 2020. Some questioned the need for nationwide implementation given that most hospitalizations were concentrated in two of the 13 regions; others have even questioned the impact of the lockdown on the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), arguing that the epidemic’s natural peak was about to be reached. Here we discuss the impact of the lockdown on COVID-19 outbreaks in regions of mainland France.

As of March 17, 2020, daily hospitalizations were indeed the highest in the Grand-Est regions (5 · 3 per 100,000 inhabitants) and Île-de-France (3 · 6 per 100,000 inhabitants). Yet a surge in hospital admissions for COVID-19 was occurring around this time in all regions of mainland France, as shown in the annex. The COVID-19 epidemic has spread from east to west France, crossing the daily hospitalization threshold of 1 per 100,000 inhabitants between March 10 (Grand-Est) and March 23, 2020 (Brittany and New Aquitaine). Île-de-France (Paris region) had the highest rate of hospitalization per day (10 · 0 per 100,000 inhabitants) and Brittany the lowest (1 · 3 per 100,000 inhabitants). Regardless of when the epidemic started in the region and its magnitude, 12 of the 13 regions experienced a peak in daily hospital admissions on average 11 days (range 8-14 days) after implementation. lock. This figure corresponds to the average time between infection and hospitalization of patients with severe forms of the disease.

1

Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study.

Since different regions were at different stages of the pandemic when the lockdown was implemented, the timing of regional peaks strongly suggests that the lockdown, rather than the natural course of the outbreak, explains the peak in hospital admissions. Additionally, most regions were experiencing exponential growth in hospital admissions (Appendix), so saturation of local intensive care units could have occurred in those regions in the absence of any lockdowns.

The lockdown therefore appears to have succeeded not only in easing the burden on intensive care units in the two most affected regions of France, but also in preventing uncontrolled epidemics in other regions. These simple observations support the results of other studies that have found the impact of lockdown on the spread of SARS-CoV-2 to be strong.

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The application of public health and social measures, coupled with strong testing, tracing and isolation capabilities, will be essential if the epidemic rebounds to avoid reintroducing a lockdown – a situation for which the economic cost and the wider impact on society are considerable.

We would like to thank the financial support of the Investissement d’Avenir program, the Laboratory of Excellence in Integrative Biology of Emerging Infectious Diseases program (ANR-10-LABX-62-IBEID grant), the INCEPTION project (PIA / ANR-16-CONV-0005 ), and the European Union’s Horizon 2020 research and innovation program under grant 101003589 (RECOVER). Donors played no role in drafting this correspondence. The SC and AF are members of the French COVID19 Scientific Council of the French Ministry of Health. All other authors declare no competing interests.

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The references

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