We searched PubMed, bioRxiv, and medRxiv from database inception to Nov 9, 2020, for English-language articles with the search terms (“COVID-19” OR “SARS-CoV-2” OR “coronavirus”) AND (“lockdown”) AND (“model”). Numerous studies have modelled the relative effects of non-pharmaceutical interventions on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission.
Evidence of substantial geographical heterogeneity began to emerge across England, with a national infection survey suggesting that in late October, around one in 45 people were infected in the northwest, compared with one in 200 in the southeast. 1, 2 This rise in infections resulted in pressure on health services, with 8822 confirmed COVID-19 cases in English hospitals on Oct 30 3-about half the number observed during the previous peak in April-and increasing numbers of deaths. By the end of October, large-scale, population-based studies in England suggested about 50 000–100 000 new infections were occurring every day. A resurgence of COVID-19 cases began in the late summer after most restrictions had been lifted. Following the imposition of a national lockdown on March 23, 2020, with residents required to stay at home except for accessing medical care, daily exercise, shopping for essentials, and essential work travel, COVID-19 cases, hospital admissions, and deaths subsided. The UK saw its first wave of COVID-19 cases in spring, 2020. In a post-hoc analysis, we estimated that the second lockdown in England (Nov 5–Dec 2) reduced R t by 22% (95% CrI 15–29), rather than the 32% (25–39) reduction estimated for a Wales-stringency lockdown with schools open. An earlier lockdown would have reduced deaths and hospitalisations in the short term, but would lead to a faster resurgence in cases after January, 2021.
A projected lockdown of greater than 4 weeks would reduce deaths but would bring diminishing returns in reducing peak pressure on hospital services.
From Nov 5, 2020, a 4-week Wales-type lockdown with schools remaining open-similar to the lockdown measures announced in England in November, 2020-was projected to further reduce hospital admissions to 186 000 (179 000–193 000) and deaths to 36 800 (34 900–38 800). From Oct 1, 2020, to March 31, 2021, a projected COVID-19 epidemic without tiered restrictions or lockdown results in 280 000 (95% projection interval 274 000–287 000) hospital admissions and 58 500 (55 800–61 100) deaths. We estimated a reduction in the effective reproduction number ( R t) of 2% (95% credible interval 0–4) for tier 2, 10% (6–14) for tier 3, 35% (30–41) for a Northern Ireland-stringency lockdown with schools closed, and 44% (37–49) for a Wales-stringency lockdown with schools closed.
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