Stay-at-home orders and lockdown measures helped greatly limit the spread of coronavirus in 11 European countries from the start of the epidemic to May 4th, according to a new modeling paper published in Nature on Monday. 

Some 3.1 million deaths were averted across the study countries thanks to “non-pharmaceutical measures” such as lockdowns and social distancing policies, according to the study.

Meanwhile, the World Health Organization said that the disease was accelerating in South Asia and Latin America, even as European countries saw declines and began lifting lockdown measures. Switzerland, which reported only 20 new cases on Sunday, reopened restaurants, nightclubs, and red-light district services on June 6, and allowed mass demonstrations of up to 300.

“Yesterday, more than 136,000 cases were reported, the most in a single day so far. Almost 75% of yesterday’s cases come from 10 countries, mostly in the Americas and South Asia,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

“We’re seeing acceleration of disease now in Central and South America,” said WHO Health Emergencies Executive Director Mike Ryan. “And we’re seeing a similar acceleration and path for South Asia.”

In his strongest statement to date, the WHO Director-General also expressed support for worldwide demonstrations against police brutality and racism, sparked by the death of a black man, George Floyd, after an officer put him in a knee hold in the United States.

“WHO fully supports equality and the global movement against racism. We reject discrimination of all kinds. We encourage all those protesting around the world to do so safely, as much as possible,” said Dr Tedros, the first African leader of the UN’s health agency.

“As much as possible, keep at least 1 metre from others, clean your hands, cover your cough and wear a mask if you attend a protest. We remind all people to stay home if you are sick and contact a health care provider,” he added.

As the US entered its third week of protests, countries around the world have rallied in support of the movement. Similar demonstrations drew masses of people in Switzerland, the United Kingdom, the Republic of Korea, Spain, and other countries.

Nature Paper Finds Non-Pharmaceutical Interventions Lowered Reproductive Number, R0

Only 3.2-4.0% of the total population, or between 12 to 15 million people, were estimated to be infected in 11 countries from the beginning of the epidemic in Europe until May 4th, according to the Nature study.

“Our results show that major non-pharmaceutical interventions and lockdown in particular have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control,” the authors, a group of researchers from Imperial College London and Oxford, wrote in the analysis.

Non-pharmaceutical measures were able to successfully lower the reproduction number R0, which estimates the average number of susceptible people that will contract the disease from one infected person. When the R0 drops below 1, the epidemic will decline. 

 “Current interventions have been sufficient to drive the reproduction number R0 below 1, and achieve epidemic control,” according to the authors. 

The analysis found that the average R0 was reduced by 82% across the 11 countries, dropping to 0.66 compared to 3.8 at the beginning of the study period, before any “non-pharmaceutical interventions” were put in place. R0 values in individual countries ranged from 0.44 in Norway to 0.82 in Belgium.

The authors used death data from the European Centers for Disease Control to estimate infections across Austria, Belgium, Denmark, France, Germany, Italy, Norway, Spain, Sweden, Switzerland, and the United Kingdom.

Pandemic Hotspots Shift From Europe + US to Latin America + South Asia

New infections are growing at an alarming rate in several countries in South America. The trends are real, not just due to increased testing and better surveillance, according to Mike Ryan.

In the past day, about 70% of COVID-19 deaths were in the Americas. Brazil overtook the United States in recording the highest number of new cases late last week, and 60% of the world’s new cases were reported in the Americas.

“I would say right now the epidemic in Central and South America is the most complex of all of the situations we face globally.. We’re seeing from Mexico all the way to Chile is an increasing pattern across the Americas across Latin America, with some notable exceptions,” said Ryan on Monday. “I think it’s a time of great concern.

“It’s not one country, it’s many many countries experiencing very severe epidemics [similar to] what we saw in Europe and North America….There’s been an increase of about 50% of cases in Guatemala over the last week, with a worrying over 100% increase in the number of fatalities [for example].”

“The pandemic epicentre moved from China & East Asia to Europe & North America, now to South Asia & Latin America. [We’re] still in the growth phase in many countries,” tweeted  Devi Sridhar, Professor & Chair of Global Public Health at University of Edinburgh.

Pakistan, now reporting the highest number of new cases per day in WHO’s Eastern Mediterranean region, reported 4,960 new cases on Sunday.

Some 70% of new cases in WHO’s Southeast Asian Region were recorded in India, now hosting the 6th highest number of COVID-19 cases. The country reported 11,000 new cases in the past 24 hours, some 500 more than the previous day.

The New Delhi’s Department of Health, Family and Welfare overrode a controversial order restricting hospital services for COVID-19 to residents of Delhi on Monday. The order, published on Sunday, limited hospital services for COVID-19 to “bona fide residents of the National Capital Territory of Delhi” – leaving Indian migrants in the capital. About 40% of New Delhi’s population are migrants, and the capital has the highest concentration of inter-state migrants compared to any other region in India.

In the WHO European region, half of Sunday’s new cases were in the Russian Federation, which reported 9000 cases. New cases in Russia have plateaued around 8,000-9,000 per day since mid-May. 

Still, the Russian Federation plans to lift its months-long lockdown starting Tuesday, said Moscow’s Mayor Sergei Sobyanin on Monday. “Moscow can practically get back to its usual rhythm of life,” said Sobyanin on his personal blog.

On Monday, New Zealand Prime Minister Jacinda Ardern declared the country ‘virus-free’, and announced that virtually all COVID-19 restrictions will be dropped reported Reuters. New Zealand last reported new cases of COVID-19 on 19 May, but the country has still taken a cautious approach to reopening, which has been largely supported by the public. 

Image Credits: S. Lustig Vijay/HP-Watch, Flickr: Nicola, Johns Hopkins CSSE, Tasleem Ul Haq.