Effect of easing lockdown and restriction measures on COVID-19 epidemic projection: A case study of Saudi Arabia.

Shafiun Nahin Shimul,Abdulrahman Al-Mohaimeed,Angi Alradie-Mohamed,Ilias Mahmud,Russell Kabir,Siew Ann Cheong

doi:10.1371/journal.pone.0256958

Shafiun Nahin Shimul, Abdulrahman Al-Mohaimeed + Show 4 more

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https://doi.org/10.1371/journal.pone.0256958

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Abstract

In this study we compared two predictions of COVID-19 cases in the Kingdom Saudi Arabia (KSA) using pre-and post-relaxation of lockdown period data to provide an insight regarding rational exit strategies. We also applied these projections to understand economic costs versus health benefit of lockdown measures. We analyzed open access data on COVID-19 cases from March 6 to January 16, 2021 in the KSA. To understand the epidemic projection during the pre- and post-lockdown period, we used two types of modeling: the SIR model, and the time series model. We also estimated the costs and benefits of lockdown- QALY gained compared to the costs of lockdown considering the payment threshold of the Government. Prediction using lockdown period data suggested that the epidemic might slow down significantly after 109 thousand cases and end on October 6, 2020. However, analysis with latest data after easing lockdown measures suggested that epidemic might be close to an end on October 28, 2021 with 358 thousand cases. The peak has also been shifted from May 18, 2020 to Jun 24, 2020. While earlier model predicted a steady growth in mid-June, the revised model with latest data predicted it in mid-August. In addition, we estimated that 4986 lives would have been saved if lockdown continued but the cost per life saved would be more than $378 thousand, which is way above not only the KSA threshold, but also the threshold of any other highly advanced economies such as the UK and the USA. Our results suggest that relaxation of lockdown measures negatively impacts the epidemic. However, considering the negative impact of prolong lockdown measures on health and economy, countries must decide on the best timing and strategy to exit from such measures to safely return to normal life with minimum loss of lives and economy considering its economic and health systems' capacity. Instead of focusing only on health, a balanced approach taking economy under consideration is recommended.

Highlights

Corona Virus Disease 2019 (COVID-19) is a newly discovered infectious disease of the respiratory system which is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2) [1]
While earlier model predicted a steady growth in mid-June, the revised model with latest data predicted it in mid-August
Our results suggest that relaxation of lockdown measures negatively impacts the epidemic

Summary

Introduction

Corona Virus Disease 2019 (COVID-19) is a newly discovered infectious disease of the respiratory system which is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2) [1]. COVID-19 was first reported in Wuhan, China [2,3], and ravaged the world to become a pandemic [4]. It is highly infectious with an incubation period of 2–14 days. An infected case can spread the disease even in the time between suspecting the case and confirmation of the case [5] This makes it difficult to suppress the speed of the transmission of the disease. As of January 18, 2021, the epidemic of COVID-19 has spread over 206 cities and infected 3,65,099 people and caused 6329 deaths in the KSA [6]

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