The effect of lockdown on the outcomes of COVID-19 in Spain: An ecological study

It is paramount to expand the knowledge base and minimize the consequences of the pandemic caused by the new Coronavirus (SARS-Cov2). Spain is among the most affected countries that declared a countrywide lockdown. An ecological study is presented herein, assessing the trends for incidence, mortality, hospitalizations, Intensive Care Unit admissions, and recoveries per autonomous community in Spain. Trends were evaluated by the Joinpoint software. The timeframe employed was when the lockdown was declared on March 14, 2020. Daily percentage changes were also calculated, with CI = 95% and p<0.05. An increase was detected, followed by reduction, for the evaluated indicators in most of the communities. Approximately 18.33 days were required for the mortality rates to decrease. The highest mortality rate was verified in Madrid (118.89 per 100,000 inhabitants) and the lowest in Melilla (2.31). The highest daily percentage increase in mortality occurred in Catalonia. Decreasing trends were identified after approximately two weeks of the institution of the lockdown by the government. Immediately the lockdown was declared, an increase of up to 33.96% deaths per day was verified in Catalonia. In contrast, Ceuta and Melilla presented significantly lower rates because they were still at the early stages of the pandemic at the moment of lockdown. The findings presented herein emphasize the importance of early and assertive decision-making to contain the pandemic.