Impact of complete lockdown on total infection and death rates: A hierarchical cluster analysis

Diabetes Metab Syndr. 2020 Jul-Aug;14(4):707-711. doi: 10.1016/j.dsx.2020.05.026. Epub 2020 May 15.


Introduction and aims: Retarding the spread of SARS-CoV-2 infection by preventive strategies is the first line of management. Several countries have declared a stringent lockdown in order to enforce social distancing and prevent the spread of infection. This analysis was conducted in an attempt to understand the impact of lockdown on infection and death rates over a period of time in countries with declared lock-down.

Material and methods: A validated database was used to generate data related to countries with declared lockdown. Simple regression analysis was conducted to assess the rate of change in infection and death rates. Subsequently, a k-means and hierarchical cluster analysis was done to identify the countries that performed similarly. Sweden and South Korea were included as counties without lockdown in a second-phase cluster analysis.

Results: There was a significant 61% and 43% reduction in infection rates 1-week post lockdown in the overall and India cohorts, respectively, supporting its effectiveness. Countries with higher baseline infections and deaths (Spain, Germany, Italy, UK, and France-cluster 1) fared poorly compared to those who declared lockdown early on (Belgium, Austria, New Zealand, India, Hungary, Poland and Malaysia-cluster 2). Sweden and South Korea, countries without lock-down, fared as good as the countries in cluster 2.

Conclusion: Lockdown has proven to be an effective strategy is slowing down the SARS-CoV-2 disease progression (infection rate and death) exponentially. The success story of non-lock-down countries (Sweden and South Korea) need to be explored in detail, to identify the variables responsible for the positive results.

Keywords: Cluster analysis; Death; Infection; Lockdown; SARS-CoV-2.

MeSH terms

  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Cluster Analysis
  • Communicable Disease Control / methods*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / prevention & control*
  • Coronavirus Infections / transmission
  • Global Health
  • Humans
  • Outcome Assessment, Health Care
  • Pandemics / prevention & control*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / transmission
  • Quarantine* / statistics & numerical data
  • SARS-CoV-2