Change points in the spread of COVID-19 question the effectiveness of nonpharmaceutical interventions in Germany

TL;DR

This study analyzes COVID-19 infection data in Germany to evaluate the timing and impact of nonpharmaceutical interventions, revealing that early measures had some effect, but later interventions' effectiveness remains uncertain due to data limitations.

Contribution

It introduces a method to estimate infection dates and identify change points, providing insights into the timing and effectiveness of interventions in Germany.

Findings

Early interventions correlated with declines in infection rates.

Later measures showed limited or no clear impact.

Infection decline attributed partly to behavioral changes, not just policies.

Abstract

Aims: Nonpharmaceutical interventions against the spread of SARS-CoV-2 in Germany included the cancellation of mass events (from March 8), closures of schools and child day care facilities (from March 16) as well as a "lockdown" (from March 23). This study attempts to assess the effectiveness of these interventions in terms of revealing their impact on infections over time. Methods: Dates of infections were estimated from official German case data by incorporating the incubation period and an empirical reporting delay. Exponential growth models for infections and reproduction numbers were estimated and investigated with respect to change points in the time series. Results: A significant decline of daily and cumulative infections as well as reproduction numbers is found at March 8 (CI [7, 9]), March 10 (CI [9, 11] and March 3 (CI [2, 4]), respectively. Further declines and stabilizations are found in the end of March. There is also a change point in new infections at April 19 (CI [18, 20]), but daily infections still show a negative growth. From March 19 (CI [18, 20]), the reproduction numbers fluctuate on a level below one. Conclusions: The decline of infections in early March 2020 can be attributed to relatively small interventions and voluntary behavioural changes. Additional effects of later interventions cannot be detected clearly. Liberalizations of measures did not induce a re-increase of infections. Thus, the effectiveness of most German interventions remains questionable. Moreover, assessing of interventions is impeded by the estimation of true infection dates and the influence of test volume.