Social capital, quality of institutions and lockdown. Evidence from Italian provinces

Impact of implementation timing on the effectiveness of stay-at-home requirement under the COVID-19 pandemic: Lessons from the Italian Case

“…Thirdly, there are several behavioral, societal, economic, institutional, and infrastructural factors influencing not only the response of a region to a healthcare emergency but also the complains with NPIs of citizens [ 38 , 44 , 52 , 66 ]. Italy presents a strong heterogeneity within the country that should be considered by policymakers when evaluating the most effective and efficient set of policies [52] . Compartmental models tend to oversimplify the dynamics of the pandemic and those differences are generally not included in the modeling and are also out of the scope of the present study.…”

“…In Italy, infections, hospitalizations and deaths have been recorded from February 24, 2020 at a national level [ 46 , 52 ]. However, considering that some regions already had on that day several critical cases in ICU (e.g., 19 critical cases in Lombardia) and the unpredictability and severity of the initial outbreak, we may expect that ICUs hospitalization started a few days earlier but were not reported due to poor testing capacity [53] , limited at the beginning to only symptomatic cases [52] , and a general low readiness of the Italian healthcare system [54] .…”

“…In Italy, infections, hospitalizations and deaths have been recorded from February 24, 2020 at a national level [ 46 , 52 ]. However, considering that some regions already had on that day several critical cases in ICU (e.g., 19 critical cases in Lombardia) and the unpredictability and severity of the initial outbreak, we may expect that ICUs hospitalization started a few days earlier but were not reported due to poor testing capacity [53] , limited at the beginning to only symptomatic cases [52] , and a general low readiness of the Italian healthcare system [54] . Assuming that all the regions should present a similar exponential growth of cases at least for the first few days of their outbreaks, we defined as “Biased regions”, those regions whose official hospitalizations started with more than one case hospitalized in ICU (Fig.S4 in SI) as opposed to “Non-biased regions”.…”

“…Several authors used regression models to assess the correlation between NPIs and the course of the pandemic [ 25 , 29 , 31 , 32 , 52 , 55 ]. Text S3 in SI lists the model used in those studies.…”

“…In fact, incubation period of COVID-19 is around 5 days while approximately 7-11 days are necessary for the development of symptoms [ 63 , 64 ]. This means that a significant amount of positive cases could emerge in the days following the implementation of social distancing measures and NPIs can therefore take days after the implementation to show an effect [ 30 , 38 , 45 , 52 ]. Alfano and Ercolano [30] and Gatti and Retali [45] suggest that lockdown takes 10 days to show its effect, while Baier et al showed that NPIs on average may take 2 weeks before being effective [61] .…”