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Table 5 Process of exiting- Findings on types and effects of suggested exit strategies from the reviewed studies

From: Exit strategies from lockdowns due to COVID-19: a scoping review

1. Phase wise opening up
Country Study (type of study) Details of strategy Determinants Effects
Belgium Abrams et al. [30]
(Modelling study)
Phase 1b —Shops re-opened under strict requirements related to the organization of the work and restricting access to the store to avoid overcrowding;
Phase 2a — Schools partially re-opened (first phase —selected grades in primary and secondary schools);
Phase 2b — Schools partially re-opened further (second phase — pre-primary schools);
Phase 3 — Restaurants, bars, and cafes re-opened un-der strict measures including physical distancing and a limited number of customers;
Based on the daily number of new hospitalizations and admissions to the ICU. None given
Coletti et al. [31]
(Modelling study)
Phase 1 – Work-places reopen
Phase 2 – Schools reopen
Phase 3 – Leisure activities reopen
Regular re-assessment is crucial to adjust to evolving behavioural changes that can affect epidemic diffusion. In addition to social distancing, sufficient capacity for extensive testing and contact tracing is essential for successful mitigation. None given
Germany Dorn et al. [32]
(Modelling study)
Gradual lifting of shut down Long duration of remaining restrictions would increase relative economic costs compared to alternative gradual opening strategies Reproduction number is around 0.8.
USA Gulbudak et al. [33]
(Modelling study)
Rapid measured lockdown with intermediate fatigue (rapid reactive lockdown as soon as possible) in conjunction with the subsequent wave being detected lasting 30 days before 50% return to normalcy Sustained public social distancing and mask wearing, targeting transmission reduction rather than removing susceptible altogether, to reduce R. None given
India Bhattacharya et al. [34]
(Modelling study)
Graded/staggard exit Progressive social awareness   This can minimize the peak and flatten the infection curve.
Goel et al. [35]
(Observational study)
Phase 1-Relaxation of all zones except containment zones. Opening of liquor shops. Govt offices opened with 33% capacity. Movement with a pass.
Phase 2 - Domestic travel resumes. Opening commercial activity decided at the state level.
Phase 3- Lockdown in containment zones and social gatherings and venues closed.
Phase 4 – Night-time curfew from 9 pm-5 am.
Phase 5 - Gyms and yoga institutes open. Revocation of night curfew.
Economic relief measures
Technological advances
Evolution of testing criteria and testing methods
Strengthening health system
Any initial success of handling the pandemic will not last without continuous and reliable testing followed by contact tracing.
2. Cyclic/ rolling lockdown
France Boulmezaoud et al. [36]
(Modelling study)
Zigzag strategy of alternating between periodic and moderate deconfinement. The period should remain small compared to the time needed to reach the peak of the epidemic if deconfinement is maintained (which is in the order of 4 to 5 months). A periodic deconfinement is equivalent to a weekly organized deconfinement with 3 and a half days of strict lockdown per week.
Scenarios alternating strict lockdown and moderate deconfinement can allow the epidemic to be brought under control without resorting to group immunity.
  Moderate deconfinement with strong but non-drastic interventions, whether gradual or sudden, can lead to a rapid resumption of the epidemic, with a saturation of intensive care units in the fall and a peak of the epidemic in winter.
Germany German et al. [37]
(Modelling study)
Repetitive short-term contact reductions. Such reductions can be triggered adaptively if death rates, need for ICU, etc. exceed a threshold.
With additional hygienic measures, the situation can be enhanced further. However, repetitive short-term lockdowns and hygiene measures need to be in place for the next two or three years until herd immunity can be obtained (if vaccination is not available before).
The effects of antibody tests would add significant benefit to exclude people with antibodies from the contact reductions.  None given
3. Zonal lockdown
India Chowdhury et al. [25]
(Policy paper- overview)
Zonal or local lockdowns may be suitable for some countries where systematic identification of new outbreak clusters in real-time would be feasible Requires generalised testing and surveillance structure, and a well-thought-out (and executed) zone management plan.  None given