Did the National lockdown lock COVID-19 down in India, and reduce pressure on health infrastructure?

Background: & objectives: The spread of COVID19 in India has posed a major challenge for policy makers. Policy response in form of imposition of a prolonged national lockdown has imposed substantial costs on the entire population. But the extent to which it has contained the spread of the epidemic needs to be assessed. Methods: We use an Interrupted Time Series model to assess the success of lockdowns in containing COVID-19. In the second step, we use four variants of the SIR models to develop a counterfactual- what would have happened without the lockdown. These results are compared with actual data. The analysis is undertaken for India, and Maharashtra, Gujarat, Delhi, and Tamil Nadu. Results: Lockdown has reduced the number of COVID-19 cases by 23.65 to 337.73 lakh in Class I cities and towns, where COVID has mainly spread. It has averted about 0.01 to 0.10 lakh deaths. At the regional level, however, lockdown has averted a health crisis as existing ICU and ventilator facilities for critically ill patients would have been inadequate. Interpretation & conclusions: Overall, the results for three of the four models reveal that lockdown has a modest impact on spread of COVID-19; the health infrastructure at the national level is not over strained, even at the peak. At the regional level, on the other hand, lockdowns may have been justified. However, given that identification of new cases is limited by levels of daily testing that are low even by Asian standards, analysis based upon official data may have limitations and result in flawed decisions.