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A new analysis published in the journal “The Lancet” shows what criteria countries should meet in order to ease the restrictions related to the reduction of SARS-CoV-2 coronavirus transmission. There are five criteria and most countries are not even close to meeting them.
- Mitigation of restrictions in connection with the COVID-19 pandemic should be conducted in a responsible and transparent manner. Meanwhile, it turns out that some countries do not meet the criteria for lifting blockades
- Western countries, unlike Asian countries, initially did not take the looming epidemic seriously, believing it to be similar to the flu rather than the SARS or MERS epidemic
- Scientists believe it is still not too late to draw conclusions, especially as SARS-CoV-2 coronavirus infections surge in European countries
- More information about the coronavirus can be found on the TvoiLokony home page
In an article published in “The Lancet” – one of the most prestigious medical journals – we can read that governments should decide to alleviate the restrictions related to COVID-19 only when the following conditions are met: knowledge of the infection status, community involvement, adequate fitness public health, adequate capacity of the health system and border controls.
The authors of the analysis looked at nine high-income countries and territories that began to ease restrictions – Hong Kong, Japan, New Zealand, Singapore, South Korea, Norway, Spain and the United Kingdom. It found that many governments did not meet the criteria necessary to avoid new waves of infection. Among the countries surveyed, these were Spain, Germany and the United Kingdom.
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The researchers’ analysis also showed that an effective search, test, track, isolate and augment system is needed to reopen safely. «Actually, no country does it perfectly… Britain is doing it particularly badly. Spain and France are also not doing very well, »said study co-author Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, in an interview with CNN.
The authors of the article stated that governments should base their decisions on easing the restrictions, taking into account the epidemic situation and the social and economic consequences of the restrictions. Regardless of the strategy chosen, the government should clearly define its goals and make decisions transparently, and the steps taken should be part of a clear overall strategy, and as scientists say, “this is not always the case”.
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Knowing the status of your infection is very important
The study found that Singapore, Norway, Spain and (in the case of local outbreaks) the UK all use expert advice to decide how to alleviate restrictions. However, without explicit and public criteria, the risk assessment stance is often “unclear, with little evidence that the increasing understanding of aerosol-related SARS-CoV-2 transmission has been considered”.
Other countries, including Japan, Germany, South Korea and, in some cases, the UK remove or impose restrictions based on epidemiological thresholds. In Germany, local authorities are responsible for lifting the restrictions and considering re-imposing them if there are more than 100 new infections every day for every 000 inhabitants for seven consecutive days. Hong Kong has a similar strategy, while New Zealand has a four-level warning system. Singapore, South Korea and the United Kingdom also benefit from a similar gradual system. However, research shows that the latter country does not consistently.
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Scientists believe that the principle that countries should not reopen until they have a high-quality epidemic surveillance system has been very often flouted. According to them, detailed real-time data is necessary to accurately calculate the level of transmission taking place in a given area and determine how to reopen.
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Public trust in government activities
Scientists’ research has shown that for countries to reopen safely, community involvement in the use of PPE is essential. Government recommendations should be consistent and credible, especially with regard to the most vulnerable populations. Meanwhile, messages on issues such as safe social distance, wearing protective masks and working remotely were in many cases confusing and kept changing. According to the researchers, this causes a lack of trust and public support.
It is clearly visible on the example of Poland and the obligation to wear protective masks. Changes in recommendations, hasty statements about the safety or not of masks and the sense of wearing them, made many people hate the recommendation of covering the mouth and nose, arguing that “walking with a muzzle is for people who do not think for themselves”.
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Scientists believe that to some extent, countries can be divided into those that took the pandemic seriously (such as SARS or MERS epidemics) and those that thought of COVID-19 as the ordinary flu. «Asian countries knew from the start that they had to deal with the epidemic, because if they did not take it seriously, it would be really bad. Western countries were more likely to practice “we don’t have to worry too much” – said McKee.
These differences in dealing with a pandemic are very evident. Early tracing of telephone contacts in the UK had “little success”, while South Korea used medical records, credit card transactions, GPS and CCTV for tracing, and Hong Kong relied on the police supercomputer system.
Singapore, South Korea and the UK have developed large spaces for welfare centers, with the UK having a shortage of staff compared to the two countries, preventing the centers from being fully utilized.
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The shortage of personal protective equipment, which the medics of Western countries struggled with, forced them to work without adequate protection. According to the report, in Spain 10 percent. all infected patients are healthcare professionals.
Border control and the reopening of borders certainly played a role in keeping the epidemic under control. Hong Kong, New Zealand and Singapore kept their borders closed to most visitors and ordered testing and a 14-day quarantine. European countries quickly decided to reopen their borders, and did not require newcomer testing (some countries have selective testing, but it usually concerns passengers arriving by plane).
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What to do to avoid a full blockage during the next wave of infections?
Scientists believe it is not too late to draw conclusions and prepare the right tools to tackle the epidemic. According to the study, in order to avoid a return to full blockade, states need a clear and transparent plan that sets out the criteria for transition to the next phases and related measures. Robust systems for close monitoring are needed and further measures to reduce transmission are needed – distance, mask and hand hygiene. Governments should also support the development of health care systems, provide them with the necessary resources to perform safe and effective work.
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