When Will It Be Safe to Loosen Wuhan virus Lockdowns?


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 4 days ago '19        #1
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When Will It Be Safe to Loosen Wuhan virus Lockdowns?

As the new coronavirus spreads across the world, governments and scientists are bracing for a monthslong siege rather than a swift victory—one marked by shifting strategies and potentially prolonged economic disruption.

Sweeping restrictions and unprecedented lockdowns from New York and San Francisco to Milan, Paris, Manila and Kuala Lumpur, Malaysia, are expected to slow the spread of the disease, but they aren’t likely to halt the contagion altogether, public-health experts say. Places like Singapore and Hong Kong are learning that early accomplishments in containment can be undone by new waves of infection.

In the coming weeks and months, authorities will grapple with a thorny problem: When is it safe to loosen the grip and by how much without risking a resurgence—and how much economic pain are countries ready to endure?

The Trump administration issued guidelines for “15 Days to Slow the Spread” last week, calling on Americans to avoid gatherings of 10 or more people and stay home as much as possible. President Trump has said his administration will decide once the 15 days are up what to do next, and he is pushing to get people back to work.

“THE CURE CANNOT BE WORSE (by far) THAN THE PROBLEM!” Mr. Trump said in a tweet Tuesday.

Scientists say the pandemic is likely to be brought to an end in one of two ways: with a vaccine, or by achieving so-called herd immunity, which occurs when a large percentage of the population—half or more—survives infection and develops immunity to the virus. An effective treatment would also help slow the contagion and reduce the risk.

All three are problematic. Millions of people would have to be infected, and many would die before herd immunity is reached, experts say. A vaccine is likely to take much longer than a year to develop and be made widely available, said Kristian Andersen, an infectious-disease researcher at Scripps Research in La Jolla, Calif. New drugs also are not easy to develop.

Life is not going to be back to what we consider normal for years to come,” Dr. Andersen said. “We need to figure out how we are going to function as a society for the next three years.”

Many governments are preparing for a strenuous effort of fits and starts, taking their cue from how the virus behaves.

“Transmission chains can continue at a low level and then resurface once physical distancing measures are lifted,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.

“The entire episode, the entire challenge, will take quite some time,” Singapore’s Health Minister Gan Kim Yong said last week. “It could last more than a year, so therefore we have to prepare for the long haul.”

Places like Hong Kong, Singapore and Taiwan, which contained the first wave of infections originating in China at the start of the outbreak, are now confronting fast-rising numbers. Their early experiences show the unpredictable path ahead. In an interconnected world, the failures of some countries can upend the successes of others, and the pandemic could yet spread to new regions—like Africa, for instance—that haven’t recorded big outbreaks yet.

For weeks in Hong Kong, people stayed away from each other, helped teach their children at home and wore masks in public. The number of new cases fell to single digits, then began to rebound over the past week, registering record-high figures. Most among the recent surge are travelers returning from Europe and North America, but the disease is also spreading locally after people began to mingle more freely again, filling bars and restaurants.

In Singapore, which won praise for its rigorous efforts to keep the virus in check, more than half of all confirmed cases have come in the last week alone. Prime Minister Lee Hsien Loong has sought to prepare Singaporeans for a long f*ght, warning in a recent speech of “new clusters and new waves of infection.”

The government says it will tighten and loosen measures when necessary—with measures including temporary closures of schools and workplaces for a few weeks at a time as “circuit breakers” if cases surge.

The U.S. is looking at what is happening in Asian countries as they relax lockdowns or social distancing measures after cases have declined. The Chinese city of Wuhan, the epicenter of the outbreak, has been under quarantine since Jan. 23. Travel restrictions will be eased starting April 8, according to a provincial government notice.

“There won’t be a new normal. What we’re coming back to [in China] is a new non-normal,” said Kent Kedl, head of Greater China and North Asia at consulting firm Control Risks. “Businesses will have to find stability in being resilient, because we’re going to see massive, massive changes.”

The biggest challenge will be the uncertainty, he said. He is advising clients to create crisis-response teams tasked with navigating the flux for at least six months.

A recent report by researchers at Imperial College London said that to effectively suppress the virus and sharply lower transmission, far-reaching and restrictive measures would be required. The drastic steps—including social distancing of entire populations outside the home and workplace—would need to be maintained until a vaccine becomes available, it said.

The authors acknowledged a suppression campaign “carries with it enormous social and economic costs.”

Months of isolation, social distancing and economic distress could lead to more health problems than Covid-19 itself, said David Katz, founding director of Yale University’s Prevention Research Center. Job losses lead to lack of health insurance, food insecurity, stress, and sometimes drug and alcohol abuse and suicides, he said.

He has proposed a stratified approach in which those most vulnerable to Covid-19—people ages 75 and older, and those of any age with heart disease or another serious underlying condition—would remain isolated or maintain social distancing. Meanwhile, people under age 60 would largely go back to their daily lives after a few weeks, while following hand-washing and other precautions.

“What I’ve been concerned about is we can hurt people if we let them get this infection, and we can hurt people with an all-out war that destroys their lives in other ways,” said Dr. Katz, who said he has spoken with two U.S. governors about his proposal. “I’m saying how about we do this in phases.”

The first phase is the current one: strict social distancing for a few weeks to avoid sharp peaks of infection and prevent the health-care system from being overwhelmed, he said. Testing should be expanded in the U.S. to figure out how many people are sick, he said.

Then experts in epidemiology, virology, mathematical modeling and other fields should analyze the data and figure out a way to protect the vulnerable while allowing others to get on with their lives, he said.

Businesses are making plans to cope with the uncertainty. That includes the possibility that the coronavirus could re-emerge with new outbreaks in China and other places where it currently appears under control.

Daniel Wesley, the Florida-based owner of Blush and Bar, a jewelry company, manufactures his products exclusively in southern China but has struggled to get rings made. The factory he contracts with is grappling with worker shortages and has pushed back deadlines several times.

Mr. Wesley has sent samples to a factory in northern Thailand in a bid to diversify so that production isn’t hobbled by a virus resurgence in one area.

“I read recently that this could be an 18-month event where this comes in waves,” he said. “You’ve got to diversify now and just hope that demand is there.”

A second wave of infections “is a very real risk,” said Petra Klepac, a*sistant professor of infectious-disease modeling at the London School of Hygiene and Tropical Medicine, in part because immunity levels are still low in places where the virus appears to be contained, such as China.

The many unknowns about the virus are part of the problem. Scientists say that unlike the severe acute respiratory syndrome, or SARS, that swept across Asia in 2003 until it was defeated by containment efforts and summer weather, Covid-19 is unlikely to die a natural death.

For one, there isn’t enough information to ascertain with certainty whether warmer temperatures will slow transmission of the new coronavirus. The disease is already spreading in tropical climates such as Singapore and Thailand. But even if the weather has an impact, the virus could still survive the cycle of seasons, since the disease is already a pandemic while SARS was largely limited to Asian countries.

That means the virus could keep spreading in cooler climates and then reinfect others when the weather changes, shifting from one hospitable place to another.

The U.S. also faces challenges that could make it harder than it will be for other countries to figure out a path forward. States and local governments, not the federal government, decide which social distancing or quarantine measures to impose.

California and New York have imposed stay-at-home shutdowns, for example, while citizens move around more freely in other states where the virus is not thought to be circulating as widely. And states that quell their outbreaks will still be at risk of new chains of transmission from travelers from other states, public health experts say.

visit this link https://www.wsj.com/artic .. us-11585128601


 4 days ago '04        #2
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The best solution isnt full lockdowns or massive quarantines. Most research on large-scale quarantines suggests that they only work partially anyway

Testing and isolation is what they did in South Korea

Weve being doing lockdowns basically because we're way behind in testing and are basically looking at a population where we have no idea who has the virus.

Once we get better more widespread testing, then we should be able to ease lockdowns

We've gained a lot of momentum in testing recently though

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