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How can countries know when it鈥檚 safe to ease coronavirus lockdowns?

By Jessica Hamzelou

20 May 2020

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It isn’t safe to lift lockdowns until new case numbers are low

Justin Paget/Getty Images

By April this year, was under some kind of lockdown. Such restrictions helped slow the spread of聽the coronavirus. As new cases decline in many places, countries are beginning to ease restrictions. How can we know it is safe to do so?

The World Health Organization鈥檚 principal recommendation is that, in order to move to a sustainable level of virus transmission, countries should have the spread of the virus under control. In practice, this means seeing聽a robust decline in聽the number聽of cases.

The WHO also advises that countries use testing and contact tracing to identify and isolate new cases of covid-19. Without screening and isolation, easing restrictions will inevitably lead to the number of new聽infections rising again. The UK聽government imminently, after controversially abandoning it in March, although details are scarce.

Yet to ease restrictions, a country鈥檚 number of cases also needs to be at a聽manageable level, says Christina Pagel at University College London. A聽lot of attention has been paid to the聽R, or reproduction number: the number of people each person with the virus is likely to infect. If this is above one, cases will continue to rise聽exponentially, so the aim is to keep it below this. But that alone isn鈥檛聽enough, says Pagel.

鈥淪ay you have an R of just less than one. That will give you a stable level of infection,鈥 says Pagel. 鈥淏ut if that stable level of infection is thousands a聽day, that鈥檚 not really going to help you聽鈥 you鈥檙e going to end up with a really burdened health system.鈥

The UK government reported 2684 positive test results on 18 May, and 2412 on 19 May.

Even when new case numbers are聽low, lifting restrictions will always carry a risk of a second wave of infections. South Korea brought its聽outbreak under control with a stringent policy of testing, isolation and contact tracing. In recent weeks, the country was reporting only around 10 new cases per day. However, following eased restrictions from 6 May, the Korea Centers for Disease Control and Prevention last week confirmed 102 new cases linked to nightclubs in Seoul. As a result, some clubs and bars have been ordered to close again.

There are concerns that similar outbreaks might occur in Germany, thanks to the gradual lifting of restrictions since the end of April. Germany鈥檚 early response to the virus and mass testing strategy brought the country鈥檚 R down from more than three to just below one during March. But last week, between 407 and 927 new cases were reported every day, and estimates from the Robert Koch Institute in Berlin suggest that the R may have risen above one since 6 May.

In Wuhan, China, five new cases聽of聽the virus were reported on聽10聽May,聽after the city where the global outbreak started eased some restrictions in early April. However, other than a handful of cases, there doesn鈥檛 appear to have been a second聽wave of infections.

It is unlikely that any country exiting lockdown will return to how things were before the outbreak. Social distancing, regular handwashing and,聽in some places, face masks may become a new normal. 鈥淭here鈥檚 an assumption that we can get to a point and then relax,鈥 says Paul Hunter at the University of East Anglia, UK. 鈥淭hat鈥檚 a false assumption.鈥

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