COVID 19: How long should social isolation and lockdowns continue? What will happen when everyone leaves their homes again?
Billions of people around the world are confined to their homes, and of course many are wondering how long this lockdown will last and what happens when we hit the streets again? New models state that this social exclusion is only the first phase of a war that may last until 2022.
Over three billion people around the world have long suffered a degree of social alienation. Nearly 70 countries have taken home restraint measures, overseen by police or the military, to softer isolation recommendations and curfews.
Restricting billions of people to their homes could stifle the spread of new virus, but some huge questions arise: How long should we stay in our homes? Weeks; Months; One year;
On January 23, China launched a massive quarantine on a scale we had never seen before. Wuhan, the epicenter of the infection with more than 11 million people, has been locked up. Transportation to and from the city has stopped. Residents could not leave their homes for any reason other than buying food or medicine.
Some areas were stricter than others, but as the days passed, the isolation measures generally became much more aggressive. Food distributors kept the city alive as health facilities began conducting door-to-door checks, isolating anyone who had the virus.
China's lockdown policies vary, with the most extreme measures being taken against some 57 million people in Hubei Province. At its peak, more than 500 million people were affected by a policy of restraint.
On March 19, China did not report any domestic cases of COVID 19. A small number of cases were still reported, but were associated with travelers returning from another country.
And now what;
After two months of emergency restrictions, China began withdrawing the restrictions very late. Areas in Hubei that have not seen new infections in more than two weeks have begun to withdraw from social isolation and travel restrictions. If no new infections occur, Wuhan City will begin removing traffic restrictions from April 8.
A leading infectious disease modeling team based at London's Imperial College reports that China's extreme measures of social isolation have succeeded in curbing the virus, and that there are very early indications that the initial relaxation phases of these austerity measures have not revived spread of the virus.
So far, at least.
The big question facing the rest of the world today is "will it happen like in China?"
A new study University of Sydney examines the spread of COVID-19 across Australia and quantifies the direct relationship between the duration of social isolation measures and the percentage of the population that complies with the regulations.
"If we want to control the spread of COVID-19, at least 80% of the population will have to comply with strict social isolation measures for at least four months," the study said. "However, if it complies, 90% of the population then the duration could be less than 13 to 14 weeks, ie if we started tomorrow we could expect the COVID-19 test in July."
Perhaps the most striking finding in the study is the revelation that if less than 70% of the population adheres to social distancing practices, the pandemic cannot be suppressed.
Mark Lipsitch, a professor of epidemiology at Harvard University, says China may have successfully passed the peak of the virus after eight weeks, but its measures were extreme and started before the health care system collapsed.
"Or in other cities in China, which did not come close to collapsing the health care system, you can see six to eight weeks of social alienation," Lipsitch said in a recent interview Press.
"The question is, if you start social alienation now, you will see the healthcare system collapse, as it did in Italy, and I am afraid it will happen in many parts of the United States that do not seem to have a plan. Then you will have more cases in the population and it will take more time to reach zero. ”
A recent tweet from President Donald Trump states that social alienation measures in the United States should begin to ease in mid-April, but a group of health experts warned that this would be too soon. Tom Inglesby, an epidemiologist and director of the Johns Hopkins Health and Safety Center, presented a disturbing picture of what could happen in the United States if social alienation measures were eased prematurely.
"Anyone showing the end of social alienation should fully understand what the country will look like if we do that," Inglesby wrote in a Twitter message. "COVID will spread widely, quickly, terribly, it could kill potential millions next year with huge social and economic repercussions across the country."
These big social distancing measures take time to work. The impact of big interventions in Wuhan China took about 3 wks to start to reverse things. And then everyday after the situation got better. In the US, we're about 7 to 10 days into this, depending on the state.10 / x- Tom Inglesby (@T_Inglesby) March 23th 2020
What will be the second phase? It's a big mystery right now and every government around the world is likely to approach things differently. Even if China manages to quell a second virus attack in the coming months, no other country in the world has the means to replicate the integrated surveillance methods it uses.
Juliette Kayyem, a former senior security official, says that if we can get through the first phase of social alienation and neutralize the spread, the world will continue to be very different as long-term efforts to end state operations begin.
"Then at this stage, we could isolate the sick, find their contacts, care for them in available intensive care beds with available ventilators because we would have increased our resources." Reported Kayyem on NPR.
In the second half of 2020, massive examinations and contact detection will be required to identify and isolate new cases, stopping the spread of detected cases.
"We will need an airport screening system so that no one enters the country with the disease without being diagnosed and isolated." he says Tom Inglesby, discussing what this second phase should look like.
"We will need a test that could be used to identify those who have been infected to find out how common the disease is in the United States. We hope that new therapies will be developed and in an amount that can at least treat patients with COVID 19. Once we have these things, it would be much less dangerous to take stock of social distancing measures and consider what to do. could be reduced gradually. "
A powerful model from Imperial College London last week he revealed that active measures of social distancing may need to be discontinued intermittently for the next 18 months until a vaccine is developed to achieve mass immunity. A more recent model, by Mark Lipsitch and his team at the Harvard TH Chan School of Public Health focuses specifically on the United States, and reports:
… The total duration of the SARS-CoV-2 epidemic could last until 2022
This model confirms that if a phase of social alienation is not accompanied by comprehensive monitoring, surveillance and intervention, then the peak of the epidemic in the United States will simply take place in the fall. The study warns that a winter epidemic could worsen along with the contagion, as it is still unclear if the virus spreads faster in colder seasons.
One of the worst-case scenarios presented in the new Harvard model states that the epidemic could extend to 2022. This scenario is based on current incidents in the United States health services.
The final conclusions are not exactly comforting, but the study states that a huge number of variables could provide more positive results. This model does not take into account the development of new therapies, innovative methods of detection and testing or even the unlikely possibility of the virus being reduced naturally.
When will all this pass? When will you be able to leave your home comfortably and return to your normal activities?
Unfortunately, there is no simple reassuring answer to this question and whether it will end sometime soon, or whether we will have to wait another 12 or 18 months. In the last updateWHO Director-General Tedros reiterated a message he is trying to send to all countries at the moment: these initial measures are only a buyout of time to establish wider control systems and absorb the pressure on healthcare providers. .
"Either by themselves, these measures will not stop the epidemics," said WHO Director-General Tedros.
"These actions will allow us to take more precise and targeted measures needed to stop the transmission and save lives. We call on all countries that have adopted the so-called lockdown to continue using it. It will create a second chance. The question is, how will you use it? ”