The second wave of the epidemic and the lifting of the quarantine: the predictions of virologist on the situation with coronavirus

Why the second wave of infection with coronavirus are more dangerous than the first? When you can undo the quarantine and what to consider? Answers to frequently asked questions provided by the British virologist from Lancaster University Dr. Muhammad Munir in an interview with the Balkan service of “Radio Liberty”.

Вторая волна эпидемии и отмена карантина: прогнозы вирусолога о развитии ситуации с коронавирусом

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— Dr. Munir, in the United States and some European countries, where levels of mortality and cases of infection with coronavirus are reduced, the authorities took measures to restore the economy. If it’s a good time [for the weakening of quarantine]?

If we look at the General spread of the infection, it has a different intensity. Some countries are ahead of others, such as Italy, Spain and France. Some countries are relatively behind, for example, if we talk about Denmark, the Netherlands or Sweden. Therefore, because of this difference in the intensity of the outbreak impose various control measures. For this reason, the number of cases began to decline in Italy and Spain. They slowly began to undo the restrictions imposed.

But I think that it is too early to remove any [limitations], mainly because we don’t know much about this infection. The virus rages, only three and a half months. And I still have much to learn before we can understand that there were enough measures to suppress it and to ensure that he never returned. Because if the virus came back again, it would be much more terrible situation, because people would have been exhausted and the government would also be economically affected. Therefore, to return [limit, when people again will be] in the workplace, it would be really hard. So, premature lifting of control measures need to be taken very carefully.

— What are the greatest risks to health carries a premature lifting of restrictions?

— How do we know this virus spreads through very close contact between different people, and the whole point of the restrictions on movement is that we will intervene in the transmission of the virus and suppressing the infection. So if you prematurely cancel control measures, people will return to contact with each other. And then the virus would spread quite rapidly among people who were not previously infected. And even people who have been infected before and are immune — we don’t know how long this immunity will last. Thus, these people will be able to re-infected, and the number of cases will increase significantly.

It would be really problematic, especially since the primary controls are simple, but measures to control the second wave of infection, which returned to society, more difficult. And it’s not very surprising, since in any pandemic that we saw, the second wave was inevitable.

So, this time, I think precautions need to be taken very seriously, and we must ensure that [the virus] will not return.

— Did you verify the likelihood of re-infection with coronavirus?

— [13 April] and the day before the world health organization from South Korea have reported 91 cases of the disease in patients who have already had a negative test result for coronavirus. They were allowed to return back into society.

But then they test again showed a positive result, although we do not know exactly what this phenomenon is, after all, is a new virus, a new disease, and we need to get much more information.

But there is a fair chance that the tests that were used in the previous diagnosis of the patient was not sufficiently effective.

— You mentioned a second wave — a new wave of infection and said she can be deadly. Why?

— One of the reasons that the second wave is always [more] deadly is the fact that people who are already in quarantine, say, six or seven weeks are exhausted. So they start to return to his normal life. And if you re going to apply the restrictive measures, the trend of implementation of these measures will already be lower. Thus, it will complicate re-gaining control over the disease.

The second problem is that people who are not immune, not infected for the first time, may face a more terrible defeat due to a virus because they have never experienced its effects.

But the relative advantage of this is that if, for example, the first wave was 20-30% of people [with] contamination, it means that people have the immunity and it would slow down the spread of infection in smaller clusters. But the clusters that were not previously affected, will be affected very much. And the government reluctantly will return restrictions, because governments with limited economic opportunities do not want to have another round of difficult decisions.

— Quarantine in Wuhan officially abolished through 76 days. What can we learn from the experience of this city — first world epicenter of coronavirus?

This is a very important question, and thank you that you gave me, because quarantines in other countries — it’s basically a mirror reflection of what practicing China.

China began to introduce an unprecedented quarantine. [Never] was not yet aware of the extent of quarantine in history. So it was quite a good experience, as it quickly reduced the number of new infections.

Thus, it gave confidence to other countries to enter quarantine at home. But now they lifted the restrictions, and this is another example that other countries will try to repeat. But there are a few important messages.

Although the quarantine in Wuhan was canceled, it did it on the symbolic [way] because people actually are still under the rules of limited movement. Only people who have the QR code of the green color (on their smartphones), it was allowed to go somewhere — people whose blood has enough antibodies, so they are protected.

It’s also people who work for major works, for example, in the production of drugs or medical devices, and they can go. But, of course, there is a risk of phasing out of restrictions in other countries because of the geopolitical differences between the countries are very large. For example, we cannot expect such a scale of increase or lifting of the quarantines in European countries, where the level of personal choice is relatively higher and the relatively high level of independent statements of opinion.

So, we have, of course, there are aspects that can be learned from the General scenario of Wuhan. However, they should be treated with caution, depending on what country we’re talking about.

Respectively, what is the exit strategy from this situation?

— This is really an unprecedented situation, and someone needs to have a crystal ball to predict how and when exactly can we get out of it. Different countries use different level restrictions. Therefore, this exit strategy must be determined at the state level or at least at the continental level.

So, I can tell you that there are certain criteria that will determine when you want to apply an exit strategy and when to relax the quarantine.

The first criterion is that when the number of cases of new infections begins to significantly decline for 14 consecutive days, it’s time to start thinking about mitigation of restrictive measures.

The second important criterion for lifting of restrictive measures is that your national health system is able to cure every infected person.

And the third criterion is that you’ve created enough opportunities to identify each person using the test, and you can then isolate those who test for coronavirus was positive. Those who have a negative result, it is possible to test for antibodies.

Therefore, it is important to keep in mind that this is not really a simple strategy, but there are three key criteria by which you will be able to determine when you can cancel the restrictive measures.

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