Wuhan epicenter of coronavirus — back to normal: the authorities removed severe restrictions on the movement of open shopping centers. Austria has become the first European country that will significantly ease restrictions for its citizens: many stores should open next week, reports the BBC.
While the hospitals of many countries are working to the limit, and epidemiologists are closely monitoring the spread of the virus, the Austrian experience can provide answers to many questions. France, Belgium, Finland and Spain are already trying to come up with a plan out of isolation, but experts warn about the danger of repeated waves of infection.
So when will it all end?
Everyone wants to know when we will be able to freely leave home to go back to the office, walk as you want, meet with friends and have the opportunity to fly on vacation to another country.
This is a wrong formulation of the question. The New York Times offers a different formulation: “How do we know that can come out of isolation?”
In Russia holidays and “restrictive measures” will continue at least until April 30. In Britain, under the current rules, self-isolation should last until April 14, but given the dynamics of the spread of coronavirus, most likely, measures will be extended.
To date, any date is just a guess.
On March 19 Prime Minister of Britain, Boris Johnson (now he is in intensive care with confirmed diagnosis Covid-19) argued that the country will be able to reverse the situation in 12 weeks, if people will follow the advice of the authorities. Johnson believed that by the end of June, the epidemic could go into decline.
And yet in April, every day in the country reveals several thousand infected people. For one only this environment in British hospitals died 938 infected with coronavirus patients.
Even if the forecast of the British Prime Minister will come true, does this mean that it will be possible to cancel the withdrawal?
Simple answer: probably not, and here’s why.
Limitations in Wuhan was removed after two months. Everywhere is the same?
Wuhan city, became the center of the flash Covid-19, has been on lockdown since January 23, though the first cases were diagnosed in late 2019. All residents had to stay home, closed the metro, stopped the train and stopped flying planes.
Only two months later, on March 25, in Hubei province, whose capital is Wuhan, and a weakening of quarantine measures: opened the road, people were allowed entry and exit, opened key businesses, shops and shopping centers.
April 7 was the first day in China no one died from the coronavirus. On this day, according to official statistics in the country was only 32 new cases of infection, and they are all imported. And in Hubei province has not revealed any new cases.
Does this mean that in two months, and other countries can expect to resume normal life?
No, not necessarily. First, Western experts are skeptical of the veracity of Chinese data: previous studies have shown that in official documents often have serious distortions. In the case of coronavirus alarming, for example, and the fact that the government of Wuhan for a long time, intentionally conceal information about the outbreak of a dangerous disease.
In addition, last week CNN, citing a Chinese publication reported that Wuhan delivered to several thousands of funeral urns, more than the official number of victims of coronavirus in the city. Time magazine notes that in its official documents China eight times changed the definition Covid-19.
Second, despite the claims of China, there is, albeit small, number of cases of transmission within the country.
In addition, the national Commission on health statistics does not include cases in which the infected have no symptoms, despite the fact that these people are distributors of the virus. A large part of the population of China still have not developed immunity to the virus, so the risk of a new wave of infections persists.
Given the fact that the coronavirus has spread around the world, its penetration into China from the outside will inevitably lead to a local transfer within the country, says epidemiologist from the Chinese Institute of Duke Kunshan (working with the support of American colleagues) Benjamin Anderson.
Epidemiologist Ira Longini from the University of Florida involved in the creation of models of viruses, warns: “the Virus can return as soon as they lifted restrictions. I would like to be wrong, but I can’t imagine how could it be otherwise”.
What’s the solution?
At the moment the most clear and structured exit strategy from the isolation presented the American enterprise Institute. The experts of the Institute amounted to a road map of three main steps.
Step 1. To stop the spread of the virus. It is at this stage is now most of the countries affected by the pandemic, including the USA, Britain and Russia. It is in order to successfully accomplish the first step, closed schools and universities, shopping centers and gyms, employees are transferred to remote work, and people are asked to keep your distance on the street.
What you need to do at this stage?
As often as possible to test and receive test results the same day. Tests should be sufficient to identify the disease in hospitalized patients, health care workers, those with whom contact was sick, and in patients who have no symptoms. The researchers believe that it is at least about 750 thousands of tests per week — and this is when the number of infected will begin to decline. At the peak, you may need a million tests. Now the US is doing about 65 thousand tests per day — that is, approximately 455 thousand in a week. Some States cope with this task much better than others, so the identification is uneven in different parts of the country.
To expand the capacity of the national health system. You need to have five to seven of the ventilator for every ten thousand people (now in the U.S. three of them), as well as five to seven beds in intensive care for ten thousand people (now 2.8). Russia is much better equipped with ventilators than many countries: in many regions the ratio of ventilation is much better than in the US (per 100 thousand inhabitants), but is adversely affected by other problems of the Russian health system.
To provide physicians with personal protective equipment. We are talking about disposable medical masks in sufficient quantity for all the employees of medical institutions and special standard N95 masks for doctors who have direct contact with infected with the coronavirus.
A large-scale contact tracing of patients with healthy people, to establish the isolation of potentially ill. That is, immediately isolate patients with Covid-19 and control their condition for 14 days. This country needs to be able to keep track of thousands of cases every day and tens of thousands of contacts.
When you go to the next stage?
When the state can achieve a sustainable reduction in the number of new cases of the disease for at least 14 days;
When the state hospital will be able to treat all patients requiring hospitalization, without resorting to crisis measures;
When the state will have the opportunity to test all people with symptoms Covid-19;
When the state will be able to monitor all contacts of people with confirmed diagnosis.
Step 2. Open every state. At this stage you can open a school, business can get back to work, but people will have to continue to keep a distance, and mass actions will remain banned. All in order to prevent a new wave of infections. With people older than 60 years and also those who are at risk, will be required to limit social contacts.
The staff should be able to respond quickly to the repeated increase in cases and immediately return to the measures described in step 1.
To proceed to the third step, when it invented the vaccine.
Step 3. To remove restrictions on social contacts. It is possible to do when the doctors can save patients in critical situations or to prevent serious condition in people at risk. Or when it invented an effective and safe vaccine.
Think it’s a very long way. In reality all this will happen?
The path is really long: some experts say that the restrictive measures really should be saved for 18 months is the time needed for development and testing of the vaccine.
Whether people will be able to spend those months in isolation, while many around the world were left without work and money? Professor Neil Ferguson of Imperial College London believes that some restrictions can be removed after three to four months after people first recommended to isolate themselves. However, measures will have to re-enter and cancel every few weeks to control the number of severe cases and give physicians the opportunity to provide assistance to all who need it.
In reality Britain can not choose this path, says expert: it is difficult to expect from businesses that they can quickly resume work, and then immediately roll it on the demand of epidemiologists. As you can’t expect the Bank of England and the Treasury will be able to pay compensation to the people for 18 months, without bankrupting the country.
Former member of Parliament Tory Nick boles has written for the Times column in which he called the British to draw attention to the “road map” at the American enterprise Institute and to develop a clear scheme, to make people understand that they need to do and why.
The lifting of the measures should be gradual, agrees Bols. And it should happen only after physicians will record a steady decline in the number of hospitalizations and deaths from coronavirus, when the national health system of Britain will be able to treat all patients in need of intensive therapy, and everyone in the country with symptoms Covid-19 will have the opportunity to know their diagnosis, making this test.
Only then, he believes, it is possible to cancel the most stringent measures for most people, but save them for the most vulnerable segments of the population. But even then, he said, the British should not immediately return to his former life: those who can work from home, need to continue to do so.
Bolsom do not agree with the foreign Minister of Britain Dominic Raab, who is currently partially acting Prime Minister of the country. He is sure too early to think about your exit strategy, you need to concentrate on the implementation of the current rules to pass the peak incidence “as fast as necessary.”
In Britain today, not the most stringent measures to combat the virus: people (not only dogs) are allowed, for example, go for a walk once a day. Advisers the British government do not support the introduction of more stringent measures: they believe that this approach will only postpone the peak incidence to fall.
In Germany (a country far more successful than others to help patients with coronavirus), a nationwide lockdown at the moment needs to remove 19 APR. Journalists of Reuters was familiar with the government document in which it is assumed that the pandemic will last until 2021. This document also assumes a gradual return to normal life, for example — the compulsory wearing of masks in public places after the end of quarantine.
The draft plan, writes Reuters, suggests that Germany will be able to identify more than 80% of people infected with coronavirus persons contacted within 24 hours before diagnosis. These people will immediately be isolated.
However, Germany, according to estimates of the Robert Koch Institute, have not yet reached the peak incidence — it is expected in the second half of April.
Russia sure will peak in 10-14 days. According to the head of the Federal medical-biological Agency Veronika Skvortsova, the increase in the number of patients in Russia is now 18-20% per day. She is sure that Russia managed to contain the explosive spread of the disease.
No matter how timely and successful the measures taken by the countries, it will not stop the pandemic: the virus until there is at least someone there is still a possibility of infection even where the incidence peak has long passed.
The American edition of Atlantic sees three scenarios: first, all countries will be able to suppress coronavirus (but the chances of this are negligible), the second is to wait until a significant part of the population will develop immunity, and then the virus will not be able to find a “host” (but this option will lead to a large number of deaths), third countries will continue to wage a protracted fight against the virus, quenching of the outbreak until a vaccine is developed it will be. The last option seems the most optimal, but it is also the most lengthy and complex.
As reported ForumDaily:
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