How the US and the world plan to return to normal after quarantine

Wuhan, the epicenter of the coronavirus, is returning to normal: authorities are lifting strict restrictions on movement and shopping centers are opening. Austria is set to become the first European country to significantly ease restrictions for its citizens, with many shops set to open as early as next week, reports Air force.

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While hospitals in many countries are working to their limits and epidemiologists are closely monitoring the spread of the virus, Austrian experience can provide answers to many questions. France, Belgium, Finland and Spain are already trying to come up with a plan to get out of isolation, but experts warn of the danger of a second wave of infection.

So when will it all end?

The question is incorrect

Everyone wants to know when we will be able to freely leave home, return to the office, walk as much as we like, meet friends and have the opportunity to fly on vacation to another country.

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This is a wrong statement of the question. The New York Times offers a different wording: “How do we know if self-isolation can be overcome?”

In Russia, non-working days and “restrictive measures” will remain at least until April 30. In Britain, according to current rules, self-isolation should last until April 14, but taking into account the dynamics of the spread of coronavirus, measures will most likely be extended.

As of today, any date is just a guess.

On March 19, British Prime Minister Boris Johnson (currently in intensive care unit with a confirmed diagnosis of COVID-19) claimed that the country could turn the tide in 12 weeks if people followed the advice of the authorities. Johnson believed that by the end of June the epidemic could decline.

And yet in April every day in the country several thousand infected are detected. In this environment alone, 938 coronavirus-infected patients died in British hospitals.

Even if the forecast of the British prime minister comes true, does this mean that it will be possible to cancel self-isolation?

The simple answer: most likely not, and here's why.

The restrictions in Wuhan were lifted two months later. Will it be the same everywhere?

The city of Wuhan, which became the center of the COVID-19 outbreak, has been on a lockdown since January 23, although the first cases of infection were diagnosed at the end of 2019. All the inhabitants of the city had to stay at home; the metro closed, trains stopped and planes stopped flying.

Only two months later, on March 25, in Hubei Province, whose capital is Wuhan, quarantine measures were loosened: roads were opened, people were allowed to enter and exit, key enterprises, shops and shopping centers were opened.

April 7th was the first day that no one died of coronavirus in China. On this day, according to official statistics, only 32 new cases of infection are registered in the country, and all of them are imported. And in the province of Hubei did not reveal a single new case.

Does this mean that in two months other countries can count on resuming their usual lives?

Not at all necessary. Firstly, Western experts strongly doubt the reliability of the Chinese data: past studies have shown that serious distortions are often observed in official documents. In the case of coronavirus, for example, it is also alarming that the authorities of Wuhan deliberately concealed information about an outbreak of a dangerous disease for a long time.

In addition, last week, CNN, citing Chinese publications, reported that several thousand funeral urns were delivered to Wuhan more than the official number of coronavirus victims in the city. Time magazine notes that in its official documents, China eight times changed the definition of COVID-19.

Secondly, despite the statements of China, there is, albeit a small, the number of cases of transmission of infection within the country.

In addition, the National Health Commission does not include statistics in cases in which the infected have no symptoms, despite the fact that these people remain spreading the virus. Most of the Chinese population has not yet developed immunity to the virus, so the danger of a new wave of infections remains.

Given that coronavirus has spread around the world, its entry into China from the outside will inevitably lead to local transmission within the country, says Benjamin Anderson, an epidemiologist at the Chinese institute Duke Kunshan, who works with the support of American colleagues.

Epidemiologist Ira Longini of the University of Florida, a virus model designer, warns: “The virus can return as soon as restrictions are lifted. I would like to be mistaken, but I can’t imagine how it could be otherwise. ”

What is the solution?

At the moment, the most understandable and structured strategy for overcoming self-isolation has been presented by the American Enterprise Institute. Institute experts have compiled a roadmap of three main steps.

Step 1. Stop the spread of the virus. It is at this stage that most of the countries affected by the pandemic, including the United States, Britain and Russia, are now in the process. It is in order to successfully complete the first step that schools and universities, shopping centers and gyms are closed, employees are transferred to remote work, and people are asked to keep a distance on the street.

What needs to be done at this stage?

1. Test as often as possible and get test results the same day. Tests must be sufficient to detect the disease in hospitalized patients, health care workers, contacts of sick people, and asymptomatic patients. Researchers believe that we are talking about at least 750 thousand tests per week - and this is when the number of infected people begins to decline. At its peak, a million tests may be required. The United States now does about 65 thousand tests per day, that is, approximately 455 thousand per week. Moreover, some states cope with this task much better than others, so detection occurs unevenly in different parts of the country.
2. Expand the capabilities of the national health system. To do this, you need to have five to seven ventilation devices for every ten thousand people (now there are three in the USA), as well as five to seven beds in intensive care for ten thousand people (now only 2,8). Russia is much better equipped with mechanical ventilation devices than many countries: in many regions, the availability of mechanical ventilation is much better than in the United States (per 100 thousand inhabitants), but other problems of the Russian health care system can adversely affect.
3. Provide doctors with personal protective equipment. We are talking about disposable medical masks in sufficient quantities for all employees of medical institutions, as well as special masks of standard N95 for doctors who have direct contact with infected coronavirus.
4. Expand large-scale tracking of contacts of sick people with healthy people, establish isolation of potentially sick people. That is, immediately isolate patients with COVID-19 and daily monitor their condition for 14 days. To do this, the country must be able to track thousands of infections every day and tens of thousands of contacts.

When can I go to the next stage?

• When the state can achieve a steady reduction in the number of new cases within at least 14 days;
• When state hospitals can treat all patients in need of hospitalization without resorting to crisis measures;
• When staff will be able to test all people with COVID-19 symptoms;
• When the state can monitor the contacts of all people with a confirmed diagnosis.

Step 2. Open each state one by one. At this stage, you can open schools, business can return to work, but people will have to continue to keep their distance, and mass events will remain banned. All this in order to prevent a new wave of infections. But people over 60, as well as those at risk, will need to limit social contacts.

At the same time, the staff should be able to quickly respond to a repeated increase in cases of the disease and immediately return to the measures described in step 1.

You can proceed to the third step when the vaccine is invented.

Step 3. Remove restrictions on social contacts. This can be done when doctors can save patients in critical situations or prevent serious conditions in people at risk. Or when an effective and safe vaccine is invented.

It seems to be a very long way. In reality, will it be so?

The path is indeed long: some experts argue that restrictive measures should indeed be maintained for 18 months - this is the time needed to develop and test a vaccine.

Will people be able to spend these months in isolation, while many around the world are left without work and money? Professor Neil Ferguson of Imperial College London believes that some restrictions can be lifted three to four months after people were first advised to isolate themselves. True, the measures will have to be re-introduced and canceled every few weeks in order to control the number of severe cases and give doctors the opportunity to provide timely assistance to everyone who needs it.

In reality, Britain cannot choose this path, the expert believes: it is difficult to expect from enterprises that they can quickly resume work, and then immediately collapse it at the request of epidemiologists. As one cannot expect, the Bank of England and the Treasury will be able to pay compensation to people within 18 months, without at the same time bankrupting the country.

Former Conservative Deputy Nick Bols wrote for the Times a column urging the British to pay attention to the American Institute of Enterprise’s roadmap and devise their own clear outline so that people understand what they should do and why.

Removing restrictive measures should be gradual, agrees Bols. And it should only happen after doctors have recorded a steady decrease in the number of hospital admissions and deaths from coronavirus, when the British National Health System will be able to treat all patients requiring intensive care, and every resident of the country with COVID-19 symptoms will be able to do a test and find out your diagnosis.

And only after that, the politician believes, it is possible to cancel the most stringent measures for most people, but to preserve them for the most vulnerable segments of the population. But even then, according to Bols, the British should not immediately return to their previous lives: those who can work from home should continue to do so.

British Foreign Minister Dominic Raab, who currently partially acts as the country's Prime Minister, does not agree with Bols. He is sure: it’s too early to think about an exit strategy, you need to concentrate on fulfilling the current rules in order to pass the peak of the incidence “as fast as necessary”.

In Britain, to date, not the most stringent measures to combat the virus: for example, people (and not only dog ​​owners) are allowed to go for a walk once a day. Advisers to the British government do not support the introduction of stricter measures: they believe that this approach will only postpone the peak incidence until the fall.

In Germany (the country has so far succeeded more successfully than others in helping patients with coronavirus), the nationwide lockdown is currently due on April 19th. Reuters reporters familiarized themselves with a government document stating that the pandemic will last until 2021. This document also provides for a phased return to normal life, for example, the mandatory wearing of masks in public places after quarantine.

The draft plan, Reuters writes, suggests that Germany will be able to identify more than 80% of the people with whom a person infected with the coronavirus contacted for 24 hours before being diagnosed. Such people will immediately isolate themselves.

However, Germany, according to the Robert Koch Institute, has not yet reached the peak of incidence - it is expected in the second half of April.

Russia is confident that it will peak in 10-14 days. According to the head of the Federal Biomedical 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 countries are, this will not stop the pandemic: as long as at least someone has the virus, the likelihood of infection remains even where the peak incidence is long gone.

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The American publication Atlantic sees three scenarios: first, all countries will be able to suppress the coronavirus at the same time (but the chances of this are negligible); the second is to wait until a significant part of the population has developed 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, extinguishing outbreaks of the disease, until a vaccine is finally developed. The last option seems to be the most optimal, but it is also the most time-consuming and difficult.

As reported by ForumDaily:

• A new virus was discovered in the Chinese city of Wuhan in December 2019. In 2020, it covered all continents except Antarctica. On March 11, US President Donald Trump imposed a ban on entering the United States from EU countries. The ban came into force on Friday, March 13, and will last at least 30 days. In particular, it will concern people who have visited the Schengen area over the past 14 days.
• March 13 Trump due to coronavirus introduced a nationwide emergency regime in the US.
• On March 11, WHO recognized the situation with the coronavirus pandemic, which covered more than 110 countries. Symptoms of Coronavirus COVID-19 Disease Available here.
• Virologist's tips on how to protect yourself from infection - here to register:.
• Trump has signed into law on paid leave due to coronavirus. Who can count on paid leave, read here.
• Read all news about coronavirus in our special project.

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