More testing and better tracing key in phasing out lockdown
Monday, 13 April 2020
The low number of tests is a bottleneck in fighting the coronavirus. Until infected persons have been identified, isolated and treated, they have already infected other persons. WHO warned on Friday that it is too early to start lifting restrictions.
When WHO Director-General Tedros Adhanom Ghebreyesus gave his opening remarks at the virtual press conference (10 April), nearly 1.5 million confirmed cases of COVID-19 had been reported and more than 92,000 deaths. Since then the numbers have increased to more than 1.8 million infected and 114 000 deaths.
Although there has been a slowing of the pandemic in some of the hardest-hit countries in Europe, like Spain, Italy, Germany and France, he did not recommend any lifting of restrictions any soon anywhere.
“I know that some countries are already planning the transition out of stay-at-home restrictions,” he said. “WHO wants to see restrictions lifted as much as anyone. At the same time, lifting restrictions too quickly could lead to a deadly resurgence. The way down can be as dangerous as the way up if not managed properly.”
He listed a number of important factors to consider before deciding on an exit strategy.
First, that transmission is controlled; second, that sufficient public health and medical services are available; third, that outbreak risks in special settings like long-term care facilities are minimized; fourth, that preventive measures are in place in workplaces, schools and other places where it’s essential for people to go; fifth, that importation risks can be managed.
“And sixth – and I cannot over-emphasize this point – that communities are fully aware and engaged in the transition. Every single person has a role to play in ending this pandemic.”
These conditions are hardly met yet in any country, including Belgium. Public health experts in Belgium have recently warned the public and the government that any relaxation of the rules on protection against the spread of the coronavirus could have serious and long-lasting consequences.
The curves show a mixed picture. While the number of persons admitted to hospitals has started to decrease, the number of infected persons and fatalities are still rising, though with lower growth rates. It remains to be seen some days after the Easter holiday, if this trend will continue.
In nursing homes, which account for up to half of the reported deaths, generalised testing for the virus will take three to four weeks. Inspections by the Inspectorate of Welfare at Work (TWW) show that 85 % of the inspected workplaces did not comply with the rules on social distancing.
In South-Korea, which has been highlighted as a model for other countries of fighting the coronavirus, the emphasis was on mass testing and rapid tracing of those who had been in contact with confirmed cases. But even there, the danger is not over yet.
Recently, persons who had recovered from the virus were tested positively again. There is no explanation yet. Previous and new tests could have been wrong, the virus could have been “activated” again or the disease does not give rise to immunity, as is the belief in the group immunity theory.
There is a delay of about a week until an infected person starts to show symptoms and is eventually tested if the symptoms are enough severe. In the meantime, he might have infected other persons. Other infected persons are asymptomatic, i.e. do not show any symptoms, but can still be infectious.
To slow down the spread of the virus, besides social distancing and lockdown measure, the number of tests must be increased and the tracing system improved.