The lifting of measures is starting to be seen in different countries, but not always with the best results.
Singapore lifted its quarantine and opened borders. This Wednesday, Singapore health authorities reported that only this Tuesday there have been more infected than in all February and March, the vast majority coming from abroad.
In Wuhan, China, after lifting the measures, saw more cases emerge.
Therefore, trying to return to normal without causing new infections is a difficult balance to achieve.
“We have science and evidence in one hand; in the other, reality and what happens in practice, the consequences that are experienced in the daily lives of the population. There is no way to have zero risk, but we must learn to balance that risk so that it is as low as possible, ” said the World Health Organization (WHO) top emergencies expert Dr. Mike Ryan.
On opening up global travel too quickly, Ryan warned it would require “careful risk management”.
Costa Rica is studying how to achieve that balance to avoid abrupt resurgences.
At the Wednesday coronavirus briefing, the Minister of Health, Daniel Salas, indicated that it is something that he and a group of specialists analyze every day.
“We are walking through an eggshell floor, very fragile, because the majority of the population, due to the short time of the presence of the virus in Costa Rica, has not been exposed. So we may have an increase in cases because the majority have not been infected and there may be new transmission chains. That is why we must continue to comply with the measures, even if it becomes a tedious matter, and make ourselves aware that there is still a long way to go and that we must get used to a dynamic of social functioning and adequacy, where we all must enter to play in that dynamic,” he said.
This is one of the WHO’s biggest concerns.
“Some countries that had experienced casualties are re-registering spikes in cases. We cannot be mistaken: This virus will be with us for a long time,” emphasized Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO).
“Most countries are still in the early stages of their epidemics and some that were affected early in the pandemic are starting to see a resurgence in cases,” Tedros told Geneva journalists in a virtual briefing.
María Van Kerkhove, technical leader of that organism in matters of covid-19 complemented: “if we are seeing the resurgence of cases it is because there is still a lot of population susceptible to becoming ill”.
Six rules for a new normal
“Getting out of quarantine does not imply that we can live as before, it will be a new normal.” That phrase is constantly repeated by health authorities, epidemiologists and scientists, but it is not so easy to make people see it.
1. The transmission of the virus must be controlled. Community transmission should not be at active levels, and if you have case clusters, these should be in isolation, to ensure that they do not have the possibility of transmitting it outside your home.
2. The health system and public health authorities must have capabilities to identify, isolate, test, trace contacts, and quarantine them. “To be clear, the WHO recommendation is to find and test each of the suspected individuals, not everyone in the population,” emphasized Ghebreyesus.
3. That the risks of outbreaks are minimized in highly vulnerable sites. These include nursing homes, mental hospitals, and mental health clinics and the most populous places of residence.
4. That preventive measures be established in all work sites. Physical distance, not only between desks or workstations but also in the way in which co-workers coexist and interact. Workplaces should also have hand washing facilities and hygiene protocols.
5. That the risks of importing cases can be managed. This relates to travel, not only between countries but also between cities in the same country. As long as this cannot be guaranteed, it is not recommended to soften the measures.
6. That communities have a voice and be taken into account in the transition. Populations must be empowered, know the information, have a voice, and be heard. This does not mean that everything that the population indicates will be done, since each decision must be based on science, but it must be guaranteed that the people know the information and their voice can be heard.
Returning to this new normal will include an emphasis on three things:
- TESTING, both for COVID-19 and, especially, antibody tests to assess immunity
- TRACING of contacts of those who are COVID-19-positive, followed by quarantine of those contacts, and
- TREATMENTS for COVID-19 while we await vaccine development. These treatments include both drugs and plasma treatments from recovered patients.
In addition, it is likely that in public settings, temperature-testing will occur (upon entering a restaurant, or other activities), a mask will be required, and some degree of physical distancing implemented.
We will probably continue to wash our hands a lot and be aware of keeping surfaces in our personal space disinfected.
The numbers guide decisions. The most important number is how many people have been infected with COVID-19 and have recovered or continue to be infected.
There is little doubt that the coming months will be challenging. We will need as much resilience as possible and continue to be aware of the world around.
