As China seems to have “flattened the curve” of its coronavirus cases and is no longer the country with the highest number of infected people or with the highest death toll, all eyes are going to be on it in the coming weeks, as restrictions are slowly lifted on residents after over two months of lockdown in different provinces.
In Wuhan, the former epicentre of the infection outbreak, restrictions are scheduled to be lifted on April 8. But this hardly means that China is done dealing with coronavirus, as experts have advised caution and will observe the country to see if there is a resurgence in cases once the restrictions are lifted.
When lockdowns are lifted, what research says
The trajectory China follows after restrictions are lifted will have significant takeaways for the rest of the world, especially for the US and countries in Europe, which are the new epicentres of the global pandemic.
When lives of residents in China slowly slip back to normal, what needs to be seen is if the number of COVID-19 cases increases again, and if due to this, a second lockdown will be required in the country.
An article in Nature says that the virus will have difficulty in resurfacing as strongly as the first time if the majority of people in a given population have been infected and developed “herd immunity” as a result.
But this may not necessarily be the case. If one considers even Wuhan, which recorded more than half of China’s COVID-19 cases, the majority of the people in the province are still not infected. Thus, if the virus were to resurface, the number of vulnerable people would still be high.
The article puts those infected and immune to the disease in Wuhan to be less than 10 per cent of the population.
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Therefore, it is imperative that when governments at the Centre or at the state level decide to ease back to normalcy, the restrictions be lifted gradually, and be followed up by interventions such as monitoring, testing and contact tracing.
A study conducted by London’s Imperial College COVID-19 response team published on March 30 has said that in 11 European countries (UK, Norway, Spain, Italy, Denmark, France, Austria, Belgium, Norway, Switzerland and Germany) where widescale social distancing measures have been implemented, the reproduction number — number of people on average that a COVID-19 positive person infects — has come down.
They estimate that with the interventions in place at least till March 31, these countries will avert over 59,000 deaths up to this date. “Many more deaths will be averted through ensuring that interventions remain in place until transmission drops to low levels,” the researchers have said.
This study suggests that the timing of interventions should be taken in context of when the epidemic started to grow in an individual country along with the speed with which mitigation measures were undertaken. Among the 11 European countries considered for the study, for example, Italy was the first to begin mitigation measures.
Significantly, the Imperial College researchers conclude that the number of infected cases is being underreported across these countries, since testing is limited to hospital settings and is not being done at the community level. For instance, they estimate that over 600,000 may be infected in Germany, when the reported figure at the moment is around 74,000. However, even the higher figure is nowhere close to the majority of the population.
This means that the populations in these countries are not close to attaining herd immunity, implying that lifting restrictions will enable the virus to “spread rapidly”.
Further, Ben Cowling, an epidemiologist at the University of Hong Kong, told Nature that while China implemented stringent social distancing measures, they also held “extensive testing”, built new hospitals during that period, and officials went door-to-door to check people’s temperatures. “People are following China, but not in exactly the same way,” he was quoted as saying.
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