New modelling research, published in The Lancet Public Health Journal, suggests that school and workplace closures in Wuhan, China, have reduced the number of coronavirus cases and substantially delayed the epidemic peak — giving the health system the time and opportunity to expand and respond.
Using mathematical modelling to simulate the impact of either extending or relaxing current school and workplace closures, researchers estimate that by lifting these control measures in March, a second wave of cases may occur in late-August, whereas maintaining these restrictions until April would likely delay a second peak until October. This, the researchers pointed out, could relieve pressure on health services in the intervening months.
The researchers, led by those from the London School of Hygiene and Tropical Medicine, concluded: “Our projections show that physical distancing measures were most effective if the staggered return to work was at the beginning of April; this reduced the median number of infections by more than 92% and 24% in mid-2020 and end-2020, respectively. There are benefits to sustaining these measures until April in terms of delaying and reducing the height of the peak, median epidemic size at end-2020, and affording health-care systems more time to expand and respond.
“However, the modelled effects of physical distancing measures vary by the duration of infectiousness and the role school children have in the epidemic.”
Uncertainties, however, remain about the number of people each coronavirus patient is likely to infect, and this may have a large effect on the timing of the epidemic peak and final size of the outbreak, researchers have warned.
There has been no new confirmed case in Wuhan in the last 24 hours. The lockdown in the city ends on April 8, even as China has decided to lift the three-month lockdown in the central Hubei province.
While India is banking hugely on social distancing to break the chain of transmission of the deadly virus — and PM Narendra Modi announced a 21-day lockdown — extrapolation of these results into another country may not give the accurate picture, the researchers warned.
Results of the study will not look exactly the same in another country “because the population structure and the way people mix will be different”, said Dr Yang Liu of London School of Hygiene & Tropical Medicine. “But we think one thing probably applies everywhere: physical distancing measures are very useful, and we need to carefully adjust their lifting to avoid subsequent waves of infection when workers and school children return to their normal routine.
“If those waves come too quickly, that could overwhelm health systems.”
Dr Kiesha Prem, from the same institution, who led the research, said, “The unprecedented measures Wuhan has put in place to reduce social contacts in school and the workplace have helped control the outbreak. However, the city now needs to be really careful to avoid prematurely lifting physical distancing measures, because that could lead to an earlier secondary peak in cases.
“But if they relax the restrictions gradually, this is likely to both delay and flatten the peak.”
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