Safely reopening requires testing, tracing and isolation, not just vaccines

‘The Moderna and Pfizer vaccines were developed in record time. However, these announcements highlight significant challenges: delivering two-dose vaccines with stringent cold-chain requirements to almost eight billion people, many of whom reside in communities with underfunded and strained health systems, is no small feat. Even if we address the logistical challenges, the reality is that it takes time and funding to deliver vaccines, treatments and tests that reach everyone in need. It is a sobering reminder that when lifesaving antiretrovirals were introduced for HIV-positive people, it took seven years before the medicine reached the poorest communities. And during that time, millions of people died, and millions more were infected, and the HIV pandemic continued to grow.

‘Until we can overcome these obstacles and ensure equitable delivery of vaccines and treatments once available across the globe, the fundamentals of controlling this virus remain as important as ever.

‘For a long time, many countries will continue to rely on already proven tools to control the pandemic. The formula is simple: test, trace and isolate. This straightforward but effective process is key to safely reopening economies and societies. It is made possible through the rapid and equitable scale-up of diagnostics, which have proven to be the most important tool for limiting the spread of COVID-19. Test, trace and isolate—and ultimately test, trace and treat once more treatments become available—is an efficient, sustainable way to control the virus, especially in contrast to last-resort emergency lockdown measures, which can erode the public support and trust necessary for the success of many other helpful public health measures, including vaccination and mask-wearing.

‘We have seen this strategy implemented successfully around the world for decades with age-old diseases like tuberculosis. This strategy is also making a difference in the fight against COVID-19.’

Read here (Scientific American, Feb 9, 2021)

All countries should pursue a Covid-19 elimination strategy: Here are 16 reasons why

‘As governments draw up their battle plans for year two, we might expect them to base their strategies on the wealth of data about what works best. And the evidence to date suggests that countries pursuing elimination of Covid-19 are performing much better than those trying to suppress the virus. Aiming for zero-Covid is producing more positive results than trying to “live with the virus”.

‘Here are 16 reasons why we think all countries should at least consider an elimination approach:

1. It saves lives.
2. The elimination of community transmission also spares populations from “long-Covid”.
3. Elimination is pro-equity.
4. Countries that have eliminated Covid-19 are experiencing less economic contraction.
5. Elimination is achievable and works in a variety of settings.
6. The virus can be eliminated even after intense local transmission has occurred.
7. It’s easier if more countries adopt this approach.
8. The rollout of effective vaccines will make Covid-19 elimination easier to achieve.
9. Having an explicit “zero-Covid” goal provides a strong motivating and coordinating focus.
10. It is sustainable.
11. If the virus mutates, elimination still works.
12. It also still works if vaccines provide only limited long-term protection.
13. It may reduce emergence of more dangerous virus variants.
14. The use of lockdowns should be less necessary.
15. Vigorous control of Covid-19 infection has substantial co-benefits.
16. It provides a good interim strategy while we identify an optimal long-term approach, which is currently uncertain.  

Read here (The Guardian, Jan 28, 2021)

Vaccines have been oversold as the pandemic exit strategy

‘Covid will be around for a long time — virus suppression is the right policy...

‘If regions with raging transmission do act as breeding grounds for resistant variants, then failing to control spread will prolong the pandemic. Prof de Oliveira stresses that Taiwan, China, Australia and New Zealand, which have chased elimination, are the role models to follow. “This should be a wake-up call for all of us to control transmission, not just in our own regions but globally. This virus will keep outsmarting us if we don’t take it very seriously,” he says.

‘That means not just vaccinating but fast testing, accurate and quick contact tracing, quarantine and isolation. In short, vaccination must go hand-in-hand with virus suppression, not become a substitute for it. A successful vaccine rollout will count for little if the country then becomes a crucible for resistant variants.’

Read here (Financial Times, Jan 26, 2021)

A Covid-19 ‘exit’ strategy to end lockdown and reopen the economy | Uri Alon

‘How can we return to work without spurring a second surge of coronavirus infection? Biologist Uri Alon shares a thought-provoking strategy: four days at work followed by 10 days of lockdown, a cycle that would exploit a weakness in the virus's biology and potentially cut its reproductive rate to a manageable level. Learn more about this approach -- which has already been adopted by both companies and countries -- and how it could be a key to reopening the economy responsibly. (This virtual conversation, hosted by head of TED Chris Anderson and science curator David Biello, was recorded on May 20, 2020.)’

Watch here (TED Talk, May 28, 2020)

8 ways Covid will transform the economy and disrupt every business

‘In this report, we look at eight major trends underway in the world, and pinpoint the possibilities for savvy business operators, investors and innovators. We all know how much our lives have changed, and how we’re not likely to go back to our old ways. We’ll be more cautious but we also may be more creative. As history likes to remind us, with unprecedented times come unprecedented opportunities.’

Read here (RBC Thought Leadership, May 22, 2020)

Testing rate here among highest in world - over 281,000 done so far

‘Over 281,000 tests for Covid-19 have been carried out on 191,000 individuals [in Singapore] so far, the Health Ministry's director of medical services, Associate Professor Kenneth Mak, said yesterday. This comes to around 49,000 tests per million people in the country...’

‘Minister for National Development Lawrence Wong, who co-chairs the task force, pointed out that the Republic has already drastically increased its volume of daily tests [from 2,000 to 8,000 a day]. "We're today already testing at a rate that's among the highest in the world, and we want to do even more beyond this. As we reopen the economy, as we resume activities, testing capability and testing capacity will be a critical enabler for us to do all of these things safely."

Read here (Straits Times, May 20, 2020)

Guide for Covid-19 prevention in schools

‘As we attempt to open schools and learn from the few countries that have done so, we must recognise that the key will be to try and create a bubble (a shield) in which students who go to school "live in" so as to minimise infection spread. This "bubble" also means that if one group has Covid-19 infection, only they are isolated and the rest of the school can probably continue.’

This guide by Amar-Singh HSS and Shyielathy Arumugam can be downloaded here.

Read here (Malay Mail, May 20, 2020)

Singapore schools to open in phases from June 2 after Covid-19 circuit breaker: How this will work

‘Students will return to school from June 2 over two phases as part of the easing of the coronavirus circuit breaker measures that are expected to end on June 1. Here are some of the adjustments planned for schools and pre-schools that the Government announced on Tuesday (May 19).’

Read here (Straits Times, May 19, 2020)

No exit strategy until high SOP compliance from Malaysians, says DG

Health Ministry director-general Dr Noor Hisham Abdullah said there needs to be a high compliance rate for the standard operating procedure (SOP) under the conditional movement control order (MCO) as well as a steady two-digit daily new Covid-19 cases before an exit strategy can be discussed. “Before we can discuss an exit strategy – and we are not discussing an exit strategy now, only loosening under the conditional MCO – Malaysians must comply (with the SOP). If they do not comply, we might extend the conditional MCO...’

Read here (Malaysiakini, May 18, 2020)

No shortcuts and people must get used to a new way of living, warns WHO's chief scientist

‘It is critically important for governments to present facts in a way that people really understand what the Covid-19 coronavirus is, and the logic behind some of the measures put in place, said Dr Soumya Swaminathan, chief scientist at the World Health Organisation (WHO). When countries open up, their basic principle must be to test people with symptoms, identify the contacts and quarantine them until they are free of the risk of getting the disease, she said in an interview. "Those basic principles will have to be actually followed by governments and cities everywhere. There's no shortcut to that," she warned.

Read here (Straits Times, May 18, 2020)

Learning how to dance - Part 5: Prevent seeding and spreading

This is Part 5 of ‘Learning how to dance’, a series which goes in depth to understand what countries need to do to Dance, to reopen their economies without new outbreaks.

‘The bad news first: (1) We will likely need to heavily slow down national and international tourism for months, (2) Big events like business fairs or music concerts will need to remain closed for now

‘The good news: (1) We should still be able to travel for one-way or very long trips (2) There are ways we can accelerate the reopening of tourism (3) We can probably reopen schools (4) A clear order is emerging for which businesses should reopen. The most important to keep open are likely banks, grocery, and general stores, and the least important are likely cafés, dessert parlors, and gyms’.

Read here (Medium, May 13, 2020)

Ominous warning for world governments as South Korea hit by ‘super spreader’ after lockdowns lifted

‘At the weekend, the country’s health system reported the sudden appearance of more than 40 new coronavirus cases. It was the first time in a month the figure had spiked so high. Contact tracers immediately went to work. What had caused this disturbing turnaround? Turns out, it was mostly due to just one 29-year-old man...’

Read here (News.com, May 12, 2020)

Mixed reactions as SOPs rule the day

‘As we're deadlocked on how to jumpstart the economy or flatten the curve, it'd be useful to reflect what Gerald R. Ford, the 38th United States president (American presidents were taken seriously until very recently), had to say on dubiety: "History and experience tell us that moral progress comes not in comfortable and complacent times, but out of trial and confusion." There you go, we still have to fine-tune many issues before the "new normal" settles in. Whatever the procedures, there must be greater uniformity as tales of different strokes for different folk were aplenty in the treatment of some MCO offenders.’

Read here (New Straits Times, May 8, 2020)

Six flaws in the arguments for reopening

Leana S. Wen, an emergency physician and visiting professor at George Washington University Milken Institute School of Public Health, debunks the six reasons offered by the US government to open up the economy. She says: “Most states are reopening to some degree this week, even as public-health experts warn that it’s too soon.”

Read here (Washington Post, May 6, 2020)

Why has eastern Europe suffered less from coronavirus than the west?

‘Veronica Anghel, a Romanian political scientist currently at Stanford University, said some countries in the region “are being given more credit than they should” for their responses. “Timing of lockdown is a blunt instrument, and a bad measure for authorities’ success,” said Anghel. She praised the response of some countries, including Czech Republic and Slovakia, both of which have comparatively well-funded healthcare systems. “But Hungary, Romania and Bulgaria are on the edge; any increase in cases will tip the system over,” she said.’

Read here (The Guardian, May 5, 2020)

As some countries ease up, others are reimposing lockdowns amid a resurgence of coronavirus infections

As many parts of the world, including the United States, explore ways to ease restrictions aimed at containing the spread of the coronavirus, countries that had already opened up are closing down again after renewed spikes in infections. [Lebanon, South Korea, China, Iran, Germany]

Such a resurgence of cases had been widely predicted by experts, but these increasing numbers come as a sobering reminder of the challenges ahead as countries chafing under the social and economic burdens of keeping their citizens indoors weigh the pros and cons of allowing people to move around again.

Read here (Washington Post, May 5, 2020)

Inventive routes back to normal life

‘Across the world, countries are embarking on enormous experiments in ending coronavirus lockdown measures - and others are looking on nervously, asking themselves what's the best way back to normality.

‘All these novel schemes, and many more, may help a return to some form of normality. But Ngaire Woods, professor of global economic governance at Oxford University, says easing lockdown requires us all to rethink our lives. "We have got to get testing tracing and isolating up and running fantastically well," she told Radio 4's Briefing Room. "We have to start thinking about preventative measures in public spaces and schools. We have got to manage the import of cases - so think about travel restrictions. That's a clear checklist in order to safely start lifting the lockdown."

‘Prof Woods says thinking will have to go far beyond just re-opening closed-down businesses. We may need to split workforces by age group - an example could be that older teachers must take their classes by video link. "Those are the questions we have to ask - they are not insurmountable problems. The alternative is to stay in a total lockdown."

Read here (BBC, May 4, 2020)

UrbanFutures: Building a trust economy

‘In a time of crisis, trust is a key currency. Not just trust in the system, but as a foundation for economic recovery. Here, we look at the essence of what makes an economy tick, how this relates to the current Covid-19 crisis and its impact on the most vulnerable, and the role of government in building a bounce-back economy based on trust.

‘Developing the trust economy involves three key aspects: (1) An enhanced role for government (2) Hyperlocalism and digital infrastructure (3) Protecting the welfare of the people.’

Read here (The Edge, May 4, 2020)

Singapore: New safe distancing guidelines, standards for workplaces after Covid-19 circuit breaker

‘When workplace activities gradually resume after the circuit breaker lifts, the Government will need to put in place new guidelines and standards to ensure that they remain safe from potential Covid-19 outbreaks, National Development Minister Lawrence Wong said on Friday (May 1).Speaking at a virtual press conference, Mr Wong said these guidelines will build upon existing measures to ensure safe distancing in workplaces for workers in essential services, such as wearing masks at work or not having workers socialise among themselves.

‘These guidelines... will also be complemented by a testing regimen as well as some form of technology that can ensure better tracking and monitoring should a confirmed case emerge in the workplace.’

Read here (Straits Times, May 1, 2020)

Conditional MCO might cause third wave of infections, say health experts

Health experts are voicing concern over the move to ease the movement control order (MCO) by allowing businesses to reopen starting next week, warning that this might lead to new waves of Covid-19 infections.

Azrul Mohd Khalib, the executive director of the Galen Centre for Health and Social Policy, said people might be confused over the standard operating procedures (SOP) given the short time frame for preparation, warning also of non-compliance by others.

Read here (Free Malaysia Today, May 1, 2020)