Non-pharmaceutical intervention (NPI) measures that work, lag time, population compliance and more: The Lancet

‘A recently published article in Lancet Infectious Diseases has taken a look at potential associations between country-level reproduction numbers (R) and non-pharmaceutical interventions introduced and lifted throughout the course of the pandemic.

‘Increases in R were associated with relaxing of the following measures: school closures, public event bans, bans on gatherings greater than ten people, stay-at-home orders and other movement restrictions. However, the only significant associations for increases in R above 1 were school reopening and lifting bans on gatherings over 10 people. 

‘Authors noted that the full effect of introducing or lifting non-pharmaceutical interventions took 1-3 weeks on average from the date of implementation. Authors made further recommendations regarding the use of non-pharmaceutical interventions by national governments, noting that other factors, such as population compliance, also influence the success of non-pharmaceutical interventions and may not be fully captured in the study.’

Read here (The Lancet via Johns Hopkins University, Oct 22, 2020)

Europe, which thought it had the virus tamed, faces a resurgence: Averaged over 100,000 new cases per day last week

‘From France to Russia, from Britain to the Czech Republic, European leaders are confronting a surge in coronavirus cases that is rapidly filling hospital beds, driving up death tolls and raising the grim prospect of further lockdowns in countries already traumatized by the pandemic. The continent, which once compared favorably to the United States in its handling of the pandemic, is being engulfed by a second wave of infection. With an average of more than 100,000 new infections per day over the past week, Europe now accounts for about one-third of new cases reported worldwide.’

Read here (New York Times, Oct 14, 2020)

Fact check: Does the WHO now agree with Donald Trump on ending lockdowns?

‘The president's tweet followed news reports in recent days that David Nabarro, a special envoy for the WHO director-general, had spoken out against lockdowns. Some news outlets reported remarks by Nabarro in an interview with Spectator TV on Thursday to suggest the WHO itself had reversed a pro-lockdown stance. But that is not the case.

‘As was reported by various outlets, Nabarro did tell Spectator TV: "We in the World Health Organization do not advocate lockdowns as the primary means of control of this virus" and "we really do appeal to world leaders, stop using lockdown as your primary control method."... Nabarro said a number of approaches are needed to ensure there is a robust defence to quickly suppress outbreaks if there is an uptick in cases. The "backbone to controlling this kind of thing is always testing, contact tracing and isolation," at a local level, he said. The second is dealing with small spikes locally, and ensuring the public is on side and practicing disease prevention measures such as physical distancing.’

Read here (Newsweek, Oct 13, 2020)

The anti-lockdown scientists’ cause would be more persuasive if it weren’t so half-baked

‘The [Great Barrington] declaration, which calls for an immediate resumption of “life as normal” for everyone except the “vulnerable”, is written by three science professors from Harvard, Oxford and Stanford, giving it the sheen of academic respectability. But there is much to set alarm bells ringing. It makes claims about herd immunity – the idea that letting the virus rip among less vulnerable groups will allow a degree of population-level immunity to build up which will eventually protect the more vulnerable – that are unsupported by existing scientific evidence... And what are scientists doing fronting a campaign whose back office is run by a thinktank that flirts with climate change denial?’

Read here (The Guardian, Oct 11, 2020)

Will the economic and psychological costs of covid-19 increase suicides? It is too early to say, but the signs are ominous

‘When America’s Centres for Disease Control and Prevention (CDC) carried out a survey this summer, it found that one in ten of the 5,400 respondents had seriously considered suicide in the previous month—about twice as many who had thought of taking their lives in 2018. For young adults, aged 18 to 24, the proportion was an astonishing one in four.

‘The survey, published in August, was one of a growing number of warnings about the toll that the pandemic is taking on the mental health of people. For legions, the coronavirus has upended or outright eliminated work, schooling and religious services. On top of that, lockdowns and other types of social distancing have aggravated loneliness and depression for many.’

Read here (The Economist, Oct 5, 2020)

Countries should meet these five criteria before easing lockdowns, study says. Many aren't even close

‘Countries should not ease coronavirus lockdown restrictions until they meet five criteria -- and many nations are not even close, according to a new analysis published in The Lancet medical journal. The research, published Thursday, said that the prerequisites for easing Covid-19 measures are: knowledge of infection status, community engagement, adequate public health capacity, adequate health system capacity and border controls.

‘The authors looked at nine high-income countries and territories that have started to relax restrictions -- Hong Kong, Japan, New Zealand, Singapore, South Korea, Germany, Norway, Spain and the UK. They found that many governments had failed to meet the criteria necessary to avoid new waves of infection, as seen in Spain, Germany and the UK.’

Read here (CNN, Sept 25, 2020)

Philippines’ President Duterte extends coronavirus state of calamity for another year

‘Philippine President Rodrigo Duterte says he has extended a state of calamity in the entire Philippines by a year to allow the government to draw emergency funds faster to fight the Covid-19 pandemic and harness the police and military to maintain law and order. Duterte first placed the country under a state of calamity in March when the number of confirmed infections was approaching 200 with about a dozen deaths. The country now has more than 290,000 confirmed cases, the highest in Southeast Asia, with nearly 5,000 deaths.

‘State of calamity allows officials to draw emergency funds quickly anywhere in the country, and to control the prices of basic commodities like rice and cooking oil. President Duterte also signalled that the country remains at the mercy of a vaccine, which is unlikely to be developed and distributed until the second quarter of 2021.’

Read here (South China Morning Post, Sept 22, 2020)

Indonesia: Can Jakarta get its raging Covid-19 outbreak under control?

‘Seven months after Indonesia reported its first cases, the country is struggling with mounting infections. It reported 4,071 new cases on Tuesday, bringing its total to 252,923, with 9,837 fatalities – the highest death toll in Southeast Asia.

‘While other countries have managed to slow the spread of infections with partial lockdowns – only to see a resurgence in cases when they reopened – Indonesia has not yet passed the peak of the first wave, according to Mahesa Paranadipa Maikel, the chairperson of the Indonesia Health Law Society, an industry body of medical workers and legal experts.’

Read here (South China Morning Post, Sept 22, 2020)

Can European countries avoid a second lockdown?

"Catastrophic," "disastrous," and "devastating" — the words European leaders are using to describe the consequences of a second lockdown are more than clear. In order to curb the spread of COVID-19 in the spring of this year, public life across Europe was brought almost completely to a halt. In the summer, many places relaxed those restrictions. For weeks now, however, infection rates have been rising in almost every European country. According to the World Health Organization, Europe is registering between 40,000 and 50,000 new coronavirus cases each day. That increase is down to more than just more widespread testing. The numbers from September "should serve as a wake-up call for all of us," said the WHO's regional director for Europe, Hans Kluge. The weekly infection numbers have even exceeded those reported in the first phases of the peak in March, the WHO says.’

Read here (DW, Sept 21, 2020)

How people coped in lockdown

‘The first wave of COVID caused huge suffering, and has led to warnings of an ‘epidemic’ or ‘tsunami’ of mental health problems. But there is another, more hopeful story to tell, about how people coped and even thrived during the adversity of 2020. It’s important to remember this as we head into the winter and a likely second wave.

‘The Collective Psychology Project has been researching how people coped, for a report for the Wellcome Trust called Collective Resilience. We were interested in how people discovered the ‘active ingredients’ of mental health, not just through therapy and pills, but also through self-care and mutual aid activities — from poetry to philosophy, from baking to cycling, from online learning to joining a neighbourhood support group.

‘What we discovered tallied with a lot of evidence, such as from the What Works Centre for Well-Being, about how people cope and flourish through non-medical activities like exercise, gardening, the arts, faith, philosophy & spirituality.’

Read here (Medium, Sept 18, 2020) 

With RMCO extended to Dec 31, here’s a (gentle) reminder of what you can and cannot do

‘Bearing in mind the strict standard operating procedures (SOP) enforced by the National Security Council (NSC), here are some of the things we can and cannot do until New Year’s Eve, or when the government announces otherwise.’ 

Read here (Malay Mail, Sept 11, 2020) 

Coronavirus crisis shatters India's big dreams

‘Not so long ago, India’s future looked entirely different. It boasted a sizzling economy that was lifting millions out of poverty, building modern megacities and amassing serious geopolitical firepower. It aimed to give its people a middle-class lifestyle, update its woefully vintage military and become a regional political and economic superpower that could someday rival China, Asia’s biggest success story. But the economic devastation in Surat and across the country is imperiling many of India’s aspirations. The Indian economy has shrunk faster than any other major nation’s. As many as 200 million people could slip back into poverty, according to some estimates. Many of its normally vibrant streets are empty, with people too frightened of the outbreak to venture far.

‘Much of this damage was caused by the coronavirus lockdown imposed by India’s prime minister, Narendra Modi, which experts now say was at turns both too tight and too porous, both hurting the economy and spreading the virus. India now has the fastest growing coronavirus crisis, with more than 80,000 new infections reported each day.’

Read here (New York Times, Sept 5, 2020)

Hysteria is the most dangerous coronavirus symptom

 ‘Steve Reicher, a professor of social psychology at the University of St Andrews who advises the Government as part of its Scientific Pandemic Influenza Group on Behaviours, tells the Telegraph: “When you look at the literature on fear and risk, it’s not pointing out there is a danger which causes people to be terrorised by fear. If you tell people what the risks are and give them a clear understanding of what the mitigation is, you don’t get dread and anxiety as people know what to do.” He wants ministers to show clarity about their strategy, warning: “In a vacuum, when people are already concerned, they’ll imagine the worst circumstances.”... ‘For example, the average Briton was found last month to estimate that the disease had wiped out as much as 7 per cent of the United Kingdom, which would equate to around 4.6 million people, rather than the actual rate in the tens of thousands.

‘Although Covid-19 sparked a more draconian response from the British Government, its effectiveness will remain open to question given the UK’s better death rate and economic performance can still be compared unfavourably with Sweden, which eschewed any lockdown whatsoever... When the winter draws near, speculation about whether strict measures like local lockdowns may be necessary to clamp down on Covid will no doubt run rife. In response, many Britons will undoubtedly be tempted to focus on keeping calm and follow what the Prime Minister hails as “good British common sense” - with a bit of Swedish sangfroid.’

[This story is behind a paywall]

Read here (The Telegraph, August 22, 2020)

How China controlled the coronavirus: From the micro point of view of an American teaching and learning in Sichuan during the pandemic

‘Despite the political indoctrination involved in Chinese schooling, the system teaches people to respect science. Hard work is another core value, and somehow society has become more prosperous without losing its edge. Nearly a quarter century ago, I taught young people who were driven by the desire to escape poverty; these days, my middle-class students seem to work at least as hard, because of the extreme competitiveness of their environment. Such qualities are perfect for fighting the pandemic, at least when channelled effectively by government structures. In comparison, the American response often appears passive—even enlightened citizens seem to believe that obeying lockdown orders and wearing masks in public is enough. But any attempt to control the virus requires active, organized effort, and there needs to be strong institutional direction.

‘Instead, the flailing American leadership seems more interested in finding scapegoats, sometimes with a racial tinge—the Kung Flu and the China Virus. Throughout the spring, the Chinese government periodically responded by lashing out at the U.S. and other foreign countries, but such tensions had little impact on my life in Chengdu. Daily interactions remained friendly, and people often made a point of telling me that the problems between governments had nothing to do with our personal relationships.’

Read here (The New Yorker, August 17, 2020)

Is Sweden's coronavirus strategy a cautionary tale or a success story?

‘Sweden was one of the few European countries not to impose a compulsory lockdown. Its unusual strategy for tackling the coronavirus outbreak has been both hailed as a success and condemned as a failure. So which is it? Those who regard the strategy as a success claim it reduced the economic impact, but it isn’t clear that it did. What is clear is that so far Sweden has had a more protracted outbreak with far more deaths per capita than its neighbours.

‘While it is sometimes implied that Sweden didn’t have a lockdown, it did. It was just largely voluntary, with only a few legal measures such as a ban on gatherings of more than 50 people. “Voluntary restrictions work as well as legal ones,” says the architect of Sweden’s strategy, chief epidemiologist Anders Tegnell.

Read here (New Scientist, August 13, 2020) 

What we know – and what we don’t know – about stopping the spread of the coronavirus

What's successful: (1) Fast action (2) Well-timed lockdowns (3) Travel restrictions (4) Face masks and coverings. What we still don’t know about the virus’ spread: (1) Mass gatherings (2) Super-spreaders (3) Indoor locations (4) Schools 

Read here (South China Morning Post, July 25, 2020)

Meet the generation changed by lockdown

“We should not trivialize [teenagers’] stressors or grief in the context of the larger issues playing out during this pandemic,” Beth Marshall, associate director of the Johns Hopkins Center for Adolescent Health, said during a Johns Hopkins faculty roundtable in May. “Their grief over what they are experiencing — or not getting to experience — is real.” But out of stagnation often comes transformation.

‘To be a teenager is to be in a state of constant growth and transition; to form values, priorities and plans that will affect your life for years to come. And for a generation of young adults who have seen their lives upended by a global pandemic and then witnessed their communities lit up by grassroots activism, this year might prove crucial in determining how they see the world and their home country as they grow up and gain power.’

Read here (Huffington Post, July 22, 2020)

Will universities learn from lockdowns?

‘Like many businesses, universities are struggling with how to reopen and are adopting a range of strategies. For example, the University of Cambridge in the United Kingdom has announced that its lectures will be online-only until at least the summer of 2021. Others, including Stanford University, are offering a mix of in-person and online classes, as well as spreading out their academic year so that fewer students will be on campus at any time.

‘Make no mistake: COVID-19 represents a massive economic hit to higher education. Dorm rooms are unoccupied, sports stadiums remain empty, and students push back against paying full tuition fees. For many colleges and universities, the drop in revenue from foreign students, especially Chinese, is likely to be painful; numerous smaller and less-endowed schools may close.’

Read here (Project Syndicate, July 6, 2020)

Treasury Secretary Mnuchin says ‘we can’t shut down the economy again’

Treasury Secretary Mnuchin says ‘we can’t shut down the economy again’

‘[US] Treasury Secretary Steven Mnuchin told CNBC that shutting down the economy for a second time to slow Covid-19 isn’t a viable option. The Treasury secretary’s comments came as Wall Street grew more concerned about a second wave of coronavirus cases in the US. Mnuchin also said he’s prepared to return to Congress to request additional fiscal spending to help juice the economy if needed.’

Read here (CNBC, June 11, 2020)

The effect of large-scale anti-contagion policies on the Covid-19 pandemic

‘...we compile new data on 1,717 local, regional, and national non-pharmaceutical interventions deployed in the ongoing pandemic across localities in China, South Korea, Italy, Iran, France, and the United States (US)... We estimate that across these six countries, interventions prevented or delayed on the order of 62 million confirmed cases, corresponding to averting roughly 530 million total infections. These findings may help inform whether or when these policies should be deployed, intensified, or lifted, and they can support decision-making in the other 180+ countries where COVID-19 has been reported.

Read here (Nature, June 8, 2020)