Health
Forced isolation may be the only way to stop the virus from resurrection
The surge from Australia to Japan shows that the world has not learned early lessons from the coronavirus crisis. To stop the infection, people with mild or asymptomatic coronavirus infections need to be isolated from both the community and their families.
In Australia, as reported by Victoria, Record Deaths, about 3,000 checks against those who should have been quarantined at home last month, found that 800 were out. In Japan, where the virus has surged, people are at home but not isolated. 40% An elderly patient is ill from a family in the same apartment.
The truck sign warns people to stay home in Melbourne on August 5th.
Photographer: William West / AFP via Getty Images
The inability to effectively manage infectious people with mild or no symptoms is the driving force behind the worst resurgence in the world. But lessons from Italy, South Korea, and others that have successfully stopped large-scale outbreaks indicate trial and error. approach To stop the infection: Move from your home to a centralized facility while overcoming the infection. Infection usually takes only a few weeks.
“The laissez-faire approach of simply trusting that everyone is responsible has been shown to be ineffective because there is always a percentage that violates the conditions of isolation,” says Jeremy of Saw Swee at National University of Singapore. Lim adjunct professor mentioned a public health hook school.
Faced with a new cluster 102 days later this week, with no cases of local infection, New Zealand immediately enacted this strategy, placing about 30 people in a centralized quarantine, including at least two children under the age of 10. ..
However, other countries facing sustainable spread, such as Australia and the United States, have not broadly enacted policies, despite their proven track record. What they do not want or cannot do highlights the challenges facing democracy for freedom. That democracy is unlikely to tolerate measures that demand personal sacrifice for greater benefit.
Not at home
Existence of a large group of carriers with almost no feel Disease is a unique feature of the coronavirus crisis and a major cause of its rapid spread worldwide. Unlike previous outbreaks such as the 2003 SARS epidemic, many infected people feel It’s a disease enough to stay at home, so spread the pathogens in your daily life.
The Centers for Disease Control and Prevention Presumption 40% of Covid-19 infections are asymptomatic.
In Wuhan, a Chinese city where the coronavirus first appeared last year, patients with mild illnesses were originally told to leave the hospital and take a break from their homes because the overwhelming medical system needed to address the most severe cases. It was. However, medical professionals soon discovered that these people became infected as families and other people roamed the community, causing large-scale incidents.
Take mild or asymptomatic patients to designated facilities-Reuse convention centers, hotels, stadiums-Marked for basic medical care turning point In the city battle against the coronavirus. Simply isolating them from healthy people stopped the quiet spread of the entire community of pathogens.
Since then, this strategy has been used earlier this year in Italy, Singapore and South Korea during the coronavirus outbreak. Last month Hong Kong faced a resurgence Converted Further exhibition centers and other such facilities are being constructed to house mild Covid-19 patients.
In New Zealand, the government has put “a lot of thought” into policymaking and is asking families in confirmed cases to go to intensive quarantine with them if they need care. Field Health Director said.
The ward is being finished at the dedicated Covid Health Center at the Bandra Kurla Complex Exhibition Center in Mumbai, India on May 17th.
Photographer: Dhiraj Singh / Bloomberg
According to Lancet, this approach is effective, first of all, to prevent infection in families in the same household. Over 80% of outbreaks in Chinese cities were households after mild cases were allowed to stay at home. Investigation.. In Europe, surge Due to a household infection, Milan, Italy began to cause such an incident in a hotel, allowing the country to control its outbreak in early May.
Beyond the breadth of households, strategies are needed by aspects of human nature that have been seen many times throughout the country and culture. Depending on their device, some people just don’t follow the rules.
In Australia and Japan, infected people who were told to stay at home went out for various reasons. While others want to receive groceries and supplies, others are unable to work at home and need income. One woman in Tokyo Traveled After the infection is confirmed, cross the country by bus.
“Even in mild cases, it’s much better to be aggressive in the short term than to hide under the radar,” said Nicolas Thomas, Associate Professor of Health and Security at City University of Hong Kong.
Lock-up
However, forcing the movement of mild or asymptomatic patients to central facilities is facing opposition in countries where citizens have not accepted government directives. Some people can lose their jobs if they disappear for two weeks or if they are responsible for caring for an infant or older parents who are unable to divorce.
“The University of Sydney is a professor of public health and community medicine,” said Stephen Leader. “I don’t think it works so well because I know about the Australian spirit.”
In places such as Venezuela and India, where quarantine facilities are in poor condition, prospects of being taken away may prevent them from being tested, lie to contact tracers for fear of becoming positive, or make health authorities’ jobs more difficult. I am doing it.
In an email reply to Bloomberg News queries, Victoria’s Department of Health and Human Services offers alternatives for quarantine by the government, but these “may not live safely at regular addresses A vulnerable group said to be for healthcare professionals.
Instead of forcing segregation of mild cases, authorities have blocked 5 million residents of Melbourne and tightened restrictions until new cases are controlled.
The information sign informs all customers on July 23 that they should always wear protective masks in the Melbourne shopping area.
Photographer: Carla Gottgens/Bloomberg
The authorities said that fine While paying A$4,957 (A$3,550) to persuade infected people to stay at home, repeat offenders are fined A$20,000 in court. More than 500 military personnel are helping police check 4,000 households daily to make sure there are people who should be at home.
Indeed, active and thorough contact tracking and case follow-up successfully prevented outbreaks in countries like Germany without a central quarantine strategy. However, these places relied on an efficient army of workers to hunt down every chain of infection, a resource many governments could not spend time building.
“Traditional practice in public health is to identify, track and quarantine,” said Yang Gong Hwan, former deputy director of the Centers for Disease Control and Prevention in China. “But how that is done depends on popular sentiment and national resources.”
— With the help of Sharon Chen, Dong Lyu, Angus Whitley and Lisa Du
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