Public health experts rethink blockade as Covid cases surge

The World Health Organization has long supported interventions with less economic and social disruption than blockades, and the government pursues a strategy called “testing, tracking, and quarantining” to quarantine people exposed to the virus. Is recommended. The Western government has found that there are too few tests and there are not enough contact tracing staff to follow its action plan.

Still, recently, WHO leaders have become more vocal with their encouragement that the government can do more to improve public security measures that reduce the need for a second national blockade. There is.

“We accept what we want to avoid, and sometimes unavoidable, but what we want to avoid is these massive blockades that are very punishing the community, society, and everything else.” The Health Emergency Program of Mike Ryan WHO, Executive Director of, told reporters on Friday.

United Nations agency Not alone.. According to the author, in the last two weeks, thousands of public health experts have signed an open letter to the government to protect the most vulnerable parts of the population and enable young and healthy people to gain herd immunity. I’m looking for. The author of a letter called the Great Barrington Declaration states that he imposed their claims in discussions between US Secretary of Health and Welfare Alex Azar and Florida Governor Rondesantis.

Their views are not universally shared among epidemiologists, and some doubt whether immunity to Covid-19 will last for more than a few months. The virus has proven to be often debilitating and sometimes deadly among young and healthy people. Prime Minister Boris Johnson has made a short British attempt to pursue a herd immunity strategy infeasible as hospitals have become overloaded and even relatively healthy people have become seriously ill.

Still, public health experts, including critics of the Great Barrington Declaration, increasingly agree that the extensive months-long blockade imposed in March could be too unpopular and unsustainable. It means that there is. Experts who supported the blockade in the spring are worried that another round of the same type could backfire if the public fails to comply.

Even more blockade advocates generally want a more concise and more targeted closure, the so-called circuit breaker, and the government closes certain businesses such as bars, restaurants, and perhaps universities for a couple of weeks. To do. Other low-risk facilities, such as day care, primary schools, and outdoor facilities, can be left open.

“Public health experts’ opinions are changing very rapidly,” said Jayanta Batacharya, a professor of medicine at Stanford University, one of the co-authors of the Great Barrington Declaration. “In March, I felt lonely. [Now] I think there are a large number of public health professionals, epidemiologists and doctors who oppose further blockades. “

Between the blockade and the difficult place

Covid-19 is skyrocketing, but few governments want a nationwide blockade to continue for a few more months, a straightforward measure that many experts have questioned.

Covid’s 14-day cumulative number-19 per 100,000 people in selected countries

Changes in attitudes towards blockades show how confident authorities are in understanding the Covid-19 epidemic, despite the virus increasing the number of unprecedented cases.

The WHO said on Friday that the world reached a record 350,000 Covid-19 infections a day last week. One-third of them are in Europe, and hospitals in the most devastated countries, such as the United Kingdom, France and the Netherlands, have seen a surge in average daily cases.

In the UK, Johnson said on Monday that coronavirus cases have quadrupled in the last three weeks and that Covid-19 inpatients are the same as when the country was blocked on March 23. It was. A restricted tier system, but he said a complete lockdown “wouldn’t be the right course.” Cities in the north of Liverpool fall into the “very high” category following an increase in cases from Wednesday, and other northern regions are expected to follow. As a result, bars, gyms, bars and casinos will be closed. In the northern part of the country, three temporary hospitals are waiting in case the infection continues to increase.

In almost all European countries, very few tests have been conducted to break the chain of infection by isolating only exposed people. According to a research paper published in August for the government’s Emergency Science Advisory Group, only one-fifth of those seeking self-isolation were obeyed in the UK.

“In many parts of Europe and the United States, these strategies have failed,” said Deepti Gurdasani, a clinical epidemiologist and senior lecturer at Queen Mary University of London. “There is no shortage of advice and science. It’s just not being followed.”

As the number of incidents soars, the government of the entire European Union imposes restrictions on overseas travel to neighboring countries. Hope to stop the tougher imposition.. Most countries limit large gatherings, and in some places, such as the UK, Czech Republic, and major cities in Germany, bars are told to close early.

James Naismith, director of the Rosalind Franklin Institute at the UK Government-backed Medical Research Center, said: ..

But they can be more localized, Target specific hotspotsHe and other public health experts said, not across the country. Western governments can block access to the struck zone in order to limit the spread of the virus and the consequent disruption to other areas. According to him, the school should remain open.

“Public health is what you can do,” said Professor Nicesmith. “People are wary of the potential fragmentation of public support for the blockade.”

In March, medical scientists lacked consensus on how the virus spread and endorsed a thorough blockade as a tool to save time. At that time, it was largely unclear which age group was the most transparent or which intervention worked. From February to June, WHO’s external expert group and the US Centers for Disease Control and Prevention counterparts will discuss whether masks help, where and how the virus spreads most easily, and the most contagious age group. I discussed it.

These days, there is widespread consensus on these questions.

Cramped, crowded and poorly ventilated rooms where people are talking, screaming and singing, such as bars, nightclubs and small restaurants, are at high risk. Nursing homes require much more staff and visitor protection and testing than was provided in the early days of the pandemic. Wider wear of the mask will significantly reduce the transmittance. In a spacious outdoor setting, the risk is much less.

Children under the age of 10 appear to be experiencing mild cases and do not easily spread the disease. WHO has not officially recommended opening or closing schools, but some staff at educational institutions have expressed their personal view that the benefits of education and healthy childhood outweigh the manageable risks. doing.

“We know where the transmissions take place. We know the higher risk settings. We know how to control and maintain this. [the] The economy and society are moving, “said Devi Sridhar, a professor of global public health at the University of Edinburgh. “I’m not for the blockade either, but let’s focus on what works.”

—Max Colchester contributed to this article.

Write to I drew a Hinshaw in [email protected]