‘Extending Wuhan’s physical distancing would delay 2nd COVID-19 wave’

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Medical workers gather their luggage before their departure in Wuhan City, central China's Hubei Province

London,  Extending school and workplace closures in the Chinese city of Wuhan, where the coronavirus originated last December, until April instead of March would likely delay the outbreak of a second wave until the end of this year, said a study published in a UK-based medical journal.

In the study published in The Lancet Public Health on Wednesday, experts said the measure would help to relieve the pressure the healthcare system has faced since the outbreak began, reports Efe news.

The authorities in Wuhan closed schools and ordered a halt to most of its work operations in mid-January, which experts say has significantly reduced the number of infections.

In the study, the researchers used mathematical modeling to simulate the impact of either extending or relaxing current school and workplace closures, and estimated that lifting control measures in March, as planned, could lead to a second wave of new cases by the end of August.

On the other hand, maintaining these restrictions until April would likely push the second peak to October, allowing the healthcare system to prepare during the intervening months.

However, experts warned that it’s difficult to estimate the true impact of relieving physical distancing measures, due to a lack of precision in estimates of the number of reproductions (how many people an individual is likely to infect with the virus) and the average duration of infections.

Kiesha Prem, a doctor at the London School of Hygiene and Tropical Medicine and leader of the research, said the “unprecedented” measures implemented in Wuhan “have helped to control the outbreak”, but argued that its authorities should carefully consider epidemiological and modeling evidence before lifting the measures.

“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,” Prem said.

Using data on the spread of COVID-19 in Wuhan and the rest of China, experts analyzed the number of contacts per day by age group at school and work and compared these under three scenarios.

The first one without interventions or holidays (a hypothetical scenario); the second one without physical distancing measures and with school and Lunar New Year holidays as normal; and the third one with strict control measures involving the closure of schools and only about 10 percent of the workforce (such as health personnel, civil servants and police).

They also studied staggered lifting of control measures during various stages of the outbreak.

“Putting extreme measures in place to reduce contacts at school and workplaces, could reduce case numbers and the size of the epidemic peak, whilst also delaying the peak,” the study said referring to the third scenario.

The analysis also showed that physical distancing measures are likely to be more effective if the staggered return to work commences in early April.

This could reduce the average number of new infections by 24 percent until the end of the year and delay a second outbreak until October, according to the researchers.

Study co-author Yang Liu, a doctor from the London School of Hygiene and Tropical Medicine, said the results won’t be “exactly the same” in other countries, because the population structure and the way people relate to each other are different, but she stressed one commonality.

“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,” said the author.

As of Thursday morning, the number of confirmed coronavirus cases globally stood at 471,407, while the death toll was 21,287, according to the real-time updates by the Washington-based John Hopkins University.

In terms of cases, China reported the highest at 81,667, followed by Italy (74,386), the US (68,960) and Spain (49,515).

Italy, the worst-affected outside China, has the highest global death toll at 7,503, followed by Spain (3,647), China (3,285) and the US (1,041).