Health and Healthcare Systems

These Harvard scientists think we'll have to socially distance until 2022

Visitors stand inside boxes for social distancing inside an elevator at a shopping mall amid the spread of coronavirus disease (COVID-19) in Surabaya, East Java province, Indonesia, March 18, 2020 in this photo taken by Antara Foto.  Antara Foto/Zabur Karuru/ via REUTERS ATTENTION EDITORS - THIS IMAGE WAS PROVIDED BY A THIRD PARTY. MANDATORY CREDIT. INDONESIA OUT.     TPX IMAGES OF THE DAY - RC2CMF9AH704

Some form of distancing restrictions could be required for more than a year. Image: REUTERS

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  • Not enough is known about COVID-19 to predict its future course.
  • There is a strong risk that a second spike in infections could overwhelm healthcare systems once lockdowns are lifted.
  • Some form of distancing restrictions could be required for more than a year, say experts.

People across the globe have been forced to adapt quickly to the social distancing brought about by the coronavirus pandemic. But while the world might be eager for a relaxation of the rules, the restrictions might be around for some time to come.

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In fact, according to a group of Harvard disease experts, some form of intermittent social distancing may need to be in place until 2022.

That’s because once the initial wave of COVID-19 infections has passed, further outbreaks could occur. If lockdown restrictions are lifted at the same time, instead of in coordinated phases, a surge in new cases could overwhelm healthcare systems.

Here to stay

Too little is known about the disease or the future course it will take, prompting researchers from the Harvard T.H. Chan School of Public Health to run computer simulations modelling different ways the pandemic could play out.

With social distancing rules in place and strictly adhered to, along with intensive testing and contact tracing of new infections, the simulations show it is possible to contain the spread of a virus. However, with more than 2 million confirmed cases impacting countries around the world, the researchers believe this is an unlikely outcome.

More likely, they say, is that the virus is here to stay, recurring intermittently as the seasons come and go, much like influenza. Until a vaccine is available, this could mean some form of social distancing will need to exist for many months, if not years.

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The number of people placed on enforced lockdowns due to the COVID-19 pandemic. Image: Statista

At the height of the epidemic in China, strictly enforced lockdown orders were imposed to slow the spread of the disease.

India has enforced the world’s biggest lockdown, with more than 1.3 billion people confined to their homes. Nationwide restrictions are in place in countries from Europe to Latin America.

Restrictions range from mandatory quarantine orders to stay-home recommendations, and include prohibiting non-essential work or business, along with bans on public gatherings and events.

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Life after lockdown

As the economic costs of the pandemic mount, some governments are under pressure to lift social distancing measures to get their countries back to work. But such decisions have to weigh the economic costs of life under lockdown with the imperative to save lives.

People participate from thier balconies as Easter Sunday mass is lead from the roof of the Santa Maria della Salute church, as Italy remains on lockdown to try and contain the spread of coronavirus disease (COVID-19), Naples, Italy, April 12, 2020. REUTERS/Ciro De Luca - RC2Y2G9T96MM
Italy in lockdown: following regional shutdowns, emergency measures were extended across the whole country. Image: REUTERS/Ciro De Luca

In Europe, countries like Italy and Spain are beginning to lift lockdown restrictions. Some non-essential parts of Spain’s economy are reopening, such as manufacturing and construction, and employees are returning to work. Restrictions are still in place for other sectors with bars, restaurants and hotels remaining closed.

At a World Health Organization briefing on 13 April, officials emphasized the need to lift lockdown restrictions strategically.

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“Not lifting all at once is very critical so that we can get people back to work, get these economies going back again as quickly as possible,” said Dr Maria Van Kerkhove, the WHO Health Emergencies Programme’s Technical Lead.

WHO Director-General Dr Tedros Adhanom Ghebreyesus announced criteria that should be met before countries consider easing lockdown restrictions. These include ensuring transmission of the disease is controlled, and that health systems have the capacity to detect, test, isolate and treat every COVID-19 case and trace every point of contact.

Officials echoed the call for physical distancing measures and frequent handwashing to remain in place after lockdowns have been lifted.

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