Leaders must weigh the costs to the economy, mental health, and education against peak potential in cases that delay any progress toward reducing the spread of covid-19, the disease caused by the coronavirus.
The first easing of restrictions began this week, with Austria reopening some non-core businesses on Tuesday. Denmark is expected to allow children to return to school this week. And Spain has allowed the return of construction workers and factories, although a national blockade remains in effect if not.
Their progress will likely be watched closely on the other side of the Atlantic, where President Donald Trump is arguing with governors over how and when to reopen the economy.
While decisions to close schools, close borders, and tell the country to stay at home have come relatively quickly, considerations for lifting the restrictions are slow and difficult, requiring acceptance of increased risk for public health. There are no best practices established for timing or sequencing. And policy makers must be ready to adjust their course in the event of new outbreaks.
“We have to play by ear because there is no gold standard on how to do it,” said Frank Ulrich Montgomery, president of the World Medical Association.
Most European countries have advised to wear masks because people are allowed to start traveling again in public – the Spanish government distributed free masks to commuters this week. Extensive testing is also considered essential to monitor and isolate the chains of infection.
While antibody studies are used to try to assess which part of the population has already been unintentionally infected, problems with test accuracy and questions about the length of protection complicate “immunity passport” plans .
Some scientists have proposed closely designed strategies to protect the most vulnerable, but keeping the elderly separated from their loved ones for months must also be weighed against the health impact of isolation.
In order to avoid any repetition of the political decisions which accompanied the spread of the virus in the bloc, the leaders of the European Union in Brussels plan to unveil on Wednesday suggestions on how to gradually reopen the group of 27 nations in the coming months .
They will advise countries to reopen economies in stages, with shops and schools a priority, and restaurants and other social venues to come later, according to a draft of their plans. Policymakers warn that leaders must act slowly – potentially waiting a month between each new step – and be ready to reverse quickly if infections start to spread again quickly.
But each national government will have the final say on the lifting of restrictions within its borders. And when to resume free movement between the countries of Europe will be another discussion entirely.
French President Emmanuel Macron gave a glimpse of what France’s confinement might look like in a national television address Monday evening. France will remain closed until May 11, Macron said, but kindergartens, colleges and high schools will reopen “gradually” from mid-May.
“Many children do not go to school,” he said, “and there is an inequality with regard to those who do not have access to the Internet and who cannot be helped by their parents.” . “
However, universities would not offer face-to-face courses until at least the summer. Other businesses – such as restaurants and cafes – will remain closed in the near future, said Macron.
Chancellor Angela Merkel is expected to announce on Wednesday that restrictions could be relaxed in Germany. A study which she believes would help clarify her decision advises opening schools as soon as possible, starting with elementary students for whom distance education is less effective and in basic subjects such as German and mathematics, with staggered classes.
The study, carried out by scientists at the Leopoldina National Academy in Germany, also indicates that data obtained through tests will be essential for making informed decisions. Antibody studies can assess which part of people already have immunity as restrictions are gradually lifted.
“During the gradual easing phase, we must prevent a further rapid increase in the number of infections,” the newspaper said. “We have to walk on a tightrope. “
The majority of Germans still do not want the restrictions lifted, according to a YouGov survey released this week, with 44% in favor of extending distancing measures and an additional 12% who want to see them tightened.
Janina Possehl, 35, is one of the cautious people. Strolling through the Schoeneberg district of Berlin, with her 6-month-old son tied to her forehead and a 3-year-old child dragging behind on a tricycle, she said she would keep her children at home even if schools and gardens children reopened.
“I think it would be good for them to stay closed longer,” she said, while admitting that it was more difficult for working parents. “I would be very careful not to relax the restrictions too soon,” she added.
But most countries cannot afford to wait in lockdown until a vaccine is developed and widely available and available safely, which could take until 2021 or more, or until that their populations develop sufficient natural immunity to slow the spread of the virus, according to Merkel. could take up to two years.
“If you’re optimistic, we could have a vaccine in a year,” said Alexander Kekule, director of the Institute for Medical Microbiology at Martin Luther University in Halle-Wittenberg. “But we can’t keep people locked out for a year. You would have an economic and psychological crisis. “
European policymakers have expressed concern about the consequences of a fragmented approach to reopening, warning that if individual countries pursue their own plans without consulting their neighbors, political tensions could result, just as they did when borders suddenly sprouted in Europe last month.
Those who have successfully slowed the rate of transmission may have a longer balance ahead of them, experts say.
“One of the problems is that the more effective you are at smoothing the infection curve, the longer it takes for you to have population immunity, and that is the dilemma for our politicians,” said Montgomery .
Britain, where leaders spoke last month about strengthening “collective immunity” and which was among the last in Europe to introduce social distancing measures, is now reporting the highest number of new daily cases in Europe . And, for now, it remains attached to its lock.
It would be “premature” to say that the number of coronavirus cases has peaked in Britain, warned the country’s deputy chief medical officer, Jonathan Van-Tam. He said it was too early to discuss releasing the lock.
“We are still in a dangerous phase,” Van-Tam told reporters during a briefing before the long Easter holiday weekend. “And I have to reinforce it to you again, that it’s not over. “
In Italy, the government has used the term Phase II to describe its expected emergence from a rigid lock. He is still thinking about what the country should loosen up to and whether it will be possible to start this phase on May 4 as planned.
Official government statistics show that the total number of cases in the country is increasing by about 3% per day – and that more cases go undetected, people not being examined, isolating at the home and spreading the virus to their families.
But Prime Minister Giuseppe Conte has faced mounting pressure to reopen, as far-right party leader Matteo Salvini said on Tuesday that staying closed could result in “economic disaster”.
On Tuesday, the government took the first modest steps, allowing the reopening of bookstores, stationery stores and stores selling baby clothes.
Roberto Burioni, professor of microbiology and virology at the Vita-Salute San Raffaele University in Milan, called for the reopening of a political decision and said that the government should demand that all people wear masks after leaving home and needed some form of contact tracing.
He also suggested that Italy adopt a policy that people found infected with the virus – and their contacts – by being isolated in hotels or other facilities, not at home.
“I understand that we have to start again,” said Burioni. “But, I warn you – we need it.” Without it, it will be a tragedy, and we will have to start [lockdown] again. “
Listen to our 10/3 news podcast on Apple podcasts