In January 2020, as the epicenter of the Covid-19 pandemic, China was grappling with cases in its 29 regions, triple-digit daily increases and a looming shortage of medical supplies. To tackle this, China has been swift and forceful – implementing lockdowns of varying degrees of stringency in cities and regions of the country, which has left around 760 million people under restrictions. . Whenever an area showed a spike in cases, a lockdown followed.
Fast forward to today and China is on the other side of the pandemic: After overcoming 85,307 coronavirus cases and 4,634 deaths, the country is reporting only a handful of daily cases. As of September 23, the total number of active coronavirus cases in China was 402. The UK, heading for a potentially devastating second wave, reported 6,178 new cases.
In May 2020, Xi Chen, associate professor of public health at Yale University, published a study explaining how China’s swift and decisive response – including “quarantines, city closures and public health measures local “- in the face of the first, the Covid-19 epidemic prevented what he and his co-authors estimated at 1.4 million infections and 56,000 deaths.
But Chen doesn’t think all countries should go this route. “Each country will adopt very different measures based on several things: there are more ways to control [the virus], ” he says. “Decisions should take into account such things as the country’s culture, its social norms, whether people will accept it or not and also – very importantly – whether the health infrastructure is good enough to allow wider dissemination. He points out that China’s intensive care beds per 100,000 people are only half of those in the UK, making tighter lockdowns inevitable.
Cultural differences are also important. Regardless of the fact that China is an authoritarian state capable of imposing restrictions in the blink of an eye, it is undeniable that some cultures are more resistant to limitations than others. Chen cites a recent study explaining how people living in the westernmost states of the United States tend to be more individualistic and therefore less inclined to observe restrictions than their counterparts on the east coast. Prime Minister Boris Johnson’s remark about the ‘freedom-loving’ nature of the British people was crass, but pointed to something that has an impact.
Johnson’s remarks – an attempt to explain the UK’s less successful handling of the second wave of Covid-19 compared to countries like Germany or Italy – were made as he unveiled a new series of measures to stem the spread of the virus. Among the new measures is the requirement that pubs and restaurants close at 10 pm; the mandatory wearing of a face mask for retail workers; increased fines for Covid security violations; and recommending that workers work from home if they can.
Some rules have been met with bewilderment: why, for example, should pubs close at 10 p.m. rather than close their doors completely? And why has the ‘rule of six’ – which allows six people from different households to meet indoors and outdoors – has remained, despite the fact that the spread between households appears to be one reasons why cases are increasing?
The answer is that at this point every decision is a compromise between what is needed and what can be done without further crushing a prostrate economy and weary population.
“We know total lockdown works – the question is how many restrictions do we need?” Says Keith Neal, professor emeritus of epidemiology at the University of Nottingham. He says falling back into full lockdown every time cases start to rise would come at a different cost: failing people’s health due to failed tests and surgeries, and a more widespread deterioration in mental health. Compliance would also likely suffer.
That’s why you don’t want to overdo it. Closing pubs and bars can lead to dating at home, which is more difficult to control. Neal thinks the focus should be on ads that follow the guidelines to the letter. “If the ads play by the rules: service only when you sit down, social distancing is fine,” he says. “And the pubs that break the rules should be closed first for a day, then for a week, then for a month and so on for up to a year.”
According to David Wrigley, vice-chairman of the British Medical Association Council, while the 10 p.m. threshold seems “out of the blue” and the rule of six for home mixing “should be reconsidered”, the latest guidelines are at least clear on issues such as as facial covers. “Following the rules is the most important thing, but the rules needed to be clearer,” Wrigley says. The government’s repeated changes in tactics have often been criticized for their confusion, with the slogan “Stay vigilant” referred to as the height of the confusion.
Will clarity – and minor rule changes – be enough to bring the number of cases under control? Many experts say the government is once again doing too little, too late. But Chen doesn’t think repeated lockdowns to China will be the future: they’re far too expensive to be triggered as a routine countermeasure. In his latest study, he proposes a new way to nip contagion in the bud, imposing varying degrees of restrictions in different parts of the country – regions, towns, villages, down to the individual neighborhood – depending on the severity of the disease. what the epidemic is, and how central the general movement of the locals is to that specific location. “I don’t think a full lockdown is the optimal choice,” he says.
Gian Volpicelli is the political editor of WIRED. He tweets @Gmvolpi
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