Loosening COVID-19 social distancing interventions: lessons learned from abroad

Loosening COVID-19 social distancing interventions: lessons learned from abroad

Collection:
Health Policy and Services Research
Contributor(s):
Bipartisan Policy Center, issuing body.
Publication:
Washington, D.C. : Bipartisan Policy Center, April 2020
Language(s):
English
Format:
Text
Subject(s):
Coronavirus Infections -- epidemiology
Disease Transmission, Infectious -- prevention & control
International Health Regulations
Physical Distancing
Pandemics -- prevention & control
United States
Genre(s):
Technical Report
Abstract:
As of the end of April 2020, there are more than 3 million confirmed cases of COVID-19 resulting in over 200,000 deaths across approximately 200 countries. While initial containment efforts to identify and isolate cases as well as trace and quarantine close contacts have been attempted to varying degrees of success across the world, virtually every country has found it necessary to also implement community mitigation strategies to slow the spread of the pandemic. In the United States these strategies, which include personal protective measures, have been previously recommended and utilized to respond to pandemic influenza. For example, school closures, social distancing in workplaces, and postponing or cancelling mass gatherings are thought to slow the acceleration in the number of cases, reduce the peak number of cases and related demands on hospitals and infrastructure, and decrease the number of overall cases and health effects. This is, in essence, what "flattening" the pandemic curve is attempting to do. In response to COVID-19, most states have implemented these specific strategies in addition to broader ones, including stay-at-home orders and closures of nonessential businesses. On April 13, the Centers for Disease Control and Prevention published preliminary evidence from four metropolitan areas across the country showing that using a combination of these strategies reduces community mobility--a proxy measure for social distancing--and are likely contributing to slowing the spread of infections. Over the last several weeks, it appears the United States reached a plateau of approximately 30,000 new confirmed cases and 2,000 deaths daily. One caveat with confirmed cases is that testing unfortunately plateaued as well; thus, the percentage of positive COVID-19 tests may be a better indicator to gauge whether testing is sufficiently widespread to provide good data on which policymakers can act. Using that variable, it appears half of the states may not yet be past their peak. Nevertheless, given the significant adverse economic consequences of community mitigation measures, there has been growing pressure to gradually begin lifting social distancing interventions. On April 16, President Trump unveiled the administration's Guidelines for Opening Up America Again to assist states and localities in reopening their economies while still protecting American lives. Some states have followed suit and taken steps to ease restrictions and have offered detailed plans to do so over the coming weeks and months. Various organizations have also shared important guidance documents to support governors in this regard. There is general consensus that a more robust testing infrastructure which promptly leads to the identification and isolation of cases, a public health system that is well funded and supported to lead contact tracing efforts, and a health care system with capacity and available personal protective equipment and critical medical material are essential to successfully loosening community mitigation measures. One additional input that could be important to decision-makers involves analyzing the response of various countries around the world that are temporally similar to or ahead of the United States on their respective pandemic curves and are either contemplating or already in the process of loosening social distancing interventions. Researchers have started tracking and comparing the quantity and strictness of containment efforts and community mitigation strategies across various countries over time through a Stringency Index. Continued tracking as the initial pandemic wave recedes will help to assess how countries are loosening government policies. East Asian countries such as China and South Korea are the furthest along in opening up their business sectors, while countries such as Hong Kong and Singapore still have significant restrictions in place after a March spike in infections. Many European Union countries are also in the process of making decisions with respect to loosening social distancing interventions. Table 1 provides a high-level snapshot as of April 28, 2020 of the impact of COVID-19 on various East Asian and European Union countries. While many of these countries are distinct from the United States with respect to their size, form of government, culture, and extent of personal freedoms, lessons from their experiences could be helpful for U.S. policymakers. To that end, the Bipartisan Policy Center initiated a study to assess how countries around the world are attempting to relax social distancing interventions as they transition from the initial pandemic wave. To assist with this project, BPC analyzed real-time qualitative data from the Health System Response Monitor--a collaboration of the World Health Organization Regional Office for Europe, the European Commission, and the European Observatory on Health Systems and Policies. BPC also corresponded with experts connected to the Commonwealth Fund's International Health Policy and Practice Innovations program, reviewed various media reports and published literature, and drew on the expertise of an advisory group (see acknowledgments) which met virtually on April 23, 2020. Focus countries included Austria, the Czech Republic, Denmark, France, Germany, Italy, Netherlands, Spain, Switzerland, the United Kingdom, South Korea, Taiwan, China, Singapore, and Hong Kong. This white paper includes a case study of Germany's response and approach to loosening social distancing interventions, preliminary insights from a cross-country analysis, as well as implications and initial recommendations for the United States with respect to loosening social distancing interventions.
Copyright:
The National Library of Medicine believes this item to be in the public domain. (More information)
Extent:
1 online resource (1 PDF file (20 pages))
NLM Unique ID:
101769515 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/101769515