For the billions of people now living under some form of stay-at-home or lockdown orders, experts from the World Health Organization have new guidance: We should be ready to "change our behaviors for the foreseeable future," they say, as the agency updates its advice on when to lift COVID-19 lockdown orders.
The question of when to ease shutdowns is a hot topic, as economic output is stalled in many countries — including the U.S., now the epicenter of the global pandemic.
"One of the main things we've learned in the past months about COVID-19 is that the faster all cases are found, tested, isolated & care for, the harder we make it for the virus to spread," said WHO Direct0r-General Tedros Adhanom Ghebreyesus via Twitter as the guideline was released. "This principle will save lives & mitigate the economic impact of the pandemic."
The coronavirus has killed tens of thousands of people. It has also reshaped society and disrupted daily life for people around the world – including 1.4 billion children whose educations are now derailed by shutdowns, WHO says. The pandemic has triggered massive losses for big companies and small businesses, and forced millions of people out of work.
While full national lockdowns remain uncommon, at least 82 countries have some form of lockdown in place, according to UNICEF.
The global economy is now predicted to shrink by 3% this year, the International Monetary Fund says in its most recent analysis. That includes a contraction of nearly 6% for the U.S. economy.
Despite all the personal and economic pain the coronavirus has caused, WHO officials say that in many places, it's too soon to get back to normal. And because any premature attempts to restart economies could trigger secondary peaks in COVID-19 cases, they warn that the process must be deliberate and widely coordinated.
"You can't replace lockdown with nothing," Dr. Mike Ryan, executive director of WHO's emergencies program, said at a recent briefing. Stressing the importance of a well-informed and committed population, he added, "We are going to have to change our behaviors for the foreseeable future."
Any government that wants to start lifting restrictions, said Tedros of WHO, must first meet six conditions:
1. Disease transmission is under control
2. Health systems are able to "detect, test, isolate and treat every case and trace every contact"
3. Hot spot risks are minimized in vulnerable places, such as nursing homes
4. Schools, workplaces and other essential places have established preventive measures
5. The risk of importing new cases "can be managed"
6. Communities are fully educated, engaged and empowered to live under a new normal
The worldwide number of COVID-19 cases is quickly approaching the 2 million mark, including more than 120,000 people who have died, according to a COVID-19 dashboard created by Johns Hopkins University's Whiting School of Engineering.
The number of new cases continues to rise sharply in the U.S., where disagreements over the potential restarting of economies recently prompted at least 10 states to band together in regional coalitions. The governors of those states say they — not President Trump or the federal government — will determine when to resume normal activities, based on health statistics and science.
Even in instances where governments can lift some lockdown conditions, Ryan said, "Health workers are going to have to continue to have protective equipment and we're going to have to continue to have intensive care beds on standby, because as we come out of these lockdown situations, we may see a jump back up in cases."
The goal is to taper restrictions so governments – in communities, cities and nations — can avoid a cycle of new COVID-19 outbreaks.
"We don't want to lurch from lockdown to nothing to lockdown to nothing," Ryan said. "We need to have a much more stable exit strategy that allows us to move carefully and persistently away from lockdown."
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