Commentary: Europe learns lifting COVID-19 lockdowns doesnt come cheap

ANN ARBOR, Michigan: After a rapid rise in coronavirus cases throughout Europe – particularly Italy and Spain – tough public health measures “flattened the curve.” That is, the spread of the virus slowed enough so fewer people would need treatment at the same time.

Hospitals would not be overwhelmed; COVID-19 patients would do better. Now, two months after implementing some form of physical distancing, European governments are planning to reopen their economies.

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According to the World Health Organization (WHO), these countries are focusing on four areas during their transitions.

They are relaxing physical distancing in stages; they are tracking the spread of the disease better through improved testing and contact tracing; they are managing health systems; and they are putting in place social and economic policies to support the transition.

What is certain: Everyday life in Europe will not return to normal anytime soon. Relaxing measures are intentionally slow and replete with requirements for individuals and businesses.

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In most countries, people will still work from home when possible. Vulnerable people will remain physically isolated, or will at least be urged to remain so.

In many cases, businesses, stores, schools and places of worship will reopen, but at lower capacity. Where physical distancing is not possible, most countries are either requiring or advising people to wear masks.

RELAXING DISTANCE IN STAGES

France is using a “traffic light” system to indicate how severe COVID-19 is in different locations. “Red” parts of the country will face continued lockdown. “Green” areas will have looser restrictions.

A man, wearing a protective face mask, rides a bicycle in a street in Paris as France softens its strict lockdown rules during the outbreak of the coronavirus disease (COVID-19) in France, May 11, 2020. (Photo: REUTERS/Benoit Tessier)

Spain, following a similar strategy, is pairing different levels of restrictions with a ban on travel between regions, at least during the early stages of reopening.

Its too soon to tell how well this will work, but its likely the ability of the central government to coordinate actions in different regions and provide overall leadership will be key.

To make decisions about reopening, the countries are using scientific data. To generate its traffic light map, France is evaluating the number of new cases, hospital capacity and local testing capacity.

In other countries, the science behind their reopening decisions is less clear.

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Governments remain cautious about moving between stages, however. Angela Merkel, Germanys chancellor, has spoken of the fragility of German success in managing the coronavirus and the risk of opening too quickly.

Edouard Philippe, the prime minister of France, emphasised his country could move forward or backward between stages.

TESTING AND TRACING REMAIN KEY

Germanys early testing and relatively strong contact tracing capacity has likely slowed the spread of coronavirus.

The country is conducting a large number of tests, even on those with only mild symptoms; this more comprehensive approach generates a more accurate picture of the escalation of the disease.

The WHO warns that countries with a high percentage of positive tests are probably missing other cases of coronavirus in the population.

When it comes to tracking people exposed to the virus, some countries are emphasising contact tracing by trained staff.

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Britain remains in lockdown as it tries to pivot this month to a new strategy built around mass testing and tracing infected people and those they may have come into contact with. (Photo: AFP/Tolga Akmen)

Germanys goal is to establish a five-person team for every 20,000 people. This level of contact tracing is similar to recommendations made by US experts, but so far, few states meet this target.

European countries are also exploring technological solutions for tracking and managing the virus. Italy has selected an app that records proximity using Bluetooth technology.

But the use of tech solutions is politically controversial and remains optional in many cases.

MANAGING HEALTHCARE CAPACITY

European governments are often willing, and sometimes able, to exert more control over their health systems than the United States.

Across Europe, healthcare entities are consulting with government to plan capacity, and some governments, such as Spain, Italy and Denmark, have taken control of private providers and supplies.

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Governments in many countries decide when non-essential operations and treatments can resume, in contrast to the US, where providers usually make the decision.

They require hospitals to maintain a specific level of resources for COVID-19 patients, like the number of ICU beds. Theyve also injected more funding into their health systems to make sure they can handle new waves of COVID-19 along with normal demands for healthcare.

SUPPORTING TRANSITIONS

Finally, European countries are addressing the pandemic through social policies.

People ride bicycles at dawn during the hours allowed for individual exercise, for the first time since the lockdown, amid the coronavirus disease (COVID-19) outbreak, on the outskirts of Ronda, Spain on May 2, 2020. (Photo: REUTERS/Jon Nazca)

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