A woman waves to a city worker dressed in a hazmat suit as he disinfects the streets in her neighborhood as a precaution against the spread of the new coronavirus, in Santiago, Chile. AP Photo

The WHO's six step guide to easing coronavirus lockdowns



The next challenge in the coronavirus pandemic will be to avoid a second wave of infections as shops and businesses begin to re-open.

Italy and Spain, two of the countries that were hit hardest by Covid-19 outbreaks, have begun taking small steps to lift some of the restrictions that were implemented to contain the pandemic that has killed more than 40,000 in both countries.

With some countries declaring they are passed their peak infections, the World Health Organisation (WHO) has issued a guideline of six key criteria for governments to consider when lifting lockdowns.

1. Transmission control

The first key step to easing restrictions and preventing a second wave is having no local transmission. The WHO said they would measure this as being when new cases are either detected sporadically or when they come in clusters from known contacts or people coming into the country.

The WHO also highlighted health system capacity as key. Ensure health systems are operating at manageable levels and not overburdened, this includes maintaining what the WHO calls a substantial reserve of clinical care capacity or enough empty beds and doctors to accommodate an influx of new cases if needed.

2. Health system capacity

The WHO listed five key measures needed to continue managing the outbreak effectively. These were detection, testing, isolation, treatment and contact tracing.

The WHO recommends authorities continue to actively look for new cases through measures such as entry screening and providing test results within 24 hours.

Effective testing capacity would allow health systems to quickly asses both suspected patients and recovered patients in order to verify they are virus-free.

The WHO recommends designated isolation spaces, whether that is in a hospital or an isolation facility. Home isolation is to be used as a last resort as it further burdens authorities when it comes to contact tracing. All close contacts are to be quarantined for 14 days.

3. Protect the vulnerable

The WHO says authorities must take additional steps with high-risk or high-infection settings such as shared accommodation and nursing homes.

The measures should aim to minimise the risk of infection - with personal protective equipment and regular sterilisation - but also have plans for outbreaks that include triage capability.

4. Keep workplaces safe 

Essential but high footfall spaces such as workplaces and schools must keep measures to lower the risk of infection, such as physical distancing, hand washing, respiratory etiquette (such as covering your mouth and nose with your arm when you sneeze) and temperature monitoring.

5. Screen passengers 

Authorities should not consider lifting lockdowns until they've completed a thorough analysis of likely origin and routes of cases that entered the country.  Measures to rapidly detect and isolate travellers suspected of carrying coronavirus must also be in place.

6. Engage the public

The WHO says public co-operation will be vital to successfully transitioning out of lockdown.

Countries that ease restrictions should wait at least two weeks to evaluate the impact before moving further.

In Asia, many countries saw a rise in cases when restrictions were first eased.

China, Hong Kong and Singapore are still recording new cases after promising declines.

In China, the government says almost all new cases are coming from overseas - highlighting the need to test and monitor passengers.

Singapore, which was viewed as a model for contact-tracing during its initial outbreak, remains in a "critical situation" said Health Minister Gan Kim Yong as the country faces a second wave of infections, many originating from foreign worker dormitories.

In Spain, employees in select industries such as manufacturing and construction have been allowed to return to work, while Italy has also reopened limited shops and businesses. Germany is preparing to open schools and lift restrictions in May.

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