Summary: If we reopen carelessly, new cases will surge and further lockdowns will be required. From our recent experience, we know how to reopen safely. Why shouldn’t we?
We have seen this so many times in so many places during the last year: COVID-19 cases go down, hospitals and morgues no longer overflow, restrictions are lifted, and then cases increase again.
In several countries (Israel, France, Argentina, Chile, Uruguay, Bahrain, and more), the start of their vaccination campaigns led to a false sense of “victory”, relaxations followed, and new waves produced more new cases and deaths. Declaring this pandemic as over was and is the best way to make sure it stays around for another round.
Last week, California and New York reopened, after reaching 70% of vaccinated adults (with at least one dose). Note that less than half of the population in these states (considering people under 18) has had two vaccine doses. A single dose has shown to be insufficient to stop the Delta variant, which is already spreading globally and is expected to become dominant by mid July in the United States.
Other states have lifted restrictions using other criteria. Similar actions are being taken in Mexico, Europe, and elsewhere, as cases have gone down from the latest peak.
It seems that many countries expect vaccinations to prevent further waves. We have seen that even with high vaccination rates (more than 50% of the population), outbreaks can occur if other measures are lifted. The UK is a clear example of this. In spite of renewed lockdowns, their cases are still going up. Hospitalizations are increasing and deaths of both single and double vaccinated individuals are increasing. How many deaths are we willing to accept in exchange for the pleasure and convenience of not wearing facemasks in public? Finally, having contagion in the population will lead to a broader variety of variants which will have stronger pressure to evade vaccines as vaccination progresses.
We all would agree that lockdowns are not sustainable. So, when should they be lifted? And what should be done to avoid new surges? We can also learn from observing successful examples. Restrictions can be lifted at the point when contact tracing is sufficient to contain the outbreak (which requires frequent testing). The appropriate threshold depends on the effectiveness of contact tracing teams, but it is roughly one new case per million people per day¹. Only then should reopenings take place, region by region. To avoid new waves, borders have to be closely monitored, isolating people coming from regions that still have community transmission. Like this, “green zones” can be protected, and only limited local lockdowns will be required.
In the meantime, each of us can do what we can to reduce the spread. Get vaccinated. Wear facemasks in public. Avoid large gatherings and poorly ventilated spaces. Strengthen your immune system. If you have symptoms, stay at home. If someone has symptoms, help them stay at home. The more we do, the faster cases will go down, and the sooner safe reopenings will be possible.
We should learn from the past 18 months of suffering the effects of the SARS-CoV-2 virus. The pandemic is still ongoing. We shouldn’t be relaxing restrictions. We should strengthen them so we can defeat the virus. We should act soon and with the clear intention to stop this virus once and for all. While vaccines are among our most powerful tools, it will not go away with vaccines alone. Combining vaccines with masks, testing, contact tracing can reduce cases to reach elimination locally. We know how to end it, we “just” need to make the right decisions.
