Curve flattening for COVID-19; Lessons from some selected countries


The Corona virus pandemic took the world unawares and has become one of the worse pandemics the world has ever experienced. The strictness of measures taken has been varied for different countries as some opt for more relaxed measures (level 1 and 2) while others implement more tight measures (level 3 and 4).

Level 1: Implementing border entry measures to minimize risk of importing covid 19, intensive testing for covid 19, self-isolation and quarantining, no restriction on gatherings and physical distancing encouraged.

Level 2: Limitations on mass gatherings and encouraging increased physical distancing

Level 3: Stay at home whenever not at work, school, buying or exercising and also entails limiting interaction with others.

Level 4: Lockdown involving closing schools, non-essential work places, social gatherings and severe travel restrictions (1).

Some countries are already flattening the curve on the epidemic whilst others are still witnessing a geometric surge in the number of cases and deaths. As of the 4th of May, there were over 3.5 million confirmed cases of the virus with over 250,000 deaths globally. 

New South Wales, Australia

Australia initiated strict border control measures at a relatively early phase of the pandemic. The Federal and state governments also introduced strict physical distancing rules (level 2). Furthermore, schools, pubs, churches, community centers, entertainment venues and even some beaches were closed (level 4). This could be the reason for the slow spread of the virus in Australia. Australia is one of the few countries with a success story in containing the spread of the virus and all its states and territories are now mapping their paths towards relaxing restrictions in the coming weeks.

Italy

Italy was relatively slow to respond to the epidemic, and experienced a high infectivity rate for many weeks. This led to an explosion of cases which overwhelmed the health system, particularly in the country’s North. This was followed by some of the strictest public health control measures in Europe (level 2, 3 and 4), which has finally seen a reduction in the occurrence of new infections. Unfortunately, the time lag costed many lives as indicated by the death toll of over 27,000 which serves as a warning of what can happen if the virus is allowed to spread unchecked for long enough before restriction  measures are imposed.

United Kingdom

The UK’s initial response to COVID-19 was characterized by a series of missteps. The government initially was ambiguous in its strategy while it considered pursuing a controversial “herd immunity” strategy (level 1), before finally considering a lockdown (level 4) to control transmission of the virus. As in Italy, the result was an initial surge in case numbers, a belatedly successful effort to bring down the incidence with a huge death toll of over 20,000 to date.

Sweden

Sweden has taken a markedly relaxed (level 1 and 2) approach to its public health response. With a few minor restrictions the country remains more or less open as usual, and the focus has been on individuals to take personal responsibility for controlling the virus through physical distancing. This is understandably contentious, and the number of cases and deaths in Sweden are far higher than its neighboring countries but the curve is flattening.

Singapore

Singapore was hailed as an early success story in bringing the virus to heel, through extensive testing, effective contact tracing and strict quarantining, with no need for a full lockdown. However, the virus has bounced back. Infection clusters originating among migrant workers has prompted tighter restrictions (level 3 and 4).

Flattening the epidemic curve of covid-19 in Cameroon

The number of cases of COVID 19 has continued to increase in Cameroon despite the measures put in place. Lessons learned from other countries show that it is better to pro act hence there is the need to adjust our measures and bring the wave of infections down rather than wait for the situation to get worse. To this effect, the following are some possible recommendations for the situation in Cameroon;

  1. Impose a lockdown in the most affected towns for at least 20 days. This should be preceded by a three-day prior notice to prepare for the lockdown and should also be accompanied by a plan to assist the poor and other vulnerable groups with food and other necessities.
  2. For the month of lockdown, all utility bills of inhabitants in cities under the total lockdown should be waived or significantly reduced and the taxes of these companies (ENEO and CAMWATER) waived or reduced accordingly for that period.
  3. Test, trace and encourage Cameroonians to come for voluntary testing. Use a ‘carrot’ approach to reward all those who report themselves, their loved ones or neighbors that are manifesting the signs and symptoms COVID-19.
  4. Support the massive production of reusable face masks that can be distributed to households.
  5. Establish a plan to support healthcare workers working with COVID 19 patients especially during the lock down period.

References

  1. COVID-19 alert System. New Zealand’s 4-level Alert System specifies measures to be taken against COVID-19. 2020. https:covid19.gov.nt/alert-system/covid-19-alert-system.
  2. Hassan Vally. Associate Professor, La Trobe University. Six countries, 6 curves: how nations that moved fast against COVID-19 avoided disaster. April 29, 2020 10.07pm SAST.
  3. Jimm Chick Fomunjong. Flattening the covi-19 curve in Cameroon. Nine Immediate Action Points for the Government. April 2020.