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Only Sustainable Measures Are Helping COVID-19 Control4
HSVG misson P.O. Box 206, Hagatna, GU 96932, USA
(01/17/2022)Did G20 learn lessons from the Delta? When the world welcomed 2022, many people were actually calling the new year “pandemic year 3.” If we have had it enough and do not want “pandemic year 4,” year 5 or year 6, let’s encourage Indonesian government step forward with its Group of 20 (G20) presidency to call for an international campaign helping people around the globe fearlessly live with the coronavirus and adopt the new normal as soon as possible. Quite a number of public health experts had advised before COVID vaccines became available that the human society was inevitably going to live with the coronavirus for a while and only sustainable measures would help everybody get through the pandemic. Unfortunately, most governments , with certain high-profile scientists and celebrities, put so much faith in lockdowns and looked forward to seeing COVID vaccines would work perfectly like a silver bullet even though, at that time, almost every vaccine developer was apparently targeting at lowering the numbers of severe patients and death victims instead of guaranteeing no infections after getting vaccinated. The Delta variant’s attack last summer was a wake-up call. Many countries, after enjoying reopening and sort of returning to normal brought by successful vaccine rollouts, experienced the Delta variant of the coronavirus caused a new wave of case surge, made hospitals overwhelmed again, and, sadly, took many people’s lives. It was the time that people started being familiar with a term called “breakthrough infections.” For example, Singapore surprisingly reported 28,901 new infections and 40 deaths in September 2021 after the vaccination rate was beyond 80%. Their COVID death number was zero in September 2020 when there was no CIVID vaccine at all. The epidemiological investigation and laboratory results concluded the changed situation was mainly caused by the Delta variant. Singapore was not the only place having a bad September last year. As of 31 August 2021, 80.43% of the residents 12 years and older were fully vaccinated, but Guam, an US island territory in the Pacific reported 47 COVID-related fatalities in September 2021. The figure was higher than the death number of 39 reported in September 2020 when no vaccine was available at that time. With almost the same land size, Guam is home of less than 200 thousand residents and Singapore has a population of 5.7 million. It means the highly-contagious Delta variant was influencing everywhere, no matter a busy and crowded city or a relaxed and rural place. In addition, obviously, vaccines alone are not suppressing the coronavirus. Europe’s experience reminded that nobody should drop his/her guard even thought the population reached a high vaccination rate. European Union has been leading its member states to keep precautions and try reopening in a gradual way. The continent has maintained a basically downward curve of infections as well as hospitalizations and deaths since its successful vaccine rollouts in association with well-managed medical capacity, even though the Delta variant did make a noticeable, but not really harmful, spike. However, it seemed that most parts of the world did not learn lessons from the Delta and implement proper measures when the Omicron came. The World Health Organization did not wait for sufficient morbidity and fatality data to be collected. Its warning message on the Omicron variant released late November last year triggered many countries’ panicked decisions of tightening COVID restrictions. It’s sad that South Africa’s variant identification efforts, which should have been appreciated, made its people punished by the almost worldwide travel ban. The wait wasn’t even long. Before last Christmas, at least three scientific researches caught the media’s attention and proved the Omicron variant may be much more contagious but it’s mostly causing mild cases. However, the chaos has hurt people. For example, Guam, which finally saw a little bit tourism recovery last November, immediately suffered from more than 5000 travel booking cancellations right after the Omicron panic widely spread. More variants will definitely come and we definitely do not want more chaos. While the Omicron has shown the new variants in the future are very likely to be less lethal and the COVID vaccines are actually promisingly reducing severe cases, plus the antiviral medicines are available, the whole world really needs a leadership that urges every jurisdiction to guide people fearlessly living with the virus by using more appropriate strategies to respond to every emerging variant. Let’s try to recall whether the system was encouraging people to get tested during the flu season to try to contain flu viruses. Were we worried so much when we experienced flu-like symptoms or got diagnosed as having flu? Wasn’t the goal of flu control to avoid severe complications and save people’s lives? The best tools helping us achieve the goal are always personal hygiene and flu vaccines although so-called “breakthrough infections” did happen to flu vaccines as well. COVID is not flu, but flu control experience could apply to COVID response, especially to the current situation of “pandemic year 3,” a year that G20 presidency returns to Asia, where people totally have no issue with wearing a mask and helped prove this measure could effectively prevent COVID spread. Indonesian government needs to work with its G20 partners and make history.(Published in The Jakarta Post on January 11, 2022) http://www.hsvg.org/hot_414422.html Did G20 learn lessons from Delta variant? 2022-01-17 2023-01-17
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(July 10, 2020)

Only Sustainable Measures Are Helping COVID-19 Control



The whole world has surely noticed that China, Australia and the United States are having COVID-19 community spread again. While several places are locked down again, it is time that every government honestly informs people that we are inevitably going to live with the coronavirus for a while. Only sustainable measures, which is absolutely not another lockdown, can really help everybody get through it together.



After some restrictions were lifted in May or June, many people might think the coronavirus has gone and it’s not necessary any more to strictly practice social distancing, to wear a face covering in public and to wash hands that often. It is highly likely to be the reason why a number of places are having the second wave. Every government should learn the lesson and offer people proper information about the current status of the pandemic to at least have the majority of people keep practicing the precaution measures to maintain a flat, or downward, infection curve.



Taiwan, with more than 23 million citizens, has not reported any domestic COVID-19 cases since April 13. Even though, its nationwide health education system kept reminding people in the whole month of May to maintain social distancing, to wear a mask in public and to practice good personal hygiene. Taiwanese government is therefore confident to announce on June 17 that they will ease quarantine regulations exclusively for visitors from 11 low-risk countries and areas, including New Zealand, Australia, Macau, Palau, Fiji, Brunei, Vietnam, Hong Kong, Thailand, Mongolia and Bhutan.



Although there have been more than 350 import cases challenging Taiwan’s public health system since the country encountered the first one from China on January 21, Taiwanese government has never enforced any lockdown or stay-home orders. With no lockdown, as of July 9, only 55 domestic cases have been reported and 7 patients sadly died in Taiwan. Apparently, Taiwan has been showing the world a relevant example of the sustainable way that people can fearlessly live with the coronavirus in the long run.



A number of solid research findings have also offered evidence to prove there are effective protection measures helping people live with the coronavirus before vaccines are available. For example, a meta-analysis report published on June 1 in The Lancet showed 1-meter social distance significantly reduced the chance of human-to-human transmission to 2.6% from 12.8% with no social distancing intervention. Face masks also helped lower the chance from 17.4% to 3.1%. Eye protection decreased the chance to 5.5% from 16%. (Ref. 1)



An analysis published on June 11 in the Proceedings of the National Academy of Science analyzed data from three epicenters - Wuhan (China), Italy and New York City - and proved that mandated face covering “alone” significantly reduced the number of COVID -19 infections. The researchers concluded that wearing of face masks in public corresponds to the most effective means to prevent human-to-human transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine, and contact tracing, represents the most likely fighting opportunity to stop the COVID-19 pandemic. (Ref.2)



There are, of course, studies showing lockdowns help as well. The journal Nature published two scientific articles on June 8, which support the effect of large-scale lockdowns. One of the researches examined data from 11 European countries and showed that lockdowns effectively slowed the pandemic and saved 3.1 million lives. (Ref. 3) (Ref. 4)



However, many people were probably willing to sacrifice their freedom and convenience for saving lives in March and April and hoping everything would be fine after the pandemic ended. In May, especially late May, "lockdown fatigue" has emerged. It seems less people are comfortable in June with the all-or-nothing nature of strict lockdowns because many people have started noticing the huge uncertainty for the future after three-month lockdowns.



In fact, at least two "excess deaths" analyses based on statistics of EuroMOMO, the European morality monitoring activity, have shown that the strictness of a country’s lockdown measures had little associations with its fatality of COVID-19. These analyses concluded that it’s better to respond quickly, with proper testing and tracing protocols, rather than replying on strict lockdowns. (Ref.5) (Ref.6)



The biggest myth about lockdown is to believe it is the only solution when the epidemic gets worse. In fact, lockdown is a measure to lock the seriously-affected area in order to protect people in other areas. When SARS hit Taiwan 17 years ago, the health authority there locked a hospital where a serious nosocomial infection occurred to protect the community outsides. When Wuhan became a miserable epicenter of China in January, Chinese government issued a lockdown order in Wuhan to avoid the coronavirus from further spreading to other cities and provinces.  



To live with the coronavirus, in addition to people’s good personal hygiene and social distancing practice, since COVID-19 is highly contagious and an increased testing capacity will definitely find more infections, government officials have to learn that the number of positive cases is not an optimal indicator to monitor pandemic control and hospitalization is. Singapore is the best example regarding this. As of July 9, this city state, with 6 million residents, has reported 45,423 positive cases through its aggressive testing protocol. But Singaporeans did not panic. They watched hospitalization rate carefully. Their well-prepared medical system has controlled the death toll as low as 26.



In addition, the public health system needs to offer extra care to the elderly, especially those who live in nursing homes, to avoid the mistakes many countries have made in the past several months, which caused a lot of deaths among the seniors. The system also needs to remind the other high-risk group - people with underlying medical conditions, such as hypertension, diabetes and lung disease - to try their best to get their chronic illness under control before the coronavirus hits our community again.




Ref. 1 The Lancet:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext

Ref. 2 Proceedings of the National Academy of Science:

https://www.pnas.org/content/early/2020/06/10/2009637117

Ref. 3 Nature:

https://www.nature.com/articles/s41586-020-2404-8

Ref. 4 Nature:

https://www.nature.com/articles/s41586-020-2405-7

Ref. 5 The Economist:

https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries

Ref. 6 Bloomberg:

https://www.bloomberg.com/graphics/2020-opinion-coronavirus-europe-lockdown-excess-deaths-recession/