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      Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe

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          Abstract

          The COVID-19 pandemic is an unprecedented global crisis. Many countries have implemented restrictions on population movement to slow the spread of severe acute respiratory syndrome coronavirus 2 and prevent health systems from becoming overwhelmed; some have instituted full or partial lockdowns. However, lockdowns and other extreme restrictions cannot be sustained for the long term in the hope that there will be an effective vaccine or treatment for COVID-19. Governments worldwide now face the common challenge of easing lockdowns and restrictions while balancing various health, social, and economic concerns. To facilitate cross-country learning, this Health Policy paper uses an adapted framework to examine the approaches taken by nine high-income countries and regions that have started to ease COVID-19 restrictions: five in the Asia Pacific region (ie, Hong Kong [Special Administrative Region], Japan, New Zealand, Singapore, and South Korea) and four in Europe (ie, Germany, Norway, Spain, and the UK). This comparative analysis presents important lessons to be learnt from the experiences of these countries and regions. Although the future of the virus is unknown at present, countries should continue to share their experiences, shield populations who are at risk, and suppress transmission to save lives.

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          Most cited references13

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          Management of post-acute covid-19 in primary care

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            Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong

            Objective: To describe the infection control preparedness measures undertaken for coronavirus disease (COVID-19) due to SARS-CoV-2 (previously known as 2019 novel coronavirus) in the first 42 days after announcement of a cluster of pneumonia in China, on December 31, 2019 (day 1) in Hong Kong. Methods: A bundled approach of active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers (HCWs) with unprotected exposure in the hospitals was implemented. Epidemiological characteristics of confirmed cases, environmental samples, and air samples were collected and analyzed. Results: From day 1 to day 42, 42 of 1,275 patients (3.3%) fulfilling active (n = 29) and enhanced laboratory surveillance (n = 13) were confirmed to have the SARS-CoV-2 infection. The number of locally acquired case significantly increased from 1 of 13 confirmed cases (7.7%, day 22 to day 32) to 27 of 29 confirmed cases (93.1%, day 33 to day 42; P < .001). Among them, 28 patients (66.6%) came from 8 family clusters. Of 413 HCWs caring for these confirmed cases, 11 (2.7%) had unprotected exposure requiring quarantine for 14 days. None of these was infected, and nosocomial transmission of SARS-CoV-2 was not observed. Environmental surveillance was performed in the room of a patient with viral load of 3.3 × 106 copies/mL (pooled nasopharyngeal and throat swabs) and 5.9 × 106 copies/mL (saliva), respectively. SARS-CoV-2 was identified in 1 of 13 environmental samples (7.7%) but not in 8 air samples collected at a distance of 10 cm from the patient’s chin with or without wearing a surgical mask. Conclusion: Appropriate hospital infection control measures was able to prevent nosocomial transmission of SARS-CoV-2.
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              Social network-based distancing strategies to flatten the COVID-19 curve in a post-lockdown world

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                Author and article information

                Journal
                Lancet
                Lancet
                Lancet (London, England)
                Elsevier Ltd.
                0140-6736
                1474-547X
                24 September 2020
                24 September 2020
                Affiliations
                [a ]Saw Swee Hock School of Public Health, National University of Singapore, Singapore
                [b ]Department of Nursing and Health Sciences, University of South East Norway, Drammen, Norway
                [c ]Medical Faculty, University of Maribor, Maribor, Slovenia
                [d ]College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
                [e ]LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
                [f ]Institute for Population Health, King's College London, London, UK
                [g ]Asia Pacific Observatory on Health Systems and Policies, World Health Organization Regional Office for South-East Asia, New Delhi, India
                [h ]College of Medicine, Seoul National University, Seoul, South Korea
                [i ]ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
                [j ]Centro de InvestigaÇão em SaÚde de ManhiÇa, Maputo, Mozambique
                [k ]Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
                [l ]Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
                [m ]Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
                [n ]Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
                [o ]The Helen Clark Foundation, Auckland, New Zealand
                Author notes
                [* ]Correspondence to: Dr Helena Legido-Quigley, Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549
                [†]

                Joint first authors

                Article
                S0140-6736(20)32007-9
                10.1016/S0140-6736(20)32007-9
                7515628
                220f8147-b3b5-45cc-b092-712b0e113c99
                © 2020 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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