Nations racing to reopen warned against ‘driving blind’ without contact tracing

Nations racing to reopen warned against ‘driving blind’ without contact tracing

WHO emergencies chief says virus can flare-up again if no robust systems in place to find those who were in contact with confirmed cases; experts say phone data may not cut it

Customers drink on a terrace bar in Tarragona, Spain, Monday, May 11, 2020. (AP/Emilio Morenatti)
Customers drink on a terrace bar in Tarragona, Spain, Monday, May 11, 2020. (AP/Emilio Morenatti)

NEW YORK — A top world health official Monday warned that countries are essentially driving blind in reopening their economies without setting up strong contact tracing to beat back flare-ups of the coronavirus.

The warning came as France and Belgium emerged from lockdowns, the Netherlands sent children back to school, and many US states pressed ahead by lifting business restrictions.

Israel has also raced to reopen over the past two weeks, lifting restrictions on movement and loosening some enforcement of social distancing measures. Malls and gyms have been allowed to reopen, parks are again filled with people and most students are returning or have returned to school, with plans in the coming weeks for increased public transportation and the possible reopening of restaurants and beaches.

It has also taken steps to ease quarantine measures, no longer requiring those returning from abroad or who were in contact with confirmed cases to enter supervised isolation at specially designated hotels, instead allowing them to return home and quarantine there.

Authorities have cautioned that the scourge could come back with a vengeance without widespread testing and tracing of infected people’s contacts with others.

A health official wearing protective gear sprays disinfectant to help reduce the spread the new coronavirus ahead of school reopening in a cafeteria at a high school in Seoul, South Korea, Monday, May 11, 2020. (AP/Lee Jin-man)

Fears of infection spikes in countries that have loosened up came true in recent days in Germany, where new clusters were linked to three slaughterhouses; in Wuhan, the Chinese city where the crisis started; and in South Korea, where a single nightclub customer was linked to 85 new cases.

Michael Ryan, then WHO Director of Global Alert and Response of the World Health Organization (WHO), at a press conference in Geneva, Switzerland, May 2, 2009. (AP/KEYSTONE/Martial Trezzini)

The World Health Organization’s emergencies chief, Dr. Michael Ryan, said that robust contact tracing measures adopted by Germany and South Korea provide hope that those countries can detect and stop virus clusters before they get out of control.

But he said other nations exiting lockdowns have not effectively employed contact tracing investigators who contact people who test positive, track down their contacts and get them into quarantine before they can spread the virus. The coronavirus can spread before people feel sick, making it important to act quickly. Ryan declined to name specific countries.

“Shutting your eyes and trying to drive through this blind is about as silly an equation as I’ve seen,” Ryan said. “And I’m really concerned that certain countries are setting themselves up for some seriously blind driving over the next few months.”

At the White House, President Donald Trump declared: “We have met the moment, and we have prevailed.” He said later that he was referring to virus testing and insisted all Americans who want tests can get them even though experts say that capacity does not exist.

Only on Monday did his administration say it believed it had enough tests for a nationwide testing campaign to address significant death rates in nursing homes and other senior care facilities.

President Donald Trump speaks about the coronavirus during a press briefing in the Rose Garden of the White House, Monday, May 11, 2020, in Washington. (AP/Alex Brandon)

Worldwide, the virus has infected a confirmed 4.1 million people and killed more than 280,000, including over 150,000 in Europe and about 80,000 in the US, according to a tally by Johns Hopkins University. Experts believe those numbers understate the outbreak’s true toll.

More than 10,000 people are involved in contact tracing in Germany, a country of 83 million, or about one-quarter the size of the United States.

Britain abandoned an initial contact-tracing effort in March when the virus’s rapid spread made it impossible. Now it is recruiting 18,000 people.

France’s health minister has promised robust contact tracing and pledged the country would test 700,000 people weekly. On Monday, with progress unclear, the nation’s highest court ordered the government to take extreme care in protecting privacy rights, casting doubt on how to proceed.

Israel has pointed to South Korea as a model, and says it is planning a massive drive to test 100,000 people for antibodies, in an attempt to better gauge the true spread of a disease that can strike without symptoms. The Health Ministry says it can handle 15,000 tests a day, but too few people with symptoms are showing up to get swabbed, and the number of new confirmed cases has waned sharply, to only a few dozen daily.

While the ministry initially managed a robust contact-tracing program, that effort struggled to keep up with the rising case load at the peak of the outbreak and has since taken a backseat to the controversial use of private phone data in order to track where confirmed cases spent time and alert those who may have been in the same area.

People wearing masks visit an outdoor market in Tel Aviv, Israel, Thursday, May 7, 2020. (AP /Ariel Schalit)

Apple, Google, some US states and European countries are also developing contact-tracing apps that show whether someone crossed paths with an infected person. But the technology supplements and does not replace labor-intensive human work, experts say.

In the US, where health officials will watch closely in coming days for any resurgence of the virus two weeks after states began gradually reopening, contact tracing is a patchwork of approaches and readiness levels. States are hiring and tracing contact tracers, and experts say hundreds of thousands will be needed across the country.

Massachusetts is training more than 1,000 contact tracers aided by software. In the hardest-hit corner of the US, New York, contact tracers began online training Monday. Gov. Andrew Cuomo said some upstate areas can ease restrictions after Friday.

Meantime, a new study indicates that New York City’s death toll from the coronavirus may be thousands of fatalities more than the official tally.

Between mid-March and early May, about 24,000 more people died in the city than researchers would ordinarily expect that time of year, a Centers for Disease Control and Prevention analysis said. That’s about 5,300 more deaths than previously attributed to the virus for the period.

A patient is moved by healthcare workers at Maimonides Medical Center in New York, May 6, 2020. (AP/Mark Lennihan)

The “excess deaths” could have been caused indirectly by the outbreak, in some cases by swamping the health care system and delaying lifesaving care for other health problems, the report said.

Another new CDC report showed how difficult and time-consuming it is to track virus cases. The analysis of California efforts in the early days of the US outbreak found that contacting travelers from China and Iran consumed nearly 1,700 hours of time by local authorities and still didn’t stop the virus from entering the state.

In loosening up their country’s lockdown, German authorities have spelled out a specific level of infection that could lead to the reimposition of local area restrictions.

Israel has also introduced specific metrics for bringing back lockdowns: a 10-day case doubling rate, 100 daily cases outside of high infection zones, or 250 serious cases at any one time. While low caseloads have been sustained for over a week, experts say a second wave of infections is a near-certainty.

Other countries — and US states — have been vague about what would be enough to trigger another clampdown.

With Monday’s partial reopening in France, crowds formed at some Paris Metro stations, but the city’s notorious traffic jams were absent. Half the stores on the Champs-Elysees were open.

A man gets a hair cut at a hairdressing salon in Sevres, outside Paris, Monday, May 11, 2020. (AP/Christophe Ena)

Parisian hairdressers planned to charge a fee for the disposable protective gear they must give customers. Walk-ins will be a thing of the past, said Brigitte L’Hoste, manager of the Hair de Beauté salon.

“The face of beauty will change, meaning clients won’t come here to relax. Clients will come because they need to,” said Aurelie Bollini, a beautician at the salon. “They will come and aim at getting the maximum done in the shortest time possible.”

Hair salons in Florida contended with tight regulations and pent-up demand as they reopened across much of the state. The Fringe Salon in Naples was booked for the entire week, its capacity limited by social-distancing rules.

“It’s just pure chaos. Everybody’s excited about getting their haircut,” said owner Trish Boettcher.

Quarantines reached into the offices of two US governors. Illinois Gov. J.B. Pritzker joined his entire staff in working from home after a top aide tested positive for COVID-19. The state recorded nearly 800 deaths in the seven days ending Sunday, making it Illinois’ deadliest week yet. Iowa’s Gov. Kim Reynolds began a partial quarantine.

In South Korea, the government clamped down again, halting school reopenings planned for this week and reimposing restrictions on nightclubs and bars. It is trying to track down 5,500 patrons of a Seoul nightlife district through credit-card transactions, cellphone records and security footage.

Roughly half of Spain’s 47 million people shifted into looser restrictions, beginning to socialize, shop in small stores and sit outdoors at restaurants. Madrid and Barcelona remained under lockdown.

A visitor covers his face with a mask as he throws a baseball at Griffith Park Sunday, May 10, 2020, in Los Angeles. (AP/Marcio Jose Sanchez)

British Prime Minister Boris Johnson announced a modest easing of the country’s lockdown but urged citizens not to squander progress. Some were confused as the government shifted its slogan from “Stay at Home” to “Stay Alert.” Scotland, Wales and Northern Ireland stuck with the old motto.

Some of the globe’s premier sports leagues were taking steps to resume competition, with men’s Bundesliga soccer in Germany set to start Saturday and U.S. NASCAR racing on Sunday in South Carolina — without fans at the sites.

Major League Baseball owners approved making a proposal to the players’ union that could lead to the season starting around the Fourth of July weekend in ballparks without fans.

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