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Lockdown in Melbourne, July 2020 (Photo by Asanka Ratnayake/Getty Images)
Lockdown in Melbourne, July 2020 (Photo by Asanka Ratnayake/Getty Images)

ScienceJuly 15, 2020

Alert level more: Which parts of the world are going back into Covid lockdown?

Lockdown in Melbourne, July 2020 (Photo by Asanka Ratnayake/Getty Images)
Lockdown in Melbourne, July 2020 (Photo by Asanka Ratnayake/Getty Images)

While there are increasing examples of a return to some lockdown measures, there is little evidence to demonstrate the success of a second lockdown, because it’s too early to tell, write Maximilian de Courten, Bojana Klepac Pogrmilovic and Rosemary V Calder of Victoria University, Melbourne.

The World Health Organisation reported more than 230,000 new Covid-19 cases on Sunday – the world’s largest daily increase during the pandemic. The surge has forced governments in many places across the world to order new lockdowns.

This includes Melbourne, which is back in a six-week lockdown after a second wave of new cases exceeded the city’s first peak in late March.

But Melbourne is not the only city to suffer a second wave of the pandemic. Cities including Beijing and Leicester had lifted Covid-19 restrictions, only to re-enforce them when new outbreaks occurred.

So how have other cities gone about their second lockdown, and have the measures been effective in tackling the Covid-19 resurgence? Let’s take a look at a few examples.

Lockdowns return

Though there’s no strict definition of a lockdown, it describes the controls imposed by governments to restrict the movement of people in their communities. It’s often achieved through a combination of police presence and applying public health regulations.

It can be implemented partially, progressively or fully. The latter is called “hard lockdown” when the freedom of entry to, and exit from, either an entire building or geographic area is prohibited or limited.

The Segrià region in Catalonia, Spain re-entered an indefinite partial lockdown on July 4 following a significant spike in cases and Covid-19 hospitalisations.

The city of Leicester in the United Kingdom has gone into a second lockdown after it accounted for 10% of all positive Covid-19 cases in the country at the end of June. The city has been in lockdown for the past two weeks and despite this, the latest data show an increase in the numbers of cases.

A second wave in Beijing was tackled by increasing degrees of lockdowns. The strictest measures were limited to a few high-risk neighbourhoods, accompanied by a ring of looser lockdown measures around them.

Alongside this was extensive and widespread testing, with a peak capacity of 300,000 tests per day. This approach proved successful – the city reported zero new Covid-19 cases on July 7.

While there are increasing examples of a return to some lockdown measures, there are no examples demonstrating the success of a second lockdown – other than in Beijing – because it’s too early to tell.

Clear public health messaging is key

When entering a second lockdown, it’s useful to consider the lessons learnt from the first. Initial lockdowns in both Italy and India provide cautionary tales on what happens when public messaging and enforcement is flawed.

Italian media published information about internal movement restrictions a day before the Italian prime minister officially announced it and signed the decree. At the time, only northern Italy was heavily affected by Covid-19.

After the news spread, workers and students, many of whom carried the virus, rushed back home across the country, flooding the train stations. Even though the goal was to reduce the spread of the virus, the effects were the opposite. Soon after, it was discovered that new Covid-19 cases in southern Italy were families from students who came home from the north.

Similar panic among migrant workers occurred in India when the prime minister gave the public only a few hours notice before the start of the lockdown. This is just one reason why India’s lockdown has been labelled as “a spectacular failure”.

Lockdown, relax, lockdown, relax

After a lockdown, the majority of the population remains at risk of infection without a vaccine. So as restrictions ease, cases are likely to increase again, leading to a pattern of lockdowns, relaxation and renewed lockdowns

So why can’t governments just aim to eliminate the virus? An elimination strategy requires strict, intensive lockdowns and closing external and internal borders to eradicate local transmission and prevent the virus being imported.

Elimination strategies have worked in only a few countries and regions, such as New Zealand which imposed an early and strict lockdown.

The effectiveness of lockdowns can be diminished by increasing population fatigue in response to reimposed restrictions.

Lockdowns also have many serious repercussions, including a severe impact on mental health and the economy. French prime minister Jean Castex has ruled out another total lockdown arguing that its economic and human consequences are disastrous.

Locking down a given country can cost up to 3% of GDP per month, according to UBS Global Wealth Management.

Lockdowns can work if masks are used

It’s clear that lockdowns cannot be maintained indefinitely. That’s why the rapid development of a vaccine to achieve herd immunity, without extensive infection, is critical – along with the development of drugs to relieve the symptoms of Covid-19.

So how long should Melbourne’s lockdown last? The Grattan Institute has argued it should continue until there are no more active Covid-19 cases in the community to eliminate the virus – and after that, should remain in place for another two weeks.

We argue that the duration of the lockdown could be halved if paired with mandatory universal use of face masks. Wearing masks lowers the risk of spreading and contracting the disease.

Maximilian de Courten is Health Policy Lead and Professor in Global Public Health at the Mitchell Institute, Victoria University; Bojana Klepac Pogrmilovic is Research Fellow in Health Policy at the Mitchell Institute for Education and Health Policy, Victoria University, and Rosemary V Calder is Professor, Health Policy, Victoria University. This article is supported by the Judith Neilson Institute for Journalism and Ideas.The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Photo: Getty Images
Photo: Getty Images

ScienceJune 30, 2020

Could nature really be the best medicine?

Photo: Getty Images
Photo: Getty Images

A new breed of medical researchers and ecologists are working together to address the fundamental disconnect between humans and nature, which they say could help solve New Zealand’s worsening public health issues.

We’ve all watched aghast as the impacts of Covid-19 destroy lives and wreak havoc on medical systems worldwide, by overwhelming exhausted staff and depleting healthcare resources. But this epidemic is only one chapter in a much bigger story. Before this outbreak, demands on the global health sector were rapidly increasing due to surges in many chronic human diseases. Although the Covid-19 chapter will eventually end, cumulative impacts of these other diseases will remain.

Aotearoa New Zealand has so far largely been spared the devastating effects of Covid-19, but we have many other serious, growing public health issues to contend with. These include both physical and mental afflictions, and range from asthma (we have one of the highest rates in the world) to diabetes and depression. These are largely preventable diseases influenced by the environmental conditions in which we live.

According to the Ministry of Health, we spend an estimated $20 billion on our healthcare every year. This is about 10.3% of our GDP, and places us at 10th highest in the developed world (compared with other OECD countries). For comparison, the United States holds the number one spot (16.6% GDP) and Mexico 29th (6.1% GDP). And these enormous expenses don’t even capture the intangible costs of human suffering and reduced quality of life associated with disease.

Per-capita health costs in NZ more than doubled over 30 years (Image: NZ Ministry of Health Manatū Hauora)

So what’s causing this huge rise in public health issues and associated costs? Sure, we can blame our couch-potato lifestyles, social media addictions and fast-food binges. Pollution and chemical poisons in our workplaces and everyday life have a role, too. However, by looking carefully we may find a more deeply rooted cause – a fundamental disconnect between humans and nature.

The disconnection from nature as a cause of health decline may be a new concept to many people, perhaps because western medicine has largely developed independently from the discipline of ecology (study of nature’s interactions). In fact, ecology is one of the “new kids on the block” in the western world of scientific disciplines, compared to the ancient field of medicine’s thousands of years of development. We should, however, remember traditional knowledge here (eg mātauranga Māori), which has held nature and medicine as intertwined topics all along. Unfortunately, the dominating world of western science has taken a more divided approach, such that today researchers in the two fields may share the title of “Dr”, but they operate independently, attending separate conferences, reading different journals and using different jargon.

Fortunately, there are exceptions. Some recent, novel collaborations between medical researchers and ecologists suggest that we could learn something crucial from each other to understand and address the human-nature disconnect. It seems the more we look, the more we see hopeful signs that diseases which cost us so much could be countered through exposure to and restoration of nature.

For example, new research suggests that exposure to microbes living in the air of a healthy ecosystem near your home may become part of your own gut microbiome. Our microbiomes – both those inside us and on our skin – have immense effects on mood, auto-immune function and other fundamental aspects of human wellbeing. Knowing that our environment’s microbiome will impact our own is key to how we view what constitutes “healthcare”. This means you don’t need to run a marathon to be healthy (although if you do, yes, we’re all impressed and jealous). But instead of a workout in your local gym, think about visiting your local forest to get that workout by planting trees and getting dirt under your nails. That’s right. By creating such moments of direct contact with nature, we can actually inoculate ourselves with beneficial microbes, essential companion organisms we have co-evolved within nature… well, until our separation from them in very recent history.

My colleagues and I in the newly formed international EcoHealth Network recently published a short forum paper linking these ideas about human health and restoration of nature. In it we advocate that the global health crisis and concurrent degradation of native, functioning ecosystems are fundamentally linked. They have been locked together in a downward spiral – but by restoring ecosystems, we can both safeguard our wellbeing and reduce massive fiscal burdens on the health sector. 

There is already evidence to support this perspective, but to further expand collective knowledge about how human health is tied to nature, we propose five action steps:

  • Collaborations and conversations must occur across the “usual” disciplinary boundaries. Scientists, health professionals, practitioners and policymakers are all needed.  
  • Education and learning of restoration ecologists and health practitioners, together, must occur in order to have a shared understanding of common ground and possibilities for real collaboration.
  • Defining the causal links between ecosystem restoration and human health outcomes is vital to clarify the importance of the ecosystem-human health interface and target future decision and action. 
  • Monitoring restoration and health outcomes will allow for identification of best methods for measuring the health benefits resulting from restoring nature.
  • Community ownership and stewardship is required to push for system change and a fundamental paradigm shift to viewing humans as part of the ecosytems in which we live and on which we depend. This includes recognising and valuing traditional knowledge and world views, which often already see human health as inextricably connected to the natural world. 

This forum paper doesn’t propose to outline the cure for all human disease, nor have we discovered an instant solution to the over-burdened public health system. We’re still developing ideas about how to reverse widespread ecosystem degradation and fragmentation. But together, as medical and ecological scholars and practitioners, we now see where the pathways of healing people and healing nature converge to provide a promising new way forward. 

This isn’t a journey for just us, though. It’s up to everyone to share this vision to make it a reality. So whether you’re a policymaker, healthcare budget manager, a research funder, a restoration practitioner or a voter, you have a role to play.

Dr Kiri Joy Wallace is a member of the EcoHealth Network and a research fellow at the University of Waikato where she discovers how to reconnect people and nature for mutual benefit through the People, Cities & Nature and BioHeritage Science Challenge Scorecard research programmes. She thanks the Science Media Centre and fellow authors of the academic paper mentioned (Dr James Aronson, Dr Laura Orlando and Dr Neva Goodwin) for support in producing this article.