What lessons can we learn from the second wave of coronavirus in Asia

How the situation developed in Hong Kong, Singapore and Taiwan

These three areas have long been regarded as paradigms for how to deal with the coronavirus outbreak: halting the growth of infection while leaving the economy largely unaffected. Instead of introducing quarantine, they tested the population, identified contacts of infected people, isolated cases and tightened travel restrictions. Life did not go on quite as usual, but still did not turn into total isolation.

In recent weeks, the situation has changed: a second wave of infection has occurred in these regions. The rules have also changed. All Hong Kong residents who are now flying into the city take saliva samples, the rest are simply prohibited from entering. These measures, together with the issuance of bracelets that track the location of arrivals, were taken in order to try to contain the new wave of infections.

It was recorded at the end of March and was caused mainly by the return of local residents from those countries where the coronavirus raged: Great Britain, European countries, the United States. This created additional tension on the territory of Hong Kong: people accused the returning fellow citizens of spreading the disease. But the authorities have identified small local foci of infection, including in an area famous for its nightlife. The increase in the number of cases led to the fact that meetings of more than three people were prohibited in the city, slot machine halls, sports centers, cinemas, bars and restaurants were closed. And the travel restrictions were extended indefinitely.

Singapore, too, initially managed to avoid mass closings, but when the number of confirmed cases exceeded 1,000, the country took more stringent measures. Now you can go outside only for vital services, to visit a doctor or to exercise alone, and you need to maintain a distance. Restaurants work only for pickup and delivery, schools are closed. This second wave of infections has been linked to poor living conditions for migrant workers.

Taiwan has not yet moved into self-isolation, nor has it lifted its strict travel restrictions. And that could become the new normal, at least until effective and universally available treatment is available, or until most people in the world develop immunity from the vaccine.

What does this mean for all of us

We will have to be in self-isolation more than once

Social distancing measures can be a tool that will have to be turned to again. They will be intensified and then mitigated along with new outbreaks of the virus.

As long as the disease is in one place, there is a chance that it will spread everywhere. According to Hong Kong epidemiologist Gabriel Leung, everyone should prepare for several rounds of entering and lifting restrictions. This is necessary so that the epidemic is under control, and the economic and social consequences are not dire.

Hong Kong, Singapore and Taiwan are now actually following this course, albeit to varying degrees. They use testing, contact tracing, movement restrictions, and social distancing as a brake to press when an outbreak occurs and release when things get back under control.

Continuous adaptation and flexibility will be required

“Responsiveness to the epidemic is a dynamic process that needs adjustment,” said Keiji Fukuda, head of the School of Public Health at the University of Hong Kong."While we all hope to get back to normal life as soon as possible, countries are best served with dynamic monitoring and regulation until the vaccine is widely available."

And according to US epidemiologist Jennifer Nuzzo, an effective strategy to contain the coronavirus must include measures to deal with each case. That is, identifying and isolating the infected, checking their contacts and further monitoring.

Of course, Hong Kong, Singapore and Taiwan have advantages that other countries do not have. They are relatively small in size and Taiwan and Singapore are islands, so it is easier for them to control who crosses their borders. Plus, they've learned a lot from previous viral outbreaks. For example, Hong Kong has been actively investing money to be prepared for new infections since the SARS epidemic in 2004. The population is well informed and voluntarily changes their habits in addition to the officially adopted measures.

We can't give up social distancing until a vaccine or drug is available

In some form, isolation will be inevitable. “It’s enough to look at the experience of the past four months in Wuhan to understand that even the most extensive movement restriction measures in modern history have not stopped transmission of the virus in China,” said epidemiologist Michael Osterholm of the University of Minnesota.

Of course, the upcoming coronavirus antibody test will help people and authorities know who has been infected and if they have immunity. This, in turn, will allow many countries to reopen. But social distancing can stay with us even then. So far, no country has managed to completely prevent new outbreaks. As long as the coronavirus exists somewhere in the world, there will always be a risk of new infections.