As mass infections strike even in places that had seemed to tame the coronavirus, officials are turning to targeted and fast-but-flexible approaches to stop third or fourth waves.
Giving a coronavirus swab test in Beijing on Monday.
Giving a coronavirus swab test in Beijing on Monday.Credit...Kevin Frayer/Getty Images
By Sui-Lee Wee, Benjamin Mueller and Emma Bubola
June 24, 2020
Updated 1:30 p.m. ET
China is testing restaurant workers and delivery drivers block by block. South Korea tells people to carry two types of masks for differing risky social situations. Germany requires communities to crack down when the number of infections hits certain thresholds. Britain will target local outbreaks in a strategy that Prime Minister Boris Johnson calls “Whac-A-Mole.”
Around the world, governments that had appeared to tame the coronavirus are adjusting to the reality that the disease is here to stay. But in a shift away from damaging nationwide lockdowns, they are looking for targeted ways to find and stop outbreaks before they become third or fourth waves.
While the details differ, the strategies call for giving governments flexibility to tighten or ease as needed. They require some mix of intensive testing and monitoring, lightning-fast response times by the authorities, tight border management and constant reminders to their citizens of the dangers of frequent human contact.
The strategies often force central governments and local officials to share data and work closely together, overcoming incompatible computer systems, turf battles and other longstanding bureaucratic rivalries. Already, in Britain, some local officials say their efforts are not coordinated enough.
The shifting strategies are an acknowledgment that even the most successful countries cannot declare victory until a vaccine is found. They also show the challenge presented by countries like the United States, Brazil and India, where the authorities never fully contained initial outbreaks and from where the coronavirus will continue to threaten to spread.
“It’s always going to be with us,” said Simon James Thornley, an epidemiologist from the University of Auckland in New Zealand. “I don’t think we can eliminate the virus long term. We are going to need to learn to live with the virus.”
ImagePedestrians wearing face masks in Seoul, South Korea, on Tuesday.
Pedestrians wearing face masks in Seoul, South Korea, on Tuesday.Credit...Jung Yeon-Je/Agence France-Presse — Getty Images
Even in places where the coronavirus appeared to be under control, big outbreaks remain a major risk. In Tokyo, there have been 253 new infections in the past week, 83 from a nightlife district. In Gütersloh in western Germany, more than 1,500 workers from a meat processing plant tested positive, prompting the authorities to shut down two districts. South Korea, another poster child for fast responses, has announced dozens of new infections in recent days.
In Rome, which recently emerged from one of the strictest lockdowns in Europe, 122 people have been linked to a cluster case at a hospital, the San Raffaele Pisana Institute. Several days later, 18 people who lived in a building with shared bathrooms came down with the virus.
“As soon as we lowered our guard,” said Paolo La Pietra, who owns a tobacco shop in the neighborhood, “it hit us back.”
Some countries, like South Korea and Japan, aimed to make their responses nimble.
South Korea calls its strategy “everyday life quarantine.” The country never implemented the strict lockdowns that were seen in other places, and social-distancing measures, while strongly encouraged, remain guidelines. Still, it has set a strict target of a maximum of about 50 new infections a day — a target that it says its public health system, including its testing and tracing capacity, can withstand.
Officials shift the rules as needed. After a second wave of infections broke out in Seoul, city officials made people wear masks in public transportation and closed public facilities for two weeks.
The South Korean government has added new guidelines as it has learned more about outbreaks. It advises companies to have employees sit in a zigzag fashion. Air-conditioners should be turned off every two hours to increase ventilation, it said. It has discouraged singing in markets and other public places.
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A Tokyo cinema earlier this month.
A Tokyo cinema earlier this month.Credit...Charly Triballeau/Agence France-Presse — Getty Images
It has also advised people to carry two types of masks in summer — a surgical mask and a heavy-duty mask, similar to the N95 respirator masks worn by health care workers, to be used in crowded settings.
Japan, which endured only limited lockdowns, also wants to keep its limits light to help restart its economy. It is considering allowing travelers from Australia, New Zealand, Thailand and Vietnam. As an island nation, Japan cannot afford to keep its borders closed any longer, said Shinzo Abe, its prime minister.
Last Friday, Japan launched a contact tracing app that would alert users if they had been in touch with a person who tested positive in the last 14 days. Railway operators have launched an app and websites telling commuters how crowded the trains are at any given time.
Officials are also warning people constantly to change the way they live. Though bars and clubs are reopening, hostesses have been told to refrain from being next to a client when singing karaoke and dancing. Nightclubs must minimize music and crowd volumes to reduce the spread of respiratory droplets. Citizens are advised to continue avoiding the “Three Cs” — closed, crowded and close-contact activities.
“We need to run the economy strongly by controlling the infection risks with less-restrictive measures and take measures which put more emphasis on protecting jobs and life,” said Mr. Abe.
Some countries, like China, are learning to ease back from their more draconian methods. The Chinese government virtually isolated tens of millions of people in the city of Wuhan and surrounding Hubei Province when the outbreak began.
A restaurant in Hamburg, Germany, earlier this month.
A restaurant in Hamburg, Germany, earlier this month.Credit...Laetitia Vancon for The New York Times
Mindful of the economic damage, Chinese leaders have adopted looser restrictions. In Beijing, officials told residents that they could take off their masks outdoors. Temperature screening in the city became less widespread.
Then, on June 12, Beijing officials announced that 53 people had tested positive for the coronavirus. Instead of locking up the capital city, officials promptly shut down a market and residential communities surrounding it and mobilized close to 100,000 community workers to test roughly 2.3 million residents in about a week.
“A city as big as Beijing can’t be in a state of wartime resistance forever,” said Mao Shoulong, a professor of public policy at Beijing’s Renmin University. “How many more times can we endure this?”
Unlike Wuhan, the effort was targeted. Other Beijing neighborhoods stayed open as usual. The Chinese government tends to favor a mass testing approach focused on specific groups — in addition to the people connected to the market, it said it would also test residents living in high- and medium-risk neighborhoods, restaurant and retail staff, students and teaching staff, and health care workers.
The Coronavirus Outbreak
Frequently Asked Questions and Advice
Updated June 24, 2020
What’s the best material for a mask?
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
Is it harder to exercise while wearing a mask?
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
I’ve heard about a treatment called dexamethasone. Does it work?
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
What is pandemic paid leave?
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
Does asymptomatic transmission of Covid-19 happen?
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
What’s the risk of catching coronavirus from a surface?
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
How does blood type influence coronavirus?
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
How many people have lost their jobs due to coronavirus in the U.S.?
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
What are the symptoms of coronavirus?
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
How can I protect myself while flying?
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
China’s strategy is not to bring infections to zero, said Zhang Wenhong, an adviser to the Shanghai government on the pandemic. Instead, in an interview with China’s Caixin magazine, he described China’s game plan as “getting close to zero cases.”
“Prevention and control with precision, coupled with rapid medical treatment,” Dr. Zhang said. “This strategy will be applicable to China for a long time.”
European governments are also learning to be more flexible following their strong responses, though the process can be slow. In Germany, officials have stipulated that regions or municipalities that register more than 50 new infections per 100,000 people in seven days must quickly respond to quell the outbreak, using tools like school closings, full quarantines and mass testing.
A shoe shop in Southampton, England, this month.
A shoe shop in Southampton, England, this month.Credit...Adrian Dennis/Agence France-Presse — Getty Images
Though many of these efforts are intensely local, they require close coordination with central officials and neighboring jurisdictions. England, for example, is exploring limited, tailor-made shutdowns around clusters of infections, but local officials warn that the system is full of potential holes.
Health officials in England, Wales, Scotland and Northern Ireland are largely responsible for their own strategies. In England, where local officials have complained about a lack of testing data from the central government, employers or building managers have picked up the slack by keeping track of infections and respond to outbreaks. Some, like the headquarters of a major retailer in East Lancashire, have been praised by public health officials for taking quick action.
But controlling the virus would require an understanding of where it is lurking, especially difficult for a disease in which 80 percent of the cases have mild symptoms. Several local public health directors said in interviews that they learned about outbreaks from the news. The level of detail that officials need to decide on localized shutdowns — the postal codes of people testing positive, for example — remains elusive.
“Every pandemic begins as a local outbreak,” said Lincoln Sargeant, the director of public health in North Yorkshire. “It’s granular intelligence that we need in a timely fashion.”
Mr. Johnson, the prime minister, has maintained that local shutdowns are sufficient to control new waves of the virus. In the beginning, the government “had very few instruments at our disposal,” he said on Friday. Now, he said, officials can “identify outbreaks where they happen.”
He has likened the effort to Whac-A-Mole, the decades-old arcade game. Officials can “take the preventive measures necessary on the spot, rather than going back to the national lockdown approach,” he said. “That’s what we hope.”
In Rome, the outbreak at the San Raffaele Pisana Institute tested the ability of the local authorities to find and stop outbreaks.
Local health officials tested patients and staff at the hospital, emptied three wards and sealed off the building. Former patients and their contacts queued in their cars outside drive-in testing stations. Rome’s prosecutors opened an investigation into clusters’ origin.
One of the people who became ill was a pulmonologist, Vittorio Bisogni. He came down with a slight fever after he visited a patient who had been released from the hospital. Dr. Bisogni was diagnosed with the virus on June 9. His patient died a few days later.
More staff leaving the Roosevelt school.
How is KB and SC doing in the high school? Heard the teachers don't respect them for the out come and CT doing nothing but, rewarding them.
Did the school committee pass the vote so CT and her gain can check and fire you if you use her computers and go on face book.
A evil women is worst than a evil man.
I hope neither of the two previous posters is an English teacher!
"This string your able to just type on it and it's not to be graded. "
If this person truly is a teacher, Melrose Schools are in a great deal more trouble than already known.
Hey teacher, it doesn't take an English teacher to know that "your able" is supposed to be "you're able." If this is the writing of a "teacher," this individual is functionally ILLITERATE! "Your" [You're] a true embarrassment who probably couldn't pass the 5th-grade MCAS.
Great Article in Malden News Paper today on Mystiv Valley Charter school. The MTA is representing teachers who MV tried to collect liquidated damages from after taking higher paying jobs at Public Schools. The richest piece of data available is that the Charter has a 29% annual teacher turnover rate since 2009...WTF.
How come CT will let a person that works for the school become a teacher without the full degree. Some say if she knows your a hard worker and she likes you she will hire you for a position. Then she lets you finish school so you have the proper degree. My friend has been trying so hard and never gets the position. Maybe she should go to another city instead of Melrose. Anyone have any ideas on what she should do?
Medford schools are far superior to Melrose, just look at the curriculum.
The teachers, police, fire, should be able to get a make over like the city is in Melrose. It don't matter if its Medford, Melrose, or Malden. Winchester is a great place if you can travel. My friend loves Belmont they are so much for the staff. They have so many programs to have a happy environment in the Belmont Schools.
Over worked and under paid the fire, police and teachers. The respect is so bad for the men and women in these position now. The teachers are just becoming bullies, police ride around doing nothing, the fire department cant wait for their pensions. CT will be soon leaving Melrose with so much depth that Melrose will go close to bankruptcy again. Move on from Melrose if you haven't invest to much time. The teachers are on their cell phones majority of the time I volunteer and see it everyday. Vote yes on question 2.
Please dear God, please tell me this woman is not volunteering in my child's English class.
I'm trying to figure out all these convoluted stories about fraud being committed by school department staff. Why isn't this the big story? We are cutting staff at the High School, cutting services to kids, cutting paras in the kindergarten. And, according to these posters, we have school personnel falsifying time cards and paying staff for days they are not here? That's fraud, and everyone involved should be fired.
I'd love to see the Free Press investigate this.....
Sorry don't depend on administration helping staff that are being bullied in the work place. The bulling that goes on in Melrose is unthinkable. I witnessed the other day teachers planning a strategy to hurt a staff member. This don't matter the teachers will sit and laugh at what is going on. The thing that bothers me is I am a teacher and didn't think this existed. Glad I have not invested time in Melrose and will be looking elsewhere.
Stay for the three years in Melrose. Use the administration like they are using you. Then see if at the end of your third year you get hired. You should not stay in Melrose the pay is much lower than other cities. If your young keep looking for another schools. Its good to get your practice and mistakes in the first three years of teaching. Melrose is loaded with first year teachers. Hope the mentors are being helpful and not wishing for failure. When people say it happens everywhere that is not true in Melrose its worse here.
...goes around. Notice how many teachers give notice in July or August leaving the superintendent and principals in the lurch? This is what happens when an administrators disrespect their teachers. Teachers do talk and then the word gets around the educational community that Melrose administrators disrespect their teachers and students as well as parents. Or they could watch this all play out on MMTV school committee meetings as the school committee chair disparages members of the public who speak during public comment.
When a competent reporter shows up in Melrose and starts reporting the truth about the corruption within city hall and school administration, they are swiftly moved out of town, such as Aaron Leibowitz, who apparently wrote one too many accurate articles about the myriad MPS scandals.
I would report this to the head of the schools which is the superintendent or her assistance. You have a better chance of hearing back from the superintendent. Or go directly to the SC meeting on Tues. at city hall. Tell them quickly whats happening in your school. The problem is you have 5 minutes to speak then you have to stop. With this situation you will be so humiliated from your staff it might not be worth it.
Aaron had a GREAT story about racism and despicable treatment of black mentors and sped students. He had statements from staff and black mentors. What happened you ask? His editor went with him to see Cyndy and the story was killed. Worse, is those mentors who were honor students will no longer assist in SC's class and the racist teacher was brought into MHS by recently promoted CB as Asst. Principal is still there. Those students are left in her grossly incompetent hands.
Did you see a draft? I would love to read it.
bullying (not bulling)
Why would anyone with an ounce of awareness think that calling the very people responsible for promoting and allowing such conduct, responsible for the "racially hostile environment," as the federal investigators have documented, responsible for the pervasive atmosphere of intimidating staff, parents and students, would be the appropriate authorities to call to report more of this? This is craziness.
I would like the proper channels even if its in the school department. I type with my phone and then I leave out letters when I press post. That's not the point of the story and to be critical of that is very child like and needs to get a life.
You might not ever hear from P.W.L. she never returns calls and if your being bullied you are better off to get a Lawyer.
"Get a life" epitomizes the kind of immaturity that goes right along with the bad culture here. No, the person who wrote to "Get" wasn't a bully, just someone being realistic and factual towards someone who isn't mature enough to accept legitimate criticism. Calling "Reality" a bully is just classic projection, done by people who typically are actual bullies themselves. Too many people try to blame their electronic devices for their own sloppiness and poor communication, starting with the top bosses in this school district, who are abysmal communicators and always blame everyone but themselves.
This superintendent needs to go.
Medford schools are far more superior than Melrose. The advantage is the school is Kindergarten through eighth grade. Everyone in the schools adjust better to this type of environment. My uncle works in the McGlynn School in Medford and has a lot of good stories.
But the reporter, Aaron, who was reporting the controversial stories was moved to Malden. I would like to read his behind the scenes tell-all of his time in Melrose.
He was too good for his own good. I imagine it was eye opening for him working the beat here.
Ms. Taymore should be leaving.Not the teacher;s.Not good for are children and families.