meditrina - I think the reason there is no sign of an exit plan is that there is no imminent need for it.
I think there is. The following is from the transcript of yesterday's WHO briefing. It's very hopeful but it sets out clearly what we need to be doing now:
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Ben Qui, People's Daily: Thank you for taking my question. There is a positive signal about a lot of the things the DG said last week so how do you assess the current situation in Europe. Do you expect the turning point to come in one or two weeks for most European countries?
Dr Michael Ryan: Obviously we all dearly hope that that is the case and we've certainly seen a stabilisation in a number of countries in the direction of travel of the epidemic curve and the intensity of increase has stabilised and some countries have actually begun to see a pretty consistent drop first in the number of hospital admissions but then we should start to see that follow through.
Deaths take a little bit longer to drop because many people are in hospital already and some unfortunately may die so we look at the number of confirmed cases and we look at the number of hospitalisations as the first indicator that things may be stabilising and we're certainly seeing that.
It's of great credit to people all over the world and particularly from badly-affected European countries that they've stuck with the task of physical distancing and stay-at-home orders and that that's taken the pressure out of the epidemic but by no means does that mean that it's over. Now is the time for vigilance, now is the time to double down, now is the time to be very, very careful.
That does not mean that countries cannot begin to create an exit strategy, it doesn't mean that countries shouldn't be actively planning to do that but, as the Director-General said, in that sense there are things that need to be done. You can't replace lock-down with nothing. You must replace lock-down with a very deeply educated, committed, empowered and engaged community. We are going to have to change our behaviours for the foreseeable future and we've seen a huge embracement of that by people.
In the vast majority of cases that has not needed to be enforced. The vast majority of citizens are doing what they can for themselves and to protect others but we are going to have to have those adapted behaviours in terms of personal hygiene, physical distancing, being careful for a long time.
So the base of moving out of lock-down is communities on the alert, communities aware of the risks and communities taking action and continuing to take action to protect themselves and others. That needs to be backed up with a way of finding the virus. At the moment everybody is suffering because everyone has to be separated. That's because countries don't know exactly where the virus is.
The only way to get out of this is to find the virus. The only way we find the virus is to identify those people who may be infected and test and isolate, find contacts and quarantine contacts. That is in a sense - community empowerment, community involvement and public health intervention through the use of case finding, isolation, contact and quarantine is the alternative to having lock-down - and having a health system that's capable of absorbing any increase in cases.
We need to continue that strength in the health system. It's incredible how health systems have adapted and how hospitals have expanded, how they've done amazing things, absolutely incredible things over the last number of months and they have saved many, many lives but we're going to have to sustain that capacity and health workers are going to have to continue to have protective equipment and we're going to have to continue to have intensive care beds on stand-by because as we come out of these locked-down situations we may see a jump back up in cases and we don't want to lurch from lock-down to nothing to lock-down to nothing.
We need to have a much more stable exit strategy that allows us to move carefully and persistently away from lock-down and the only way to do that is to have fully empowered communities and a fully activated public health architecture and a strengthened health system.
Dr Maria Van Kerkhove: A small addition to that to say, it's really important that the lifting of these measures doesn't happen all at once all over Europe and we completely understand - we're in the same situation - the desire to want to release those and get people back to work and kids back to school and all that.
But it's really important that it's not done all at once because if the systems are not in place - as has just been outlined - the systems to identify where the virus is, to isolate cases, to find the contacts, to treat the cases, to have the beds free to actually care for patients - then you're going to be overwhelmed again.
So what could happen is if they're lifted in certain strategic areas maybe where there's lower incidence and if that can happen slowly then the system can divert where it needs to go to be able to quickly identify those cases while other parts of the country may still have those restrictive measures in place.
But it does have to happen slowly, it does have to happen in a very controlled manner and it is important that the community understands this because it may be a little bit longer that you have to remain at home or you have to work from home or schools may need to be closed but again this is temporary. I know it seems like a long time now but it is temporary so not lifting all at once is very critical so that we can get people back to work, get these economies going back again as quickly as possible.