“In countries seeing positive signs, the biggest threat now is complacency.” – WHO Director-General Tedros Adhanom Ghebreyesus

10 June 2020 – With the COVID-19 pandemic receding in some countries and cities, the United Nations is working with Governments to fine-tune plans to reopen battered economies, warning that complacency and lifting “stay-at-home” orders and other restrictions too fast could invite a second wave of new cases.

In some countries, businesses are slowly opening again and an increasing number of children are returning to school, following a few months of pandemic-induced closures. Elsewhere, the outbreak is yet to peak.

The World Health Organization (WHO) confirmed that although the pandemic is slowing in some parts of the world, including in Europe, it is worsening globally.

New York City, which had been the global epicentre of the pandemic, is now reopening its economy in four phases. While schools remain shut, about 400,000 people have been allowed to return to work under Phase One, which took effect 8 June. However, the United States as a whole continues to report a significant number of new cases and deaths.

A resurgence of new cases is already occurring, even in countries that had successfully flattened the COVID-19 curve, such as the Republic of Korea, China and Germany, after they lifted lockdowns.

Complacency is the “biggest threat”

In countries seeing positive signs, “the biggest threat now is complacency,” said WHO Director-General Tedros Adhanom Ghebreyesus in a recent briefing.

“We continue to urge active surveillance to ensure the virus does not rebound, especially as mass gatherings of all kinds are starting to resume in some countries,” he added.

People at a park with circles indicating to maintain social distance.

The UN health agency urges people to continue to practice frequent handwashing, respiratory etiquette, physical distancing, and to stay home if they are unwell.

“This is far from over,” said Maria Van Kerkhove, a WHO infectious disease epidemiologist.

To date, there is no indication that the virus itself is becoming more easily transmitted or causing more severe disease, she said, stressing that it can, however, “become more dangerous as people grow tired” of keeping up with all the measures in place.

“We must remain strong and vigilant to have governments fully engaged and people fully engaged as these lockdowns are lifted... It's important that no one becomes complacent,” she emphasized.

Guidance on reopening

UN agencies have issued guidance on reopening.  WHO outlined six criteria for lifting restrictions: First, that transmission is controlled; second, that health system capacities are in place to detect, test, isolate and treat every case and trace every contact; third, that outbreak risks are minimized in special settings like health facilities and nursing homes; fourth, that preventive measures are in place in workplaces, schools and other places where it’s essential for people to go; fifth, that importation risks can be managed; and sixth, that communities are fully educated, engaged and empowered to adjust to the “new norm”.

In mid-May, Mr. Tedros said that “to protect lives and livelihoods, a slow, steady, lifting of lockdowns is key to both stimulating economies, while also keeping a vigilant eye on the virus so that control measures can be quickly implemented if an upswing in cases is identified.”

Crowd in front of a street vendor.

He said countries should ask three key questions prior to the lifting of lockdowns: Is the epidemic under control?; is the healthcare system able to cope with a resurgence of cases that may arise after relaxing certain measures?; and is the public health surveillance system able to detect and manage the cases and their contacts, and identify a resurgence of cases?

However, even with three positive answers, releasing lockdowns is both complex and difficult. WHO is working closely with Governments to ensure that key public health measures remain in place to deal with the challenge of reopening.

“Until there is a vaccine, the comprehensive package of measures is our most effective set of tools to tackle the virus,” Mr. Tedros said. 

Schools

As of early June 2020, more than 1 billion students were still out of school due to nationwide school closures, but over 70 countries have announced plans to reopen schools and hundreds of millions of students have returned to the classroom in recent weeks, according to the United Nations Children’s Fund (UNICEF), which  is helping parents understand what a return to school will look like.

WHO advises decision makers to reflect on several key factors when deciding on whether and how to reopen schools: First, a clear understanding about current COVID-19 transmission and severity of the virus in children is needed. Second, the epidemiology of COVID-19 where the school is geographically located needs to be considered. Third, the ability to maintain COVID-19 prevention and control measures within the school setting.

When reflecting on the decision to reopen schools, the local government should assess the capacity of the schools to maintain infection, prevention and control measures. (Also see new guidelines on the safe reopening of schools published by the United Nations Educational, Scientific and Cultural Organization (UNESCO), UNICEF, World Food Programme (WFP) and the World Bank.)

People wearing face masks inside an office.

Businesses

WHO has issued detailed new workplace guidelines, which recommend all places of work carry out a risk assessment for workers potential exposure to COVID-19. This includes the implementation of measures to prevent the spread of the virus.

Workplaces should develop action plans for prevention and mitigation of COVID-19 as part of their overall business plan. The plan should also include measures for protecting health, safety, and security in re-opening, closing, and modifying workplaces.

Health response and economic recovery go hand-in-hand

In his remarks to the World Health Assembly on 18 May, UN Secretary-General António Guterres said that there is no choice between addressing the health impact and the economic and social fallout from this pandemic.  “This is a false dichotomy,” he said. “Unless we control the spread of the virus, the economy will never recover. So together with the health response, we need direct support that will keep households afloat and businesses solvent.”