Can putting a city under lockdown stop the spread of a coronavirus?
TORONTO -- Can keeping millions of people inside their own city actually contain the coronavirus? Canadian doctors don’t think so, but say the strategy could at least slow the virus’s spread.
“These are very drastic decisions that don’t work effectively; these are political theatre,” infectious diseases expert Dr. Neil Rau told CTV News Channel.
The Chinese city of Wuhan, the epicentre of the outbreak, was placed on lockdown Thursday. Its population of 11 million no longer have access to the train station and airport. Ferry, subway and bus services have also been halted.
On the roads, police are checking vehicles coming in and out of the city, The Associated Press reports.
“This is not going to actually stem the flow of a virus that is actually readily transmissible and if it isn’t really that transmissible this is overkill, causing huge inconvenience and it’s creating a spectacle,” Rau said.
These measures have expanded to several other neighbouring cities. In Beijing, officials have cancelled major events that are normally a staple of China’s most important holiday, the Lunar New Year.
Rau believes that these measures will likely make people think things are worse than they are.
“It’s going to have even negative economic consequences for travel to China, not just Wuhan. They’re going to go through what we went through in Canada in 2003 (during the SARS outbreak).”
The coronavirus has already spread to several other countries, including the U.S., Japan, Korea, Singapore, Thailand and Vietnam, according to the World Health Organization.
At the time of publishing, 25 deaths had been reported and more than 830 cases had been confirmed.
“It was interesting when the WHO director general was asked, ‘What do you think of this?’ He was quite cautious in his answer, saying China after all is a sovereign country that has a right to make its own decisions,” Dr. Rau added.
Rau said WHO doesn’t want to anger the Chinese government and risk losing their co-operation.
TRAVEL BAN COULD SLOW SPREAD
Dr. Isaac Bogoch, a global health and infectious diseases researcher at Toronto General Hospital Research Institute, told CTVNews.ca the Chinese travel ban was “unprecedented.”
“I can’t think of a time when a travel ban was implemented on such a large population,” he said.
“The key question is: What is the burden of infection in Wuhan? I don’t think that a travel ban will be that effective but it may slow things down.”
Bogoch said if infection is limited outside of Wuhan, then the travel ban could assist public health authorities.
Bogoch said more cases of infection were “extremely likely” elsewhere in China.
“We don’t know the total number of people infected, there could be several thousand more,” he said.
“Chinese public health are on this. They’re clearly taking this seriously. They’re (China) remarkably transparent in some of their data.”
Bogoch said a lot of lessons were learned from the SARS outbreak in 2003, which saw millions of passengers screened at Canadian airports.
According to a Canadian government report on SARS, some 25,000 residents in the greater Toronto area were quarantined. The effort was a waste of money and human resources and didn’t pick up a single case of the disease.
There were hundreds of cases of infection and 44 people died.
“Thermography (checking passengers temperature) is not the most effective way to track new cases because they have an incubation period,” Bogoch explained.
“People have to show the right signs. It’s influenza season across the northern hemisphere which can give the wrong read. But I’m not acutely against it if there are the resources.”
He said education and awareness were more effective and suggested identifying at risk passengers at the airport and advising them to report to health authorities if they have a fever or cold in the following weeks.
Jonathan Ball, a professor of virology at the University of Nottingham in England, told The Associated Press the lockdowns appear to be justified scientifically.
"Until there's a better understanding of what the situation is, I think it's not an unreasonable thing to do," he said. "Anything that limits people's travels during an outbreak would obviously work."
But Ball cautioned that any such quarantine should be strictly time-limited. He added: "You have to make sure you communicate effectively about why this is being done. Otherwise you will lose the goodwill of the people."
OTHER EXAMPLES OF QUARANTINES AND TRAVEL RESTRICTIONS
Travel restrictions or quarantines have been used for centuries in a bid to contain contagious diseases.
During the devastating West Africa Ebola outbreak in 2014, Sierra Leone imposed a national three-day quarantine as health teams went door-to-door searching for hidden cases.
In 2009, during the outbreak of H1N1 swine flu, some countries imposed travel restrictions on flights coming from and going to Mexico. A study two years later found it “only led to an average delay in the arrival of the infection in other countries (i.e. the first imported case) of less than three days.”
“No containment was achieved by such restrictions and the virus was able to reach pandemic proportions in a short time,” the authors wrote.
A 2006 study which looked at methods to stop the spread of H5N1 bird flu found “restricting travel after an outbreak is detected is likely to delay slightly the time course of the outbreak without impacting the eventual number ill.”
Researchers in the U.S. found a temporary flight ban following 9/11 didn’t stop the spread of the flu, but delayed it by a couple of weeks and led to a prolonged flu season.
A review of HIV/AIDS travel restrictions in the 1980s found they were “ineffective, impractical, costly, harmful and may be discriminatory.”
With files from The Associated Press