Life as we know it in much of the world has been turned upside down by the coronavirus. But two countries have been widely held up as examples of how to handle a pandemic: South Korea and Germany. Laura Smith-Spark specially for the CNN.
Their approaches were markedly different — but each is now in the enviable position of being able to ease restrictions imposed to quash the spread of coronavirus with some confidence that infections won’t immediately spike again.
So how are they preparing to return to “normal” life? In one word: Cautiously. And those watching enviously from other countries may notice that much remains far from normal.
South Korea — which in February had the largest outbreak outside of China — used a combination of widespread testing, aggressive contact tracing, stern public health measures and digital technology to contain the coronavirus without having to impose a widespread lockdown. It also maintained a strict quarantine regime.
Thanks to these measures, newly diagnosed cases have slowed to a trickle and the national death toll stood at 256 as of Friday, according to its Centers for Disease Control and Prevention.
Against that backdrop, the South Korean government on Wednesday started to relax its strict social distancing rules, imposed on March 22, but only in line with a set of guidelines referred to as the “distancing in daily life” policy.
According to these guidelines, people should stay at home if they become sick with suspected Covid-19 symptoms, continue to keep a distance of 2 meters (6 feet) from others, wash their hands for 30 seconds and keep rooms well ventilated and disinfected regularly. Those aged over 65 and in high-risk groups should continue to stay home and avoid enclosed and crowded spaces.
As the country’s Centers for Disease Control and Prevention stated, the policy “should not be interpreted as implying a return to ‘normalcy’ as before the outbreak but rather as an effort to achieve both infectious disease prevention/control and everyday life.”
In line with this, South Korea’s baseball season resumed Tuesday — but with games played in empty stadiums, while umpires and base coaches wore masks. In one game, instead of the ceremonial first pitch, there was a socially distant start as a boy in a big clear balloon walked from the mound to the catcher.
Children will start to return to school from May 13. Speaking Monday, South Korean education minister Yoo Eun-Hae told students what to expect in this new, post-coronavirus reality.
“As soon as you arrive at a class, you will need to wipe your desk while windows should be opened frequently,” she said. “You will also be required to wear a mask except for at mealtimes and maintain double arm’s length distance when you are on the move or are standing in line. You must remember these rules and we urge you keep them.”
South Korea’s Prime Minister Chung Sye-kyun told a briefing Sunday that closed facilities would reopen gradually and that events and gatherings would be allowed as long as they abide by disinfection guidelines.
“It is so refreshing and stress-relieving to finally be out,” Ju Eun-song, a 32-year-old store sales assistant, told AFP news agency as the restrictions were eased Wednesday.
“As we wrap up social distancing, we’re at a stage where people are getting used to daily life distancing,” Jo Jae-hong, a 38-year-old businessman, told the news agency.
But the emergence Friday of more than a dozen new cases linked to an individual who visited three nightclubs in Seoul last weekend served as a warning of how quickly the virus can regain a foothold. Officials swiftly advised clubs and bars to close for the next month.
Dr. Peter Drobac, a global health expert at the Oxford Saïd Business School, believes that other governments’ experiences indicate that a cautious approach is the right one.
“There’s no strict recipe that will work elsewhere, but there is a set of principles,” he told CNN by email.
“First, flatten the curve — or better still, crush the curve — until there is a sustained decrease in new cases. Opening up when you still have uncontrolled community spread, as in parts of the US, is lunacy.”
Secondly, he said, countries must make sure their health system can cope without crisis measures and that health care workers have the necessary protective equipment; thirdly, massive testing capacity must be in place.
“Fourth, contact tracing — which requires people and technology — and a plan to isolate cases and quarantine contacts. Isolation should not be done at home! That’s where the most transmission happens. I don’t understand why this is being ignored in the UK and the US.”
Lastly, high-risk and vulnerable groups must be protected, he said, as people’s renewed mobility increases the risk of new infections.
“The key to reopening is to offset that risk with testing, tracing, and isolation,” he said. “These are tried and true interventions that break chains of transmission. It doesn’t mean you can get back to normal, but it increases the chances that you can start to open up safely.”
Other countries can learn a lot from South Korea, he said.
“It’s easy to talk about ‘test, trace, isolate’ but hard to do. When you look at the robustness of South Korea’s response, it’s a terrific set of lessons that can be replicated,” Drobac said. “The other important factor in South Korea appears to be transparent communication and public trust. It’s going to be harder in places where the response was mismanaged or politicized, like the US and UK.”
Germans can ‘afford courage’
Germany is also taking a step-by-step approach to reopening for business after a weeks-long lockdown.
Chancellor Angela Merkel told Germans on Wednesday that they could “afford a bit of courage,” but cautioned that “we have to watch that this thing does not slip out of our hands.”
Limits on social contact would remain in place until June 5, she said, but people can now meet with members of one other household as well as their own. People must still remain 1.5 meters (5 feet) apart and cover their mouths and noses in public.
Shops can reopen but with additional hygiene measures, Merkel added, speaking at a news conference following a video meeting with the prime ministers of Germany’s 16 states. “The first phase of the pandemic is behind us but we are still at the beginning and it will be with us for a long time,” Merkel said.
Germany’s top football league, the Bundesliga, will resume play from May 16 — but under tight restrictions and without spectators. It will be the first major European league to return to action.
Germany’s coronavirus response is widely seen as a success story in Europe. The country’s Covid-19 death toll has stayed relatively low compared to other countries and its well-resourced health system allowed its hospitals to accept patients from other, more embattled, European countries. Germany’s advanced diagnostics industry meant it was able to conduct mass testing from early on.
The coronavirus reproduction rate — a crucial measure — is estimated to have fallen to 0.65, the country’s disease control agency, the Robert Koch Institute (RKI), said Thursday. That means that on average, 100 people will infect 65 others.
Currently, Germany is able to carry out 964,000 coronavirus tests per week, the RKI said, although only about one-third of that capacity was used in the past week.
Germany’s relatively cautious approach to reopening appears prudent, Drobac said.
“Daily new cases have dropped into the hundreds — this is not trivial, but it’s a level that can hopefully be managed with a strong system for testing, tracing and isolation,” he said.
Germany’s decentralized governance system, coupled with national coordination, means there is useful local flexibility to decide exactly how and when to ease social distancing recommendations, he said.
“Big cities may need to move more slowly than rural areas, for example. But importantly, Germany has instituted a trigger — if new cases rise above 50 per 100,000, it automatically halts the easing of social distancing. I don’t know if it will work, but it looks like a smart approach based on the evidence we have.”
Lifting lockdown ‘slowly but surely’
Elsewhere, urgent discussion continues on how to lift restrictions on people’s lives and reboot the economy without jeopardizing the progress made in curtailing the spread of the coronavirus. And even as measures are eased, citizens face a very different reality.
In Italy, some 4 million people were allowed to return to work this week — many of them construction and factory workers — and Italians were again permitted to visit family members in the same region. Bars and restaurants reopened, but only for takeaway orders.
Government and church leaders also announced Thursday that masses and weddings could be celebrated in churches from May 18, after being banned for almost two months. But services will not look quite the same.
According to the protocol agreed by leaders, the priest and worshipers will have to wear masks. The priest will give communion wearing gloves and must be careful “avoiding any contact with the faithful’s hands.”
Worshipers will also have to maintain a one-meter (3-foot) distance from others, inside and outside the church, and anyone with a fever will not be admitted.
France will also begin lifting stay-at-home restrictions as of Monday, Prime Minister Edouard Philippe said Thursday. He said it would be a “very gradual process” in order to “slowly but surely” lift lockdown measures.
UK Prime Minister Boris Johnson is due to give a televised address Sunday on his nation’s restrictions. Newspaper headlines have suggested a significant relaxation is on the cards. But Foreign Secretary Dominic Raab, hosting the daily Covid-19 briefing at Downing Street on Thursday, said any measures would only be “incremental” and “relatively modest.”
Meanwhile, in the United States, while some press for a faster reopening of businesses hit hard by stay-at-home orders, others fear the peak of Covid-19 infections is still to come in certain states, or that a second wave of infections may be worse than the first.
Drobac cautions that the idea of choosing between prioritizing public health or the economy “is a fallacy.”
“The only way to address the economic crisis is to address the public health crisis. Remember, a lockdown is not a solution — it’s an emergency stopgap that buys time to develop a strategy and prepare,” he said.
“Right now there are dozens, if not hundreds, of little experiments happening around the world as countries and communities try to open back up. We will learn a lot from this period about what the new normal should look like for the next couple years.”
CNN’s Yoonjung Seo and Sophie Jeong in Seoul contributed to this report. CNN’s Nadine Schmidt, Stephanie Halasz and Livia Borghese also contributed.