How Cameroon, Hong Kong, Sweden, Taiwan are fighting COVID-19 without lockdown

At a time of global uncertainty when countries across the world are locking down borders and imposing strict restrictions in their locality to prevent further spread of COVID-19, some nations/territories faced the pandemic without shutting down all activities.

Confirmed cases of COVID-19 across the globe rose above 3.1 million with over 225,000 deaths as at Wednesday April 29. The pandemic has forced a third of the world's 7.8 billion population to stay at home and observe social distancing.

Health experts had advised that ordering people to stay indoors and ramping up tests and contact tracing is the best way to flatten curve which many nations have complied with. In the midst of all the lockdown and shut down of socio-economic, religious and sporting activities imposed by hundreds of countries across the world, some countries decided that life and business should go on while they deploy their arsenal for the COVID-19 battle.

Here is a list of some of the countries/territories

1. Sweden:

Unlike other European countries, the Swedish government refused to order a total lockdown to fight the pandemic. Although universities and secondary schools were closed, while government also limited gatherings to a maximum of 50 people, borders, restaurants, some cinemas were left open, preschools and grade schools remained in full session, no limits were placed on public transport or outings in local parks.

Justifying the decision not to implement strict restrictions, Sweden Prime Minister, Stefan Löfven said he expects Swedes to apply common sense.

"We all, as individuals, have to take responsibility. We can't legislate and ban everything. It is also a question of commonsense behaviour," Löfven said on Friday March 28 when the country had 209 confirmed cases with 92 death toll.

A month after the prime minister justified his decision, Sweden has recorded 20,302 cases as at Wednesday April 29, with 2,462 deaths and 1,435 recoveries from a population of 10.23 million people. This is lower than the number of cases in New Jersey State in the United States, despite strict lockdown, over 116,000 of New Jersey's estimated 9.2 million residents have been infected, with more than 6,000 deaths.

Sweden's finance minister, Magdalena Anderson, believes the decision not to lockdown has helped local economy "of course hairdressers, restaurants and hotels are less affected compared to other countries." She, however, admitted that the economy may likely shrink by 7 percent this year.

2. Cameroon:

Cameroon has the highest number of confirmed cases of COVID-19 in Central Africa. After recording its first case on March 6 which has now jumped to 1,806, 61 deaths and 934 recoveries, the country put some measures in place to contain the spread. It shut all borders on March 18. It ordered public and private schools to close, banned public gatherings of more than 50 people and non-essential urban and inter-urban travel within the country. Bars, restaurants and entertainment spots are not allowed to operate after 6pm, while commercial bus, taxi and motorbike drivers have been warned to avoid overloading.

Cameroon with a population of 24.5 million people did not impose strict lockdown that would have severe impact on its economy as business activities are still ongoing. To slow the spread of the virus, the government made wearing of face masks compulsory for its citizens whenever they are appearing in public from April 13.

In addition to this, Prime Minister, Dr Joseph Ngute who coordinates the country's COVID-19 response team, said on April 13, that screening is being intensified while government is also establishing "specialized treatment centres for COVID-19 patients in all regional capital following the field hospital model to receive patients in case of a peak of the pandemic and to allow hospital to operate normally".

3. Taiwan

Despite lying off the coast of China where COVID-19 broke out in 2019, Taiwan faced the pandemic without a lockdown and is gradually emerging from the crisis with lessons for other countries.

With a population of 23.8 million people Taiwan adopted a unique approach in handling COVID-19. According to NBC, the temperature of anyone arriving Taiwan from overseas were checked at the airport. The travellers must hand over their mobile phones to health authorities to record the details and use the GPS signals to track the owners. This is to ensure they stay isolated for 14 days.

The arriving passengers are also banned from taking public transportation and must instead use special "epidemic-prevention taxis" to move from the airport to their destination where they will quarantine. Taiwan's borough chiefs, the lowest level of elected officials (similar to Councillors in Nigeria) are mandate to call people quarantined in their jurisdiction twice a day to make sure they do not leave their tracked phone at home while they go out when the period of their quarantine is not complete.

When the phone is not answered it can prompt authorities to send text messages such as this: "Please return home immediately. Violations of home isolation/home quarantine regulations will result in fines and mandatory placement. The Central Epidemic Command Center cares about you." Fines for violating the mandatory quarantine range from $3,333 to $333,333.

As at Wednesday April 29, Taiwan has 429 confirmed cases, six deaths and 311 recoveries

4. Hong Kong:

Despite its closeness to China the epicenter of COVID-19 outbreak, Hong Kong, a Special Administrative Region (SAR) of China managed the virus without total lockdown.

As one of the worst hit by the 2003 SARS epidemic which killed nearly 300 people in the city, Hong Kong's handling of COVID-19 shows it learnt from the experience and was better prepared to contend with an outbreak than many other countries. When the government decided it was not going to impose a total lockdown, the results show it knows what it was doing.

The city closed border crossings with mainland China but left its international airport open and a bridge connecting the city to Macau and the southern Chinese city of Zhuhai as well as Shenzhen Bay Port.

Hong Kong improved testing and hospital capacity to handle novel respiratory pathogens, while its population of 7.4 million people (based on United Nations projections) which was aware of the need to improve personal hygiene and maintain social distancing, also adhered strictly to this.

As at Wednesday April 29, Hong Kong has 1,038 cases, four death toll and 830 recoveries. The city has not recorded any new case for the sixth time in the last 10 days

"By quickly implementing public health measures, Hong Kong has demonstrated that COVID-19 transmission can be effectively contained without resorting to the highly disruptive complete lockdown adopted by China, the USA, and Western European countries," Benjamin Cowling, PhD, professor at the University of Hong Kong, said in a press release.

As the world still struggles to find a vaccine for the deadly virus, Keiji Fukuda, a former World Health Organization disease expert who is now director of Hong Kong University's School of Public Health told NBC that it will be hard for other nations to adopt the Hong Kong and Taiwan model.

"I think it's hard to duplicate the entire package; it's easier to duplicate parts of the package," Fukuda said.

"Taiwan and Hong Kong are relatively smaller; they were both directly impacted by SARS and have experience."

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