Reopening: Coronavirus Lessons from Iceland, Austria, Australia

Reopening: Coronavirus Lessons from Iceland, Austria, Australia

Iceland, Austria and Australia Have Started Reopening from Coronavirus Shutdowns, With Important Lessons for the U.S. Many U.S. states have also started reopening certain businesses, following stay at home orders. It will be some time before the effect of these reopenings on new cases, hospitalizations and deaths becomes known, however. That's for a few reasons:

  1. COVID-19 symptoms appear on average only 5-6 days after infection, and can take as long as nearly 2 weeks to appear
  2. Many who are infected have mild symptoms or are asymptomatic and can easily spread the virus without knowing they have it
  3. Most U.S. states still aren't testing their residents in sufficient numbers to understand the true prevalence of the COVID-19. For example, New York state, which has tested more than most states, as of writing has tested about 5.6% of its population. Not to pick on Kansas, but it's only tested 1.5% of its population. It goes without saying that if you don't test, you won't find cases.

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Where Iceland, Austria and Australia are in Terms of Reopening

Iceland has reopened schools, small businesses, hair salons, dental offices and museums on May 4, after 6 weeks of being shutdown, although gyms, bars and nightclubs remain closed. Currently only EU/EEA, EFTA and UK nationals are permitted to enter Iceland, no other nationals are allowed entry under travel restrictions that extend until at least May 15, 2020, and may be extended.

Austria allowed many small businesses to reopen on April 14, 2020, although with strict social distancing measures. Austria originally closed theaters, restaurants, bars, non-essential shops, sports facilities and venues, and playgrounds in mid-March.

Australia's most populous states, New South Wales and Victoria (home to Sydney and Melbourne, respectively) closed all non-essential businesses on March 24. On April 21, hospitals resumed elective surgeries, many schools reopened, and many shops reopened in early May. Restaurant and bars have not yet been permitted to reopen.

Reopening Lessons

High Testing But Low Percentage of Infected

Before states or countries can start phasing a reopening, they need to not only have a low number of known cases; they need to be sure that the testing they're doing is sufficient, and not missing many of the infections.

All three countries, Iceland, Austria, and Australia, undertook significant testing, and in all three cases, the percentage of those who tested positive was low: 1% or less. Iceland tested about 13.5% of its population, and only ~0.8% of those tested were positive for the virus.

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Ensure Daily Increase in Infections Remains Low

Of the three countries, Austria is furthest along with its reopening, and has carefully monitored the increase in infections, which as of time of writing is at 0.2%. That stability and low rate of increase has allowed the government to continue its staged reopening, with restaurants, hotels and museums due to open later in May.

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Ensure High Compliance with Social Distancing and Mask Wearing

Austria was one of the earliest European countries to require its people to wear a face mask in public, effective April 6, 2020, and the result was dramatic: within 2 weeks, the number of cases dropped from 90 per million to 10 per million.

In my own city, NYC, there's been a stark divide in infection rates and mortality between Flushing, Queens, where the predominantly Asian residents started social distancing and wearing face masks early, and Corona, a similar high density, working class neighborhood where the residents did not wear masks or social distance as early on.

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Keep Borders Closed During the Reopening

Australia and Iceland have the advantage of being remote from other countries, only reachable by air or boat. Both have travel restrictions in place; Australia has a ban not only on foreigners coming to Australia, but also a travel ban on Australians departing Australia (with limited exceptions) in order to prevent Australians from reimporting COVID-19 from overseas.

Austria isn't isolated in the same way, and has strictly enforced travel restrictions, not only the EU-wide restriction barring non-EU/EEA/Swiss citizens from entry, with few exceptions, but also requiring even eligible EU/EEA/Swiss and Austrian arrivals to either present a medical certificate from within 4 days prior to entry attesting that they are COVID-19 negative, or self-quarantine for 14 days (see 14 Day Quarantine or Pay for COVID-19 Test: Travel's New Normal?)

While strict, these measures help keep the reopening more orderly, so that the government can evaluate how safe it is to further reopen the economy without having to worry about a flood of new infections arriving from outside the country.

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What is helping (or hurting) with reopening measures in your location?

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