Reopening

Reopening

Reopening Schools

Schools can be safely reopened, especially for younger children, with standard precautions such as physical distancing, mask wearing, sanitization, and health screenings–so long as infection rates in the general community are low.

Amid the pandemic, schools around the world have adopted various strategies to safely reopen. Younger children are more likely to be asymptomatic and some argue that they are less likely to spread the infection. Researchers at the University of Washington published this comprehensive report summarizing safe schools reopening models and implementation approaches in 15 countries. The most common measures include (1) strengthening sanitization procedures; (2) reducing class sizes; (3) grouping students into “pods” or cohorts, to minimize interactions while still allowing for limited socialization; (4) staggering schedules; and (5) using hybrid models that combine in-person and virtual learning.

Transmission control efforts in schools have focused on physical distancing and health screenings. In countries such as South Korea and Taiwan, masks are required for all students and teachers; during lunchtime, some school policies require students to eat at their individual desks separated by plastic dividers. In China, one school encouraged students to design and wear meter-long hats as a creative way to teach physical distancing. Many schools have implemented temperature checks at entry and instruct students to monitor their own temperatures. Advanced technologies such as AI-based thermal scanners and surveillance robots have already been employed in schools in China and are gaining traction elsewhere, including the United States. 

One notable example of successful safe school measures came from Taiwan, where schools never officially closed. Classes were instead postponed by only two weeks; the extra time was used to prepare schools by improving ventilation, spacing out desks, and adding sanitation protocols. Families were required to complete travel surveys before returning. The government also helped to supply schools with masks, thermometers, and sanitizers.

Guidelines and recommendations for school reopening have been published by various sources throughout the pandemic. A report by UNESCO, UNICEF, World Food Programme, and World Bank detailed a framework for reopening schools. The WHO has also released guidance for school public health measures. In the United States, the CDC provides detailed information and guidance regarding schools on its website. 

The response to a school infection outbreak can range from quarantining just the affected students and teachers, to shutting down the whole system. Most countries that have reopened schools have not reported school-associated outbreaks. However, there have been a few exceptions in places like Israel, where social distancing recommendations were not strictly enforced. Public health experts have cautioned that schools should reopen only after the virus has been locally contained–a central issue in the school debate in the U.S. Importantly, countries that have successfully reopened schools had low rates of community transmission, with high testing and contact tracing capacity.

Related Ideas: Tech-Based Social Distancing; Reopening Hotspots; AI-Based Temperature Scanning

Clean Ambassadors

Volunteer community workers can distribute information, help enforce social distancing and masking, and change social norms to protect public health.

Singapore's SG Clean Ambassador program was launched in February to disseminate information on COVID-19, change social norms, and demonstrate good public health practices. Volunteer ambassadors speak with people in food markets, shops, and other public areas to remind them about social distancing, mask compliance, and other practices that can help reduce the spread of the virus. Volunteers may be employees from industries idled by the COVID-19 economic crisis.

Related Ideas: Industry-Specific Clean Certifications; Massive Media Messaging; Access to Masks

Industry-Specific Clean Certifications

Encouraging employees and businesses to follow clean standards through certification, including 15 industry-specific checklists.

In Singapore, businesses can qualify as “SG Clean Certified” when an independent inspection finds that the business meets guidelines that are specific to its industry. For employees, the standards pertain to personal hygiene and safety (e.g. handwashing, temperature checks, use of tissues, etc.), work area cleanliness, and keeping public toilets clean. For businesses, the government spells out specific standards for 15 sectors, ranging from street hawkers to schools, transport nodes, hotels, and cruise terminals. The sector-specific checklists, e.g. for shopping malls, could be used as a model for businesses in other countries. Businesses certified as “SG Clean” presumably attract more customers than those that are not. Any business that fails the inspection can reapply after fixing noted deficiencies.

Related Ideas: Clean Ambassadors

Digital Check-In System

Creating a digital log of population movement to expedite contact tracing efforts.

Singapore has implemented SafeEntry, a national digital check-in system, in over 16,000 venues, as an aid to contact tracing. SafeEntry check-in points log the IDs and mobile numbers of individuals visiting hotspots, workplaces of essential services, as well as selected public venues to prevent and control the transmission of COVID-19 (see video). The arrival and exit of all visitors is logged by scanning location-specific QR codes into the SingPass mobile app or scanning individual identification cards. All employees, associates, or vendors are required to check-in digitally as they enter the premises. The system is further expanding to all operating businesses and taxi services. The digital tool is an efficient alternative to manual tracing efforts, expediting the ability to recognize and respond to outbreaks. 

Similar systems based on individualized QR codes have been implemented in South Korea and China.

Related Ideas: COVID-19 Mapping Apps; Digital Contact Tracing; Individual QR Codes; Rapid Response Teams for Outbreaks

AI-Based Temperature Scanning

AI-based thermal scanning is a superior way to test crowds for temperature than traditional one-by-one testing with forehead thermometers

In China, AI-powered thermal scanners are widely used in hospitals, schools, airports, and other public spaces. The advanced thermal scanner Firetinas is capable of measuring body temperatures and monitoring mask compliance, and has been utilized in the reopening of schools. Chinese police use AI-based smart helmets developed by Kuang-Chi Technology, with attached infrared cameras that can rapidly measure the temperatures of crowds, scan QR codes, and employ facial recognition technology. Rokid created AI-powered smart glasses, which can be worn by security personnel to scan the temperature of crowds.

Similar AI scanning technologies are found in Singapore and Taiwan as well.

Potential Contacts: Kuang-Chi Technology; Rokid

Related Ideas: Traveler Screening; Tech-Based Social Distancing

Reopening Hotspots

Reopening after a lockdown is likely to lead to sporadic flare-ups that must be quickly identified and controlled through aggressive monitoring and containment

Worldwide, reopening appears to lead to a resurgence in cases. How governments respond to new outbreaks will be critical to the success of their reopening strategies. In Singapore, reopening has meant more infections linked to workplaces, as opposed to homes. In response, the government said employers should ask everyone to work from home, and, if that is not possible, to observe social distancing at work. The government also tracks how many positive cases had no known source of infection, because that suggests that community transmission is occurring undetected. So, when two households in one street were found to have COVID-19, the entire block was tested to prevent further spread.

Wuhan, China, where COVID-19 originated, went into lockdown in January 2020. The unprecedented quarantine – over 11 million people in total were instructed to remain at home – was finally lifted in April. After a month with no new cases, six new cases were identified in early May. The government's response was to quickly launch a massive testing campaign; all 11 million residents were to be tested over ten days using batch testing performed by thousands of medical staff. One goal of the testing was to identify and isolate all positive cases, including asymptomatic ones, to prevent a second wave. While the Wuhan approach may seem excessive, it is one option for managing a hotspot after reopening.

In South Korea, which never went into a Wuhan-esque lockdown, robust contact tracing and free, anonymous testing services have proven effective at handling case clusters. After relaxing rules, the country reported less than 100 cases per day since the beginning of April. But in May 2020, a patron visited several clubs in Seoul before testing positive for COVID-19 which became a superspreader event. Dozens of cases linked to those nightclubs emerged in the following days. Even though patrons had been asked to leave their names and phone numbers when entering, some left false information, making contact tracing harder, prompting South Korea's establishment of anonymous testing sites.

The lesson for other countries is that cities or states that have brought COVID-19 under control must be vigilant in their surveillance for flare-ups after reopening. They must quickly test, trace, and quarantine, while reclosing bars, clubs, or other businesses as necessary. 

Related Ideas: City-wide Testing; Rapid Response Teams for Outbreaks; Digital Contact Tracing

Safe Elections

South Korea and Singapore offer lessons on how national elections can be conducted safely in the midst of a pandemic

In April, South Korea became the first country to hold a major national election since the start of the pandemic. Novel campaigning methods were employed amid social distancing requirements: candidates primarily communicating through social media and campaign teams initiated community disinfection efforts. More than 14,000 polling stations throughout the country were prepared for in-person voting. At the polls, mask-wearing voters had their temperatures checked upon arrival (those with high temperatures were taken to a separate polling area) and were provided hand sanitizer and plastic gloves. Waiting lines were marked with tape to enforce social distancing. Special arrangements were made for voters who were infected with the virus; they could either vote by mail or at specialized voting booths set up at treatment facilities. Voter turnout was notably higher than the previous election in 2016.

Similar measures have also been employed in Singapore, which announced plans to hold elections in July. The government released detailed safety guidelines for in-person voting stations with strict social distancing and hygiene measures, and time slots to minimize waiting times. Unlike South Korea, Singapore did not allow mail-in voting, citing verification concerns.

The experiences of South Korea and Singapore provide an example for other countries, where voter safety is an important issue in upcoming elections. As of this writing, over 56 countries have postponed national or regional elections due to the pandemic.

Related Ideas: Encouraging Mask Usage; Massive Media Messaging; AI-Based Temperature Scanning

International Safe Travel Corridors

Travel corridors, or “bubbles,” are being developed to restart international travel

As countries consider how to restart international travel amid the pandemic, safe travel corridors or “travel bubbles” emerged as a novel strategy. In May, the first travel corridor was established between China and South Korea, allowing limited business travel between specific cities in a “fast-track” channel. Strict conditions have been set: travelers first need to receive an invitation from a company based in the other country, complete two weeks of health screenings, and get tested before departure. Upon arrival, there is a two-day quarantine and another test. Despite the requirements, local companies have shown strong interest in the program, and business travel between the two countries has slowly resumed. Similarly restrictive travel corridors have been developed between China and Singapore, where travelers from either country must apply for visas in advance and undergo two rounds of testing.

Several other Asian countries were in discussions to form additional travel bubbles, including Vietnam, Malaysia, Thailand, Brunei, and Indonesia. A “Trans-Tasman Bubble” was also in development between Australia and New Zealand. In Europe, the “Baltic Travel Bubble” was set up between Lithuania, Latvia, and Estonia to allow for free travel with a 14 day self-isolation period upon arrival.

Despite the initial interest, several news sources reported the concept of travel bubble had “burst” by the end of August. Potential arrangements, such as the Trans-Tasman Bubble, were postponed or canceled due to new COVID-19 outbreaks.

Related Ideas: Traveler Screening; Strict Isolation and Quarantining; Reopening Hotspots