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In Singapore, 29-year-old Mohammed sits alone.
It's eerily quiet. This is the first time in six years he hasn't shared a bedroom with more than a dozen other men.
When COVID-19 swept through the packed dormitories he called home, he was moved out and into a room on his own. The authorities isolated him, fearing he may be infected.
Mohammed says his dorm was small, cramped and dirty, and hard to sleep in. There was no air conditioning to cool them in the sweaty tropical nights.
Mohammed was one of around 300,000 migrant workers living in dormitories in the city-state.
Following the coronavirus outbreak, many of the workers were told to stay in their rooms for up to 22 hours a day in an effort to stop the spread, but they say it only made things worse.
Singapore's initial COVID-19 control measures received international praise for being the "gold standard" due to its aggressive testing, tracing and isolating programme. Those ignoring social distancing rules faced tough fines, and detailed information was published on every cluster.
Despite this, by the third week of April, a surge in infections among migrant workers like Mohammed meant it had the highest official levels of coronavirus in southeast Asia, with around 80% of all cases linked to the dormitories.
Once the model pupil in coronavirus containment, Singapore meticulously controlled the initial outbreak only to be blindsided by a second wave.
It is that second wave that authorities across the world are now watching out for.
Second and third waves
After confirming its first COVID-19 case at the end of January, Singapore kept infections hovering at just over 100 until the second week in March.
Cases quickly ticked up over the month hitting a total of 1,000 on 1 April. Three weeks later, cumulative infections had soared to more than 10,000 as the fresh wave barrelled in.
This isn't a blip or a coronavirus coincidence. Other areas have also been grappling with a resurgence in infection. After bringing an outbreak in Hubei province under control, China has seen rising numbers at its northern border with Russia, the majority of which are imported.
Hokkaido was the first province in Japan to declare a state of emergency and lockdown in February. A combination of social distancing and tracking and isolating patients meant daily cases had been slashed to single figures by mid-March, until a fresh influx of cases from Tokyo triggered a new lockdown less than a month later.
Meanwhile, Hong Kong faced its third wave in March after an influx of overseas residents returning home sent levels soaring.
So what's going on?
Most countries get a first wave of infections when people arrive from abroad, bringing the virus with them.
In the early stage of the pandemic, many countries were able to identify and even isolate those first cases.
But some avoided identification and went around infecting others. This resulted in what is called secondary spread.
Associate Professor Jeremy Lim, a global health expert at the National University of Singapore, told Sky News that part of the reason for this is that COVID-19, when enough people have been infected, is passed through a community by asymptomatic transmitters.
He said: "This then constitutes a second wave, which means it has passed from imported cases to members of a local community who then spread it to each other."
Typically, there is a dormant period when many infected people don't show symptoms, even those who show symptoms later. But, when their symptoms start to show, the numbers of cases can surge very quickly, like what happened in Singapore.
This resurgence scenario can occur after a country deals with its first set of COVID-19 cases, and assumes it has the situation under control.
While a second wave may not be inevitable, most experts agree it's hard to dodge.
Former World Health Organisation (WHO) health policy chief Professor Kenji Shibuya, of King's College London, told Sky News: "There is always a risk of resurgence so therefore each nation which has been successful in containing the first wave has to continue to watch out for the next resurgence."
The potential for cycles of surge and decline means that the threat from COVID-19 doesn't automatically end after a first or second wave -realistically, it's likely to be part of our daily lives at some level for next 10 to 18 months at least.
Professor Dale Fisher, chair of the Global Outbreak Alert and Response Network steering committee for the WHO, says: "I don't really look at it in terms of waves, I look at it in terms of current transmission.
"You can dial up your social restrictions or have a complete lockdown and it [COVID-19] will come down. You ease them off - you're going to get some more cases. So you ease them off a lot - you get a lot more cases. So it's more like a relationship, rather than a wave."
Migrants in the margins
In Singapore, about 10,000 workers have been so far moved out of the buildings where migrant workers like Mohammed live.
The huge steel blocks usually contain communal areas like dining rooms or provisions shops on the ground floor. Above them tower 10 or 15 storeys of sleeping areas.
An estimated 293,000 workers remain in the complexes - about a fifth of Singapore's migrant workforce, which the country regards as essential as it strives to keep its place at the top of Asia's per capita income rankings.
Many have travelled from their home countries to earn money to support their families, doing jobs native Singaporeans do not want to do.
But they are poorly paid compared to the country's citizens, leaving them no choice but to live in the closely cramped dormitories.
Social distancing is almost impossible in a room with 15 to 20 other people and it's a big issue when you're sleeping next to someone who has developed a fever.
They travel to work from the housing blocks squeezed closely together in the back of trucks - allowing the virus to jump easily from one to another.
Several of the dorms now have been designated isolation areas.
Aadi, 33, moved to Singapore from Bangladesh to work in construction so he could send money home to his wife, five-year-old daughter and one-year-old son.
Since the coronavirus outbreak he says he hasn't been paid and is worried because he doesn't have any money to give his family.
"There is no work and we don't know what the future holds for us," says Aadi. "I spend most of my day inside my room. I only go out to make calls or for essential work."
As the outbreak intensifies, the government has extended a partial lockdown and pledged workers will continue to be paid during the quarantine period.
Tarak lives with about 10,000 workers in a compound which, like all the others, is tucked out of sight on the outskirts of the city.
Each block has eight floors with 12 rooms. Some house as many as 24,000 people.
Tarak usually works all day painting in a shipyard. In his block, on the day he spoke to Sky News, five people were reported sick.
He said: "The Singapore government is doing a lot but my wife and mother are very worried since there have been coronavirus deaths.
"The company paid us a salary last month but I don't know about next month. There is... uncertainty because no one knows how long this will carry on. If in the future the Singaporean government can't control, this then we will have to go back to our own countries."
The Ministry of Manpower said it is working to improve conditions after it faced "challenges" at the start of quarantine over food and hygiene.
What triggers a second wave
The causes
The way in which authorities handle an outbreak in the early stages has implications for what happens later.
Opportunities for a second wave can result from:
- A weak response at the start of an outbreak, leading to a mass of untraceable asymptomatic silent spreaders
- A failure to inform the public about the full extent of infection
- Large numbers of people not complying with social restrictions
Most experts agree that tracking, testing and isolating patients are basics at every stage of the disease to ensure it can be brought under control. But so is ensuring the public understand and support lockdowns and changes to the way they live.
According to Prof Fisher, failure to accurately and clearly convey the facts can trigger unrest.
"A unified message that is clear and makes sense is critical because without the community behind you and engaged in this, then you're really in a struggle and that's what we're seeing in parts of the US at the moment," he said.
"The protests on the street and things which are clearly pretty exceptional at the world level, where people are demanding their right to go back to work irrespective of the public health advice, [it's] because they're getting so many mixed messages."
A pandemic also requires international co-operation on vaccine development, effective restrictions and scientific discoveries.
And even if you manage to clear COVID-19 from your borders, unless you intend to stop all traffic and trade coming in and out for the foreseeable future, the threat from a new surge of coronavirus lingers.
Prof Shibuya says: "This is a global pandemic, so one nation can't contain it. It's always circulating around the globe.
"It's very difficult to avoid some imported cases and resurgence from that. So we have to prepare for the next wave in this round or another wave of resurgence.
"Unless we work together and we invest in a concerted effort to tackle COVID-19, I think we are losing the battle."
Blind spots
Experts warn that countries should be aware of the blind spots in their communities, for it's here the virus could make its home. This is where it is claimed Singapore stumbled.
Alex Au, vice president of the Transient Workers Count Too (TWC2) group, which campaigns for better conditions for migrants workers in the city-state, is among them.
He says: "I think our authorities had a huge blind spot regarding the living conditions of migrant workers and therefore they didn't plan sufficiently or didn't put in enough protection measures."
He argues that as the authorities focused on the city at large, COVID-19 bloomed in the margins, in places like the dormitory where Mohammed lived. By the time they sealed off the dorms and began moving healthy workers out, it was too late. Cases had rocketed.
Living on the outskirts of the city in blocks of purpose-built or converted housing, it is claimed the migrant workers were invisible.
In a speech on 21 April, Singapore's Prime Minister Lee Hsien Loong told the country authorities were now aggressively testing the dormitory population. He said, so far, most cases among migrant workers had been mild and that medical resources were being stepped up. But Singapore's story should be a cautionary tale for all hoping to avoid a hidden surge.
Mr Au says what happened in Singapore should serve as a warning to authorities in other countries.
"Who are your marginalised communities, the most vulnerable and therefore the ones most likely to remain as the reservoirs of infection?" he advised them to ask.
"It could be asylum seekers in the camps, it could be prisons… nursing homes.
"Don't be like the good old bureaucrat who only looks at statistical averages; it's your marginal reservoirs which will seed a new wave if you're not careful about it. So it's not a matter of just dealing with the infection rate across the country, looking at averages and the middle-class population, look at the most vulnerable communities and make sure you are being effective there, too."
Ending lockdown
"Lockdowns can help to take the heat out of a country's epidemic, but they cannot end it alone," WHO chief Tedros Adhanom Ghebreyesus has warned.
When countries begin easing widespread restrictions they are potentially at their most vulnerable, and removing limitations too early can promote a "deadly resurgence" in infections.
Ben Cowling, professor in infectious disease epidemiology at the Hong Kong University School of Public Health, told Sky News: "If lockdown is lifted, there would be the potential for infections to resurge unless measures are put in place to keep infections at a low level."
Those considering reopening should heed what has happened in Japan, now said to be in the "explosive phase" of infection, with thousands of citizens living through their second lockdown.
Professor Shibuya adds: "There are a few lessons: one is if you act promptly you can get it under control very effectively. The basics - test and isolate - would be fundamental in all phases and also another lesson, for example, from Hokkaido is that even if you manage to control a local outbreak, if there is an ongoing transmission in other parts of the country there is always high risk of resurgence."
That doesn't mean we are doomed to live in lockdown forever, just that reopenings will have to be staged and controlled.
Infection rates will have to be carefully and continuously monitored and if they start creeping back up some restrictions may have to be reintroduced.
Anyone hoping to immediately go back to life pre-coronavirus is likely to be disappointed.
Prof Fisher says: "That's the biggest danger - if the public thinks I've done my two months of lockdown - price paid. This isn't over until it's over and most of us are thinking second half of next year would be would be a good outcome.
"There's still going to have to be some degree of social restriction."
The future
Taming the travel bug
With all the potential triggers for repeat surges, coronavirus presents a real challenge for communities in the coming months and years.
Even if a country manages to bring infections down to single figures, as soon as borders are reopened for trade and travel, the risk of imported cases remains.
Prof Cowling says: "Continued introduction is inevitable as long as some locations in the world have COVID-19 epidemics and there is international travel of people from those locations."
Prof Lim adds: "I think for a country that is a transport hub with a lot of human traffic in and out, it would be very, very difficult [to totally eliminate COVID-19].
"Major transport hubs like London, Singapore and Hong Kong will just have to change our lives because this will be the new normal for us."
Community immunity
If the virus can't be totally wiped out then the only possible permanent protection against new waves of infection is immunity, either naturally or with a highly effective vaccine.
Prof Shibuya says: "You can contain it, but unless the whole community acquires herd immunity, up to 70% of them, I don't think it will be controlled.
"[A vaccine] may take up to 18 months so meanwhile, what we can do is carefully monitor the reproduction rate and ICU capacity, share information about the virus, border control, social distancing and implement the test-and-isolate basic strategy. This is the best way to prepare for the next resurgence."
Without immunity or elimination, alterations to the way we live and interact may be the best protection we have against repeat surges. Anyone still clinging to the idea that social restrictions will be fully reversed after lockdown is sadly dreaming.
Prof Chris Whitty, the UK's most senior medic, recently noted: "We have to be very realistic. If people are hoping it's suddenly going to move from where we are in lockdown to where suddenly everything is gone, that is a wholly unrealistic expectation.
"We are going to have to do a lot of things for really quite a long period of time."
The Wuhan model
This is exactly what happened in Wuhan, the epicentre of China's outbreak. It began reopening in April after being sealed off in January.
As daily cases dwindled to zero, the city cautiously began restoring social and commercial life but measures to prevent a second wave remained.
Schools were still closed, people's temperatures monitored when they entered buildings and homes, masks were commonplace and the amount of time people spent outside controlled. But the access to some freedoms meant others were forfeited.
Prof Cowling says countries like China have only been able to do it using tools like facial recognition and mobile phone tracking to automate contact tracing and to carry out population surveillance. They have then imposed the test-and-isolate approach using enforced quarantine and mobile phone apps that monitor people's health statuses.
Letting it down gently
Whatever package of freedoms countries decide on, the lifting of restrictions will have to be incremental and authorities will have to be ready to quickly respond to any fresh outbreaks. And it will depend on the behaviour of the public.
Prof Fisher adds: "You might just want to tap on the brakes a little bit if the transmissions are going up, but if things are going well then you might just want to wind it down a little bit.
"If government and the health department have got everything in place that's possible, then you can open up a restaurant if there are very few tables and chairs and people don't all crowd in. But if the public is celebrating because they're out of lockdown and having big parties at home, then that's how you could create another cluster.
"So if people learn from what they're being forced to learn now and there's a certain behaviour, then I think it's going to be reasonable to decrease the restrictions.
"But it will obviously be stepwise."
The truth is scientists and governments can announce the best protection plans possible - but if the public is not on board, long-term strategies to contain COVID-19 and prevent future waves will fail.
Even basics like prolonged social distancing and hand hygiene require widespread compliance to succeed. Ultimately, coronavirus is a disease that's spread through the community, so without community support, any response is in tatters. Success against the virus will be decided by our willingness to adapt and leave old norms behind.
It's a message Singapore is relying on.
https://news.sky.com/story/coronavirus-and-the-second-wave-beware-of-the-danger-of-lifting-a-lockdown-too-early-11980622
It's eerily quiet. This is the first time in six years he hasn't shared a bedroom with more than a dozen other men.
When COVID-19 swept through the packed dormitories he called home, he was moved out and into a room on his own. The authorities isolated him, fearing he may be infected.
Mohammed says his dorm was small, cramped and dirty, and hard to sleep in. There was no air conditioning to cool them in the sweaty tropical nights.
Mohammed was one of around 300,000 migrant workers living in dormitories in the city-state.
Following the coronavirus outbreak, many of the workers were told to stay in their rooms for up to 22 hours a day in an effort to stop the spread, but they say it only made things worse.
Singapore's initial COVID-19 control measures received international praise for being the "gold standard" due to its aggressive testing, tracing and isolating programme. Those ignoring social distancing rules faced tough fines, and detailed information was published on every cluster.
Despite this, by the third week of April, a surge in infections among migrant workers like Mohammed meant it had the highest official levels of coronavirus in southeast Asia, with around 80% of all cases linked to the dormitories.
Once the model pupil in coronavirus containment, Singapore meticulously controlled the initial outbreak only to be blindsided by a second wave.
It is that second wave that authorities across the world are now watching out for.
Second and third waves
After confirming its first COVID-19 case at the end of January, Singapore kept infections hovering at just over 100 until the second week in March.
Cases quickly ticked up over the month hitting a total of 1,000 on 1 April. Three weeks later, cumulative infections had soared to more than 10,000 as the fresh wave barrelled in.
This isn't a blip or a coronavirus coincidence. Other areas have also been grappling with a resurgence in infection. After bringing an outbreak in Hubei province under control, China has seen rising numbers at its northern border with Russia, the majority of which are imported.
Hokkaido was the first province in Japan to declare a state of emergency and lockdown in February. A combination of social distancing and tracking and isolating patients meant daily cases had been slashed to single figures by mid-March, until a fresh influx of cases from Tokyo triggered a new lockdown less than a month later.
Meanwhile, Hong Kong faced its third wave in March after an influx of overseas residents returning home sent levels soaring.
So what's going on?
Most countries get a first wave of infections when people arrive from abroad, bringing the virus with them.
In the early stage of the pandemic, many countries were able to identify and even isolate those first cases.
But some avoided identification and went around infecting others. This resulted in what is called secondary spread.
Associate Professor Jeremy Lim, a global health expert at the National University of Singapore, told Sky News that part of the reason for this is that COVID-19, when enough people have been infected, is passed through a community by asymptomatic transmitters.
He said: "This then constitutes a second wave, which means it has passed from imported cases to members of a local community who then spread it to each other."
Typically, there is a dormant period when many infected people don't show symptoms, even those who show symptoms later. But, when their symptoms start to show, the numbers of cases can surge very quickly, like what happened in Singapore.
This resurgence scenario can occur after a country deals with its first set of COVID-19 cases, and assumes it has the situation under control.
While a second wave may not be inevitable, most experts agree it's hard to dodge.
Former World Health Organisation (WHO) health policy chief Professor Kenji Shibuya, of King's College London, told Sky News: "There is always a risk of resurgence so therefore each nation which has been successful in containing the first wave has to continue to watch out for the next resurgence."
The potential for cycles of surge and decline means that the threat from COVID-19 doesn't automatically end after a first or second wave -realistically, it's likely to be part of our daily lives at some level for next 10 to 18 months at least.
Professor Dale Fisher, chair of the Global Outbreak Alert and Response Network steering committee for the WHO, says: "I don't really look at it in terms of waves, I look at it in terms of current transmission.
"You can dial up your social restrictions or have a complete lockdown and it [COVID-19] will come down. You ease them off - you're going to get some more cases. So you ease them off a lot - you get a lot more cases. So it's more like a relationship, rather than a wave."
Migrants in the margins
In Singapore, about 10,000 workers have been so far moved out of the buildings where migrant workers like Mohammed live.
The huge steel blocks usually contain communal areas like dining rooms or provisions shops on the ground floor. Above them tower 10 or 15 storeys of sleeping areas.
An estimated 293,000 workers remain in the complexes - about a fifth of Singapore's migrant workforce, which the country regards as essential as it strives to keep its place at the top of Asia's per capita income rankings.
Many have travelled from their home countries to earn money to support their families, doing jobs native Singaporeans do not want to do.
But they are poorly paid compared to the country's citizens, leaving them no choice but to live in the closely cramped dormitories.
Social distancing is almost impossible in a room with 15 to 20 other people and it's a big issue when you're sleeping next to someone who has developed a fever.
They travel to work from the housing blocks squeezed closely together in the back of trucks - allowing the virus to jump easily from one to another.
Several of the dorms now have been designated isolation areas.
Aadi, 33, moved to Singapore from Bangladesh to work in construction so he could send money home to his wife, five-year-old daughter and one-year-old son.
Since the coronavirus outbreak he says he hasn't been paid and is worried because he doesn't have any money to give his family.
"There is no work and we don't know what the future holds for us," says Aadi. "I spend most of my day inside my room. I only go out to make calls or for essential work."
As the outbreak intensifies, the government has extended a partial lockdown and pledged workers will continue to be paid during the quarantine period.
Tarak lives with about 10,000 workers in a compound which, like all the others, is tucked out of sight on the outskirts of the city.
Each block has eight floors with 12 rooms. Some house as many as 24,000 people.
Tarak usually works all day painting in a shipyard. In his block, on the day he spoke to Sky News, five people were reported sick.
He said: "The Singapore government is doing a lot but my wife and mother are very worried since there have been coronavirus deaths.
"The company paid us a salary last month but I don't know about next month. There is... uncertainty because no one knows how long this will carry on. If in the future the Singaporean government can't control, this then we will have to go back to our own countries."
The Ministry of Manpower said it is working to improve conditions after it faced "challenges" at the start of quarantine over food and hygiene.
What triggers a second wave
The causes
The way in which authorities handle an outbreak in the early stages has implications for what happens later.
Opportunities for a second wave can result from:
- A weak response at the start of an outbreak, leading to a mass of untraceable asymptomatic silent spreaders
- A failure to inform the public about the full extent of infection
- Large numbers of people not complying with social restrictions
Most experts agree that tracking, testing and isolating patients are basics at every stage of the disease to ensure it can be brought under control. But so is ensuring the public understand and support lockdowns and changes to the way they live.
According to Prof Fisher, failure to accurately and clearly convey the facts can trigger unrest.
"A unified message that is clear and makes sense is critical because without the community behind you and engaged in this, then you're really in a struggle and that's what we're seeing in parts of the US at the moment," he said.
"The protests on the street and things which are clearly pretty exceptional at the world level, where people are demanding their right to go back to work irrespective of the public health advice, [it's] because they're getting so many mixed messages."
A pandemic also requires international co-operation on vaccine development, effective restrictions and scientific discoveries.
And even if you manage to clear COVID-19 from your borders, unless you intend to stop all traffic and trade coming in and out for the foreseeable future, the threat from a new surge of coronavirus lingers.
Prof Shibuya says: "This is a global pandemic, so one nation can't contain it. It's always circulating around the globe.
"It's very difficult to avoid some imported cases and resurgence from that. So we have to prepare for the next wave in this round or another wave of resurgence.
"Unless we work together and we invest in a concerted effort to tackle COVID-19, I think we are losing the battle."
Blind spots
Experts warn that countries should be aware of the blind spots in their communities, for it's here the virus could make its home. This is where it is claimed Singapore stumbled.
Alex Au, vice president of the Transient Workers Count Too (TWC2) group, which campaigns for better conditions for migrants workers in the city-state, is among them.
He says: "I think our authorities had a huge blind spot regarding the living conditions of migrant workers and therefore they didn't plan sufficiently or didn't put in enough protection measures."
He argues that as the authorities focused on the city at large, COVID-19 bloomed in the margins, in places like the dormitory where Mohammed lived. By the time they sealed off the dorms and began moving healthy workers out, it was too late. Cases had rocketed.
Living on the outskirts of the city in blocks of purpose-built or converted housing, it is claimed the migrant workers were invisible.
In a speech on 21 April, Singapore's Prime Minister Lee Hsien Loong told the country authorities were now aggressively testing the dormitory population. He said, so far, most cases among migrant workers had been mild and that medical resources were being stepped up. But Singapore's story should be a cautionary tale for all hoping to avoid a hidden surge.
Mr Au says what happened in Singapore should serve as a warning to authorities in other countries.
"Who are your marginalised communities, the most vulnerable and therefore the ones most likely to remain as the reservoirs of infection?" he advised them to ask.
"It could be asylum seekers in the camps, it could be prisons… nursing homes.
"Don't be like the good old bureaucrat who only looks at statistical averages; it's your marginal reservoirs which will seed a new wave if you're not careful about it. So it's not a matter of just dealing with the infection rate across the country, looking at averages and the middle-class population, look at the most vulnerable communities and make sure you are being effective there, too."
Ending lockdown
"Lockdowns can help to take the heat out of a country's epidemic, but they cannot end it alone," WHO chief Tedros Adhanom Ghebreyesus has warned.
When countries begin easing widespread restrictions they are potentially at their most vulnerable, and removing limitations too early can promote a "deadly resurgence" in infections.
Ben Cowling, professor in infectious disease epidemiology at the Hong Kong University School of Public Health, told Sky News: "If lockdown is lifted, there would be the potential for infections to resurge unless measures are put in place to keep infections at a low level."
Those considering reopening should heed what has happened in Japan, now said to be in the "explosive phase" of infection, with thousands of citizens living through their second lockdown.
Professor Shibuya adds: "There are a few lessons: one is if you act promptly you can get it under control very effectively. The basics - test and isolate - would be fundamental in all phases and also another lesson, for example, from Hokkaido is that even if you manage to control a local outbreak, if there is an ongoing transmission in other parts of the country there is always high risk of resurgence."
That doesn't mean we are doomed to live in lockdown forever, just that reopenings will have to be staged and controlled.
Infection rates will have to be carefully and continuously monitored and if they start creeping back up some restrictions may have to be reintroduced.
Anyone hoping to immediately go back to life pre-coronavirus is likely to be disappointed.
Prof Fisher says: "That's the biggest danger - if the public thinks I've done my two months of lockdown - price paid. This isn't over until it's over and most of us are thinking second half of next year would be would be a good outcome.
"There's still going to have to be some degree of social restriction."
The future
Taming the travel bug
With all the potential triggers for repeat surges, coronavirus presents a real challenge for communities in the coming months and years.
Even if a country manages to bring infections down to single figures, as soon as borders are reopened for trade and travel, the risk of imported cases remains.
Prof Cowling says: "Continued introduction is inevitable as long as some locations in the world have COVID-19 epidemics and there is international travel of people from those locations."
Prof Lim adds: "I think for a country that is a transport hub with a lot of human traffic in and out, it would be very, very difficult [to totally eliminate COVID-19].
"Major transport hubs like London, Singapore and Hong Kong will just have to change our lives because this will be the new normal for us."
Community immunity
If the virus can't be totally wiped out then the only possible permanent protection against new waves of infection is immunity, either naturally or with a highly effective vaccine.
Prof Shibuya says: "You can contain it, but unless the whole community acquires herd immunity, up to 70% of them, I don't think it will be controlled.
"[A vaccine] may take up to 18 months so meanwhile, what we can do is carefully monitor the reproduction rate and ICU capacity, share information about the virus, border control, social distancing and implement the test-and-isolate basic strategy. This is the best way to prepare for the next resurgence."
Without immunity or elimination, alterations to the way we live and interact may be the best protection we have against repeat surges. Anyone still clinging to the idea that social restrictions will be fully reversed after lockdown is sadly dreaming.
Prof Chris Whitty, the UK's most senior medic, recently noted: "We have to be very realistic. If people are hoping it's suddenly going to move from where we are in lockdown to where suddenly everything is gone, that is a wholly unrealistic expectation.
"We are going to have to do a lot of things for really quite a long period of time."
The Wuhan model
This is exactly what happened in Wuhan, the epicentre of China's outbreak. It began reopening in April after being sealed off in January.
As daily cases dwindled to zero, the city cautiously began restoring social and commercial life but measures to prevent a second wave remained.
Schools were still closed, people's temperatures monitored when they entered buildings and homes, masks were commonplace and the amount of time people spent outside controlled. But the access to some freedoms meant others were forfeited.
Prof Cowling says countries like China have only been able to do it using tools like facial recognition and mobile phone tracking to automate contact tracing and to carry out population surveillance. They have then imposed the test-and-isolate approach using enforced quarantine and mobile phone apps that monitor people's health statuses.
Letting it down gently
Whatever package of freedoms countries decide on, the lifting of restrictions will have to be incremental and authorities will have to be ready to quickly respond to any fresh outbreaks. And it will depend on the behaviour of the public.
Prof Fisher adds: "You might just want to tap on the brakes a little bit if the transmissions are going up, but if things are going well then you might just want to wind it down a little bit.
"If government and the health department have got everything in place that's possible, then you can open up a restaurant if there are very few tables and chairs and people don't all crowd in. But if the public is celebrating because they're out of lockdown and having big parties at home, then that's how you could create another cluster.
"So if people learn from what they're being forced to learn now and there's a certain behaviour, then I think it's going to be reasonable to decrease the restrictions.
"But it will obviously be stepwise."
The truth is scientists and governments can announce the best protection plans possible - but if the public is not on board, long-term strategies to contain COVID-19 and prevent future waves will fail.
Even basics like prolonged social distancing and hand hygiene require widespread compliance to succeed. Ultimately, coronavirus is a disease that's spread through the community, so without community support, any response is in tatters. Success against the virus will be decided by our willingness to adapt and leave old norms behind.
It's a message Singapore is relying on.
https://news.sky.com/story/coronavirus-and-the-second-wave-beware-of-the-danger-of-lifting-a-lockdown-too-early-11980622
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It took so long to scroll down to the reply box I've forgotten my reply
What he actually means is the ramp up into phase 2.
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