Countries should be cautious about completely ending coronavirus lockdowns for their citizens until there is a vaccine against the deadly bug, according to a new study based on China’s experience.

China’s strict public health interventions brought the first wave of COVID-19 in the country to an end — but authorities need to be proactive to prevent a second, more destructive wave without herd immunity through immunizations, Hong Kong-based researchers said in a study published Wednesday in The Lancet.

“While these control measures appear to have reduced the number of infections to very low levels, without herd immunity against COVID-19, cases could easily resurge as businesses, factory operations, and schools gradually resume and increase social mixing, particularly given the increasing risk of imported cases from overseas as COVID-19 continues to spread globally,” Professor Joseph T. Wu from the University of Hong Kong, who co-led the research, told the Guardian.

China has lowered its reproduction number — or the average number of people whom each person with COVID-19 will infect — from two or three to below one, causing the epidemic to dwindle in the country.

But, the researchers concluded, that number could easily rise again if normal life resumes too quickly and authorities are too optimistic about lifting controls.

“Although control policies such as physical distancing and behavioral change are likely to be maintained for some time, proactively striking a balance between resuming economic activities and keeping the reproductive number below one is likely to be the best strategy until effective vaccines become widely available,” Wu told the outlet.

Allowing infections to spike a second time would likely result in “marginally higher health and economic loss,” even if strict controls are restored once again, the study results said.

The researchers used Health Commission data of laboratory-confirmed COVID-19 cases between mid-January and Feb. 29 in Beijing, Shanghai, Shenzhen and Wenzhou.

In Hubei province, the original epicenter of the virus, the death rate stood at nearly 6 percent, but in other parts of the mainland, the rate was far lower, at less than 1 percent, the study found.

But “even in the most prosperous and well-resourced megacities like Beijing and Shanghai, health care resources are finite, and services will struggle with a sudden increase in demand,” senior study author Professor Gabriel M. Leung from the University of Hong Kong told the Guardian.

“Our findings highlight the importance of ensuring that local health care systems have adequate staffing and resources to minimize COVID-related deaths,” he said.

The study was published just as Wuhan, the city at the center of the pandemic, reopened after a 76-day lockdown — and saw a mass exodus.


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