1. #Lebanon is entering a very dark period with #COVID19, as we expected. The next 2-3 weeks will have more regular daily deaths of 10-20 people. Little can be done to change that. If nothing new happens, the weeks after that will be even worse.
**What is to be done?**
2. National lockdown? Ideal in some ways, but realistically unlikely. Compliance varies heavily, people exhausted by overlapping crises have limited compliance, central authorities have limited enforcement capacity.
Only alternative➡️Green Zone Strategy ...
3. Green-zoning would categorize Regions as Green/Yellow/Red, depending on #COVID19 community spread. Effectively, it means selectively imposing restrictions at sub-national level. Green zones have zero community transmission, life&work w.least restrictions, near-normal...
4. Yellow zones are those bordering Red zones. Red zones are those having community transmission. Red has most restrictions, Green has least. All will require masking, hygiene, distancing. But most effort & compliance necessary in non-Green zones, until we drive cases to Zero.
5. Does this work in the real-world? YES. It has been effective in China, New Zealand, Switzerland, Argentina & Ireland. But in some examples not completely. Necessary to follow till Zero cases, & then enjoy the fruits. Similar approaches used in some EU regions.
6. China applied Green Zoning eliminating #COVID19 in 5 weeks, & in Wuhan in 6 weeks. Switzerland was succeeding, but eased off before reaching Zero cases. Argentina applying effectively outside its capital.
Zones get upgraded to Green if 2 weeks with Zero cases.
7. Effectively, it means restricting travel between regions. Green zones can travel to each other freely. Challenging, requires deployment at region borders, but temporary for couple of weeks, & will spare us 1000s of lives.
8. Very important to combine this with *precise surveillance capacity*...where exactly cases happening, and *rapid localized response* (e.g. lockdown street or town, close school, close local shops).
9. Testing capacity can be concentrated on yellow & esp. red zones. But also must maintain vigilance & surveillance in green zones in case of new outbreaks. Like fighting a fire, don't let small fires grow bigger, put them out completely.
10. Where it is being difficult to get out of Red, work closely with local community, concentrate resources to support them, let them lead the local drive. Lebanon has some excellent firefighters...get them on board with thinking approach.
11. Is Lebanon exceptional that this won't work? Not at all. If anything, it can work extremely well in Lebanon. For better or worse, local communities strongly bound together. Use this to our advantage! More people will work together on this if you increase #skininthegame. ...
12. People will fight this fire especially when they see their individual actions count for something, in their local communities. Tie up with local authorities. This is about regions, towns, villages, neighbourhoods...and all these come together to make a country.
13. We've tried 'living with the virus', we know like many places in the world that it CANNOT work. Worse is yet to come. But if we start today, in 3 weeks time we start coming out of this hole.
14. Ideally, we also have sub-regions, i.e. Qadaa, not just at Mouhafaza level. It doesn't need to follow administrative divisions, could be more practical; central authorities should consider this, consult with locals too.
15. Weakness is that capital Beirut has many commuting for work. Consider full lockdown of capital only, 2 weeks. Otherwise sub-divide it into smaller areas for green/yellow/red-zoning.
16. Regions that are connected by travel (green & yellow), special attention to shops&locations where inter-regional people interact, e.g. highway shops.
17. Practically, some lessons will be learned along the way, & help improve the system, so we can drive #COVID19 to zero in Lebanon. & we can innovate locally & nationally.
18. The main drivers of health & economic harm are new cases & our response to them (speed & quality). Keep eye on the ball. Work to do, nationally & locally.
19. Practical example on Green Zone Strategy:
Click on PDF: static1.squarespace.com/static/5e7b914…
endcoronavirus.org/papers/ireland…
20. More on green zoning:
a. oecd-forum.org/posts/toward-a…

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