The WHO's six step guide to easing coronavirus lockdowns

Lockdown measures are slowly lifting in Europe

A woman waves to a city worker dressed in a hazmat suit as he disinfects the streets in her neighborhood as a precaution against the spread of the new coronavirus, in Santiago, Chile. AP Photo

Medical staff take care of a Covid-19 patient in an intensive care unit at the University hospital of Aachen, western Germany during the novel coronavirus COVID-19 pandemic. AFP

Transport personnel wearing hazmat suits guide travellers arriving from Wuhan to buses, which will take them to their quarantine locations, at Beijing West Railway Station. AFP

An employee stands in front of coffins stacked at the Yago Gonzalez coffin-making factory in Pinor, northwestern Spain. AFP

Health workers fill out documents before performing tests for COVID-19 coronavirus on other health workers at the screening and testing tents set up at the Charlotte Maxeke Hospital in Johannesburg. AFP

A man goes through a disinfecting tunnel set up by vonlunteers in a street as preventative measure against the COVID-19 coronavirus, in Dhaka. AFP

A woman wearing a face mask cycles in the empty Via della Conciliazione, as the Vatican's Saint Peter's Basilica is seen in the background, in Rome. AFP

A New York City Fire Department (FDNY) Emergency Medical Technician (EMT) wearing personal protective equipment assist a woman who was having difficulty breathing during ongoing outbreak of the coronavirus disease (COVID19) in New York, U.S. REUTERS

Ukraine's President Volodymyr Zelenskiy and Cuba's Ambassador Natacha Diaz Aguilera pose for a picture while greeting each other with an elbow bump instead of a traditional handshake during a ceremony to receive diplomatic credentials amid the coronavirus disease (COVID-19) outbreak in Kiev, Ukraine. REUTERS

Health workers gesture as citizens show their support from their balconies and windows, amid the spread of the coronavirus disease (COVID-19), in Barcelona, Spain. REUTERS

People walk around their living quarters at a temporary men's shelter run by the Downtown Emergency Service Center (DESC) at the Seattle Center Exhibition Hall, currently with 75 beds spaced at least six feet apart, during the coronavirus disease (COVID-19) outbreak in Seattle, Washington, U.S. REUTERS

Health and Human Services Secretary Dr. David Scrase gives an update on the COVID-19 outbreak in the state as New Mexico Gov. Michelle Lujan Grisham, left, listens during a news conference in the state Capitol in Santa Fe, N.M.. AP

A member of a cultural center wears a mask to protect himself against the spread of the new coronavirus, as he donates food for poor families in Turano favela, Rio de Janeiro, Brazil. AP Photo

Passengers on the Australian cruise ship name Greg Mortimer gesture heart signs as they arrive to port on their way to the international airport in Montevideo, Uruguay. AP Photo

A man relaxes on a bench in London, next to a sculpture of Paddington Bear, as the country is in lockdown to help curb the spread of the coronavirus. AP Photo

The next challenge in the coronavirus pandemic will be to avoid a second wave of infections as shops and businesses begin to re-open.

Italy and Spain, two of the countries that were hit hardest by Covid-19 outbreaks, have begun taking small steps to lift some of the restrictions that were implemented to contain the pandemic that has killed more than 40,000 in both countries.

With some countries declaring they are passed their peak infections, the World Health Organisation (WHO) has issued a guideline of six key criteria for governments to consider when lifting lockdowns.

1. Transmission control

The first key step to easing restrictions and preventing a second wave is having no local transmission. The WHO said they would measure this as being when new cases are either detected sporadically or when they come in clusters from known contacts or people coming into the country.

The WHO also highlighted health system capacity as key. Ensure health systems are operating at manageable levels and not overburdened, this includes maintaining what the WHO calls a substantial reserve of clinical care capacity or enough empty beds and doctors to accommodate an influx of new cases if needed.

2. Health system capacity

The WHO listed five key measures needed to continue managing the outbreak effectively. These were detection, testing, isolation, treatment and contact tracing.

The WHO recommends authorities continue to actively look for new cases through measures such as entry screening and providing test results within 24 hours.

Effective testing capacity would allow health systems to quickly asses both suspected patients and recovered patients in order to verify they are virus-free.

The WHO recommends designated isolation spaces, whether that is in a hospital or an isolation facility. Home isolation is to be used as a last resort as it further burdens authorities when it comes to contact tracing. All close contacts are to be quarantined for 14 days.

3. Protect the vulnerable

The WHO says authorities must take additional steps with high-risk or high-infection settings such as shared accommodation and nursing homes.

The measures should aim to minimise the risk of infection - with personal protective equipment and regular sterilisation - but also have plans for outbreaks that include triage capability.

4. Keep workplaces safe 

Essential but high footfall spaces such as workplaces and schools must keep measures to lower the risk of infection, such as physical distancing, hand washing, respiratory etiquette (such as covering your mouth and nose with your arm when you sneeze) and temperature monitoring.

5. Screen passengers 

Authorities should not consider lifting lockdowns until they've completed a thorough analysis of likely origin and routes of cases that entered the country.  Measures to rapidly detect and isolate travellers suspected of carrying coronavirus must also be in place.

6. Engage the public

The WHO says public co-operation will be vital to successfully transitioning out of lockdown.

Countries that ease restrictions should wait at least two weeks to evaluate the impact before moving further.

In Asia, many countries saw a rise in cases when restrictions were first eased.

China, Hong Kong and Singapore are still recording new cases after promising declines.

In China, the government says almost all new cases are coming from overseas - highlighting the need to test and monitor passengers.

Singapore, which was viewed as a model for contact-tracing during its initial outbreak, remains in a "critical situation" said Health Minister Gan Kim Yong as the country faces a second wave of infections, many originating from foreign worker dormitories.

In Spain, employees in select industries such as manufacturing and construction have been allowed to return to work, while Italy has also reopened limited shops and businesses. Germany is preparing to open schools and lift restrictions in May.