The COVID-19 landscape is shifting. The epicentre is no longer Wuhan, the capital of China's Hubei province. After 76 days, that city's complete lockdown ended on Wednesday: the borders reopened, many restrictions were lifted, however officials warned further infections are likely.

The new geographical focus of the novel coronavirus outbreak is New York City. It recorded its highest number of fatalities in a single day this week: 779 deceased. And while the situation in Italy is still dire, experts forecast the UK will become the worst hit nation in Europe.

Meanwhile, NSW recorded its lowest number of new COVID-19 cases in a single day since mid-March – 48 – which prompted NSW premier Gladys Berejiklian to remark that some of the social restrictions could be eased by 1 May.

But, the truth of the matter is, for the time being it's a waiting game. While it appears that social distancing and isolating are flattening the curve, there's always the chance that cases of the highly contagious virus will start escalating once more.

And if that's the case, there are some quite extreme containment measures being proposed overseas, which – like other initiatives first taken up abroad – could soon be mirrored in this country.

A new COVID order

Scott Morrison announced stage one COVID-19 restrictions on 22 March, which entailed closing bars, entertainment venues and sporting facilities. This was around the same time that Germany imposed a ban on individuals congregating outdoors with more than one person outside their own household.

While the Merkel government's two person rule sounded harsh, it was only a week later that the Australian PM stood at his podium late on a Sunday night to announce that the very same prohibition was being implemented as part of stage 3 restrictions.

Yet, the two person rule seems almost conservative when you factor in other considerations being made elsewhere.

Inspecting households

Speaking from the World Health Organisation's headquarters in Geneva on 30 March, WHO Health Emergencies Programme executive director Michael J Ryan suggested that now half the world is in lockdown, most transmissions will occur in households, so this must be the next line of defence.

"We need to go and look in families to find those people who may be sick and remove them and isolate them in a safe and dignified manner," Dr Ryan suggested, adding that this ability to locate and remove sick individuals from within households is key to transitioning out of lockdowns.

Dr Ryan's not the only expert spruiking this idea. The New York Times science and health reporter Donald McNeil recently appeared on television suggesting that this form of intrusive monitoring would be the new direction taken in the fight against COVID-19.

"You've got to get people who are infected out of their homes, so they don't infect their family members, even if they have mild cases," McNeil said. He then suggested that testing infected people once is not enough, as a negative test doesn't necessarily mean an individual doesn't have it.

Detaining potentials

If this doesn't sound daunting enough, we can turn to the UK, where the Johnson government recently passed the Coronavirus Act 2020, as schedule 21 of the document contains provisions relating to the forced removal of "potentially infectious persons" for screening.

These individuals can be deemed potentially infectious if they've been in an infected area – say, the entire London metropolitan region – within the last two weeks. And following screening, the subject can be ordered to remain in a specific place for a certain period, either in isolation or not.

This period of detainment can last for a maximum of 14 days. However, if a public health officer considers that person to still be "potentially infectious" at the end of the period, they can then order more isolation for a further 14 days.

And there's no limit to how many times the detainment period may be extended.

So, while we sit in lockdown in Australia, the potential for an acceleration of COVID-19 in a similar manner to the US or the UK is not the only fear.

There's also the now well-trodden pandemic path, which provides that draconian measures taken overseas will most likely be adopted over here and become the norm.

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