pandemic_mitigation

pandemic transmission mitigation through public health measures

Introduction

  • each pandemic pathogen has its own transmission and disease characteristics which will have a significant determination of optimum public health planning measures to attempt to mitigate transmission

source: https://scoeh.ch/en/some-of-the-virus-can-become-airborne-do-i-have-to-worry/

General determinants of potential mitigation measures

efficacy of mitigation of transmission

  • these require public, personal and workplace measures especially in essential high risk areas such as meat works, hospitals, aged care
  • for many respiratory pathogens, transmission indoors is far higher risk than outdoors due to higher air flows and reduced viral load in the inhaled air for example Covid-19 infections are 20-40x more likely indoors
  • droplet spread
    • social distancing
    • masks
    • face shields or goggles (with masks)
    • other PPE if high risk
    • personal hygiene - hand washing, etc to reduce viral load on person
    • environmental cleaning to reduce spread by fomites
  • aerosol spread
    • avoid or manage aerosol generating behaviours or procedures in enclosed spaces or close to others without aerosol protections
      • eg. singing, shouting, hyperventilation such as exertion
    • avoiding people being in poorly ventilated spaces
    • increase ventilation
    • encourage outdoor living with social distancing, etc to minimize droplet spread
    • viral filtration of air flows
    • masks to reduce viral load in the air space
    • reduce time in enclosed spaces
  • early detection and isolation of infectious cases
    • a community willing, able and aware of the need for early testing and self-isolation if symptomatic
    • rapid access to diagnosis
    • strict processes to ensure quarantine for period of infectivity
    • excellent responsive contact tracing system to ensure tracing completed within 48 hrs

least impact on personal lives

  • basic needs - food, water, security, care needs, intimate partner relationships
  • mental wellbeing
    • social isolation aspects
  • physical wellbeing
    • indoor gyms are a particular risk from droplets, fomites and aerosol generation
    • encourage outdoor socially distanced activities
  • financial wellbeing
    • unemployment
    • loss of income through quarantine, furlough, illness, or business closures
  • personal development and education
    • home schooling
    • remote learning

least impact on economy

  • minimising closures of businesses - temporary or permanent
  • minimising unemployment
  • optimising public finance situation

practicality and compliance

  • simplicity
  • communication to all communities
    • multi-lingual, cultural barriers, etc
    • specific management of the vulnerable and the disenfranchised in society
  • acceptability
  • fairness
  • endorceability
  • minimising panic behaviours

unintended consequences

Example conundrums

maintaining regional tourism

  • the local population is likely to demand access to overnight holiday destinations whether these be seaside resorts or mountain escapes
  • the local businesses rely on this for their survival
  • whilst most activities are outdoors and thus at much lower risk for pathogen transmission than indoor activities, overcrowding risks outdoor social distancing compromises in addition to indoor transmission risks of restaurants, cafes and hotels as well as shared communal services such as shower/toilet blocks at camping grounds
  • furthermore, movement of potentially infectious cases from a higher prevalence urban zone to a low or zero prevalence region further spreads the pandemic and stretches containment resources
  • obviously, only those NOT in quarantine/self-isolation measures would be permitted to travel
  • potential solutions when the pathogen has not been eliminated
    • ban overnight stays
      • still runs the risk of day visitor numbers being excessive
      • has an enormous impact upon accommodation businesses as well as the ability for tourists to get away and relax for an extended period
    • restrict overnight stays
      • restrict number of rooms at accommodation venues or the number of camp sites at camping grounds
      • restrict numbers at each camp site and limit numbers in communal spaces such as showers and BBQs
      • ban parties or other events where over-crowding is a risk
    • strict observance of local transmission reduction measures
      • hand hygiene at petrol stations, communal service areas
      • social distancing
        • restricted numbers on boats, buses, etc
        • enforce distances between “family” groups at beaches, parks, etc
        • minimal numbers at essential service shops and consider allowing other shops to open pending prevalence risk
      • masks for any public indoor space or outdoors where close proximity is unavoidable
      • outdoor dining only or indoor with strict limitation of numbers and spacing whilst ensuring optimised ventilation to not only reduce potential viral loads in the air but prevent a source from spreading to others in the room
        • this may require a boost to regional meal delivery services
      • bans on bars and clubs
      • bans on music festivals
      • bans on crowds at events
      • bans or substantive restrictions on indoor communal activities such as gyms, spa resorts which are likely to be relatively high risk for transmission unless very well ventilated
pandemic_mitigation.txt · Last modified: 2020/09/07 11:43 by gary1