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COVID19: DO WHAT IS NEEDED TO HOLD THE VIRUS AT BAY
By Dr David Nabarro, a Special Envoy of the World Health Organization Director-General on COVID-19
A. Widespread popular engagement: People everywhere need to adopt behaviours that make it hard for the virus to infect them. These include
- physical distancing, face masking;
- constant hand and cough hygiene with surface cleaning;
- prompt and effective self-isolating, by all as soon as symptoms appear or an individual is identified as a contact of a case (for the specified duration, usually at least 10 days);
- protecting people who are particularly susceptible or vulnerable.
B. Effective local action: Well-functioning local authorities, supported by national agencies interrupt and prevent transmission of the virus through;
- finding people suspected of having the disease and confirming through quick-turnaround testing;
- ensuring that people with symptoms or positive tests isolate properly;
- tracing individuals identified as a contact of someone with COVID-19 and ensuring they isolate as well;
- and,acting quickly to suppress outbreaks when they are building up (this may mean localised movement restrictions).
C. Integrated systemic responses: Systems need to be well organized and integrated, locally, nationally and internationally.
At local level this means, integrating local authorities, health services, residential care, businesses, religious groups, community organizations and local leaders so that they are ready to respond together as spikes in case numbers start to appear;
At national level this means ensuring that national authorities support the efforts of these integrated local groups; and,
Internationally this means strong cooperation and unified action by nations is essential – on everything from travel protocols to the development of new testing, treatment and preventive options like vaccines. The WHO, which is a product of the cooperation between nations, is a vital source of guidance and support.
D. Actions centred on the needs of people at risk: Responses to COVID-19 must focus on what really matters to people. Here are two realities;
- Responders must pay special attention to ensuring support for those who are disadvantaged; who face particular risks because of their living and employment conditions, who are vulnerable to loss of income or lack of food even if it is only for a few days;
- local and national governments must maintain essential services including health care for people who have non-COVID-19 conditions and social protection for those who are at risk of extreme poverty.
E. Avoid lockdown as the Primary means for containment:
- Lockdowns – or widespread movement restrictions – can be applied when the situation is perceived to be serious (rising case numbers, overloaded hospitals, clear community transmission and so on). They help authorities to buy time, to improve the ways in which public health and hospital systems work and to adapt them so they are ready to detect clusters of cases and suppress them quickly. Lockdowns do not get rid of the virus: they freeze it in place. The virus only disappears if transmission is interrupted through people with the virus being isolated for as long as they are infectious. Everything possible should be done to avoid widespread lockdowns as a PRIMARY containment measure.