So, what does one do, in
the middle of an outbreak,
with an illness like COVID-19.
Well, there are many
interventions that are possible
and especially are important, when,
many individuals in a local region are infected.
So, mitigation strategies for an outbreak setting,
are most successful if one
can control public gatherings.
I mean, this is all about social distancing,
if most people are infected, don't go to an area,
where you might be exposed to
all those respiratory secretions.
Physical distancing, minimum of three feet,
more like six feet, perhaps even
longer, in the setting of COVID-19,
where some transmission has been through aerosols,
those small droplets which travel far further,
than one to two meters out from the human being.
And for those situations where
one can not socially distance
and even for those cases in a crowd setting,
requiring face masks is critical.
In fact, if one looks at the pandemic to date,
one of the most successful
intervention strategies has been,
mandatory face masks to prevent
transmission of droplets
with a secondary smaller benefit of
preventing being exposed to the droplets
from other individuals.
What about, where there's a
limited number of infected people.
So, that this would typically be,
an intervention in the early stages,
either pre-epidemic or the very first stages
of introduction to a small community,
where there's a limited number of infected people.
In that situation one can
isolate the suspect case,
test them and then do contact tracing,
to see whom they are exposed to
and whom they might have
exposed and then provide a
quarantine sort of using the ring
system to limit the spread.
The ring system means taking the index patient,
quarantining all their first or primary contacts
and then quarantining the
contacts of the contacts.
It’s a two-ring system, which
has been used very successfully
in other epidemics and the
global history of the world.
There were several
general mitigation measures in place
during the first year of the pandemic.
Some of these directives included facial
masking in public, avoiding large crowds
or sick individuals, and maintaining
social distancing of two meters
or six and a half feet
to help prevent local spread
As the second year of the pandemic began,
the CDC recommended masks be worn
by both vaccinated and unvaccinated
individuals at high risk settings.
In the time since, mask
mandates have been generally lifted,
but their use is still recommended
for at risk individuals.
Other steps to take, not
touching face or eyes with hands.
This has to do with proven
by the hands, to mucosal surfaces of
active virus, within respiratory droplets.
So, potentially an infected person coughs
or sneezes onto a horizontal surface,
let's say the desk and then
your hand rests on the desk,
acquires the respiratory droplets
with active virus in and then you,
touch your eye you rub your nose,
I don't know, pick your teeth,
so, there’s absolutely
the potential for transmission that way,
so, avoiding that contact.
And then along with that
washing the hands frequently.
Soap and water scrubbing for at least 20 seconds,
followed by a strong rinse.
You can sing the alphabet song twice if that helps
or using an alcohol-based hand sanitizer,
where there is at least 60 percent
ethanol or our isopropyl alcohol,
in the hand sanitizer itself, rub till dry.
Using good respiratory hygiene,
if the person is unmasked,
now, that this may be,
maybe we had a mask rupture,
because that happens that
the strings come unattached
or we forgot the mask and it's
in our car or something.
So, coughing into the crook of the elbow,
using a tissue to cover the mouth,
anything one can do to cover nose and mouth,
when coughing or sneezing
is going to be appropriate.
Other general infection control practices
include things like improving
ventilation in indoor spaces
by opening windows, using HEPA filters
and routinely cleaning surfaces,
especially in high traffic areas.
Quarantine protocols after close contact
exposure have also shifted
since the beginning of the pandemic.
state that if an individual is up to date
on their vaccinations or has recently
had COVID, no quarantine is needed.
But they must wear a mask around others
for ten days
unvaccinated or those not up to date on
their boosters are still asked
to self-quarantine for at least five days
and wear a mask for ten days
after a close contact exposure.
If a person has a confirmed
or suspected case of COVID
with mild symptoms or positive viral test,
they should self-quarantine
for at least five days
and wear a mask for ten days
regardless of vaccination status.
Recovered patients can have detectable
COVID RNA for three months in their upper
respiratory tract, but they are unlikely
to be infectious at this point.
The number of positive flu cases
recorded by the CDC between September 2020
and January 2021 dropped 99%
from that same period the year prior.
So if these mitigation measures
have been used in
2018 to 2019, we can extrapolate that
nearly 290,000 cases of the flu
could have been prevented.