Saturday, March 7, 2020

COVID 19 Control Strategies Contain, Delay. Research and Mitigate

COVID 19 Control  Strategies Contain, Delay. Research and Mitigate

Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA

Contain (identify, isolate and trace contacts) is based on the fact that if it could be controlled in China it would be controlled everywhere else. They locked down the 5 crore city. But that has not happened. Despite monumental contact tracing and screening efforts and prompt isolation and first-rate care of people with COVID-19 there is a continued increase in the number of COVID-19 cases across the globe.

Delay: The aim of this phase is to slow the spread of the virus, reducing the impact and pushing it away from the winter season. If the peak of the virus can be delayed until warmer months, it can reduce the risk of overlapping with seasonal flu and other challenges that the colder months bring.

Public can help delay the peak of the infection with simple measures including adhering to the "catch it, bin it, kill it" strategy for sneezing and coughing, and hand-washing.

Next steps for the delay phase include the possibility of school closures, encouraging more home working, and reducing large-scale gatherings.

The research phase: Research takes various forms including looking into new diagnostic tests, drugs to treat Covid-19, preventative vaccines, and coming up with the best course of care for people affected.

The mitigate phase: In the event of the outbreak worsening, or a severe, prolonged pandemic, the response will escalate and the focus will move away from "contain" and "delay" to "mitigate". This phase involves providing the best care for people who become ill, supporting hospitals, and ensuring support for those who become infected but do not require hospital treatment.

It also involves plans to minimise the impact of disease on society, public services and the economy. The next steps in the mitigate phase could include emergency services focusing on critical functions - for instance, this could mean police concentrating on responding to serious offences and maintaining public order if the number of officers dwindles. In hospitals, non-urgent cases could be delayed and staff leavers and retirees could be called back to duty.

The stages of contain, delay and mitigate don't have to be separate – in fact, some countries are choosing to use parts of all three stages at the same time. The steps don’t have to happen in isolation. In some parts of the world containment is not practical or feasible.

If you model out the epidemic, is you will get 50% of all the cases over a 3-week period and 95% of the cases over a 9-week period.

Like UK India is also using both the, modes contain and delay at the same time.

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