Countries
that successfully kept COVID-19 infections and deaths down not only acted early
but in a more community-centred way, says a public-health physician who aims to
improve preparedness for the next wave and beyond.
Dr.
Saverio Stranges chairs the department of epidemiology and biostatistics at
Western University's medical school in London, Ont. In a recent commentary in
the International Journal of Health Policy and Management, he examined some of
the reasons why places like South Korea, Vietnam, Hong Kong and Germany curbed
community transmission of the novel coronavirus early on compared with Italy,
France, Spain, the United Kingdom and the U.S. Stranges, colleague Mostafa
Shokoohi and co-author Mehdi Osooli of Lund University in Sweden said that what
counts is a strong community health response.
What
works? A community-centred approach means testing people outside of hospitals
quickly to find cases, tracing their contacts and containing infections in a
timely and efficient fashion. Community-based approaches—implemented
at the right time—are vital to reduce community transmissions and manage the
response for pandemics until an effective vaccine becomes available.
Trained staff are
an essential part of outbreak investigation and control programs. There is a need
to boost training in infectious disease epidemiology, as well as in control and
surveillance of communicable diseases and emerging infectious diseases. There
is an existing body of evidence underscoring the need for promoting
international partnership in mitigation and suppression strategies to fight
epidemics, expanding national and international investments in prevention and
control of emerging infectious diseases, allocating an adequate supply of
scarce resources and facilities (e.g., personal protective equipment),
increasing staffing capacities, enhancing collaborative research, and
transparently sharing data during the pandemics. In addition, as supported by
evidence from South Korea4 and Taiwan, utilizing the advanced information technology
system for either tracing cases or aggregating critical data are essential in
the containment process of the epidemics.
The paper's authors gave successful examples,
such as:
· South
Korea's rapid expansion of diagnostic capacity and innovative drive-through and
walk-in screening.
· Quarantine
of suspected cases and mass masking in Vietnam.
· Taiwan's
efforts to address stigma associated with people who test positive.
· Germany's
extensive testing policy to identify milder cases, including in younger people.
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