What works when fighting a Pandemic?

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.