Public health mitigation of COVID-19
Part of managing an infectious disease outbreak is trying to delay and decrease the epidemic peak, known as flattening the epidemic curve.[1] This decreases the risk of health services being overwhelmed and provides more time for vaccines and treatments to be developed.[1] Non-pharmaceutical interventions that may manage the outbreak include personal preventive measures such as hand hygiene, wearing face masks, and self-quarantine; community measures aimed at physical distancing such as closing schools and cancelling mass gathering events; community engagement to encourage acceptance and participation in such interventions; as well as environmental measures such surface cleaning.[5] It has also been suggested that improving ventilation and managing exposure duration can reduce transmission.[6][7]
This article is about public health management of COVID-19. For medical management of COVID-19, see Treatment and management of COVID-19.
During early outbreaks, speed and scale were considered key to mitigation of COVID-19, due to the fat-tailed nature of pandemic risk and the exponential growth of COVID-19 infections.[8] For mitigation to be effective, (a) chains of transmission must be broken as quickly as possible through screening and containment, (b) health care must be available to provide for the needs of those infected, and (c) contingencies must be in place to allow for effective rollout of (a) and (b).
By May 2023, in most countries restrictions had been lifted and everyday life had returned to how it was before the pandemic due to improvement in the pandemic's situation.[9][10]
Costs and challenges[edit]
Simulations for Great Britain and the United States show that mitigation (slowing but not stopping epidemic spread) and suppression (reversing epidemic growth) have major challenges. Optimal mitigation policies might reduce peak healthcare demand by two-thirds and deaths by half, but still result in hundreds of thousands of deaths and overwhelmed health systems. Suppression can be preferred but needs to be maintained for as long as the virus is circulating in the human population (or until a vaccine becomes available), as transmission otherwise quickly rebounds when measures are relaxed. Until now, the evidence for public health (nonpharmaceutical) interventions such as social distancing, school closure, and case isolation comes mainly from epidemiological compartmental models and, in particular, agent-based models (ABMs).[18] Such models have been criticized for being based on simplifying and unrealistic assumptions.[19][20] Still, they can be useful in informing decisions regarding mitigation and suppression measures in cases when ABMs are accurately calibrated.[21] An Argentinian modelling study asserted that complete lockdowns and healthcare system overextension could be avoided if 45 percent of asymptomatic patients were detected and isolated.[22] Long-term intervention to suppress the pandemic has considerable social and economic costs.[23]
Research and development[edit]
There are research-based developments that aim to mitigate COVID-19 spread beyond vaccines, repurposed and new medications and similar conventional measures.
Researchers investigate for safe ways of public transport during the COVID-19 pandemic.[57][58]
Novel vaccine passports have been developed.
Researchers are developing face-masks which could be more effective at reducing SARS-CoV-2 spread than existing ones and/or have other desired properties such as biodegradability and better breathability.[59][60][61][62][63][64] Some are also researching attachments to existing face-masks to make them more effective[63] or to add self-cleaning features.[63] The pandemic has increased efforts to develop such masks and some have received government grants for their development.[63]
Ventilation and air cleaners are also the subject of research and development.[65][66]
Researchers report the development of chewing gums that could mitigate COVID-19 spread. The ingredients – CTB-ACE2 proteins grown via plants – bind to the virus.[67][68]
On 23 April 2020, NASA reported building, in 37 days, a ventilator (called VITAL).[69][70] On April 30, NASA reported receiving fast-track approval for emergency use by the United States Food and Drug Administration for the new ventilator.[71] As of March 2020, 26 manufacturers around the world have been licensed to make the device.[72] The COVID-19 pandemic increased the demand for oxygen concentrators. During the pandemic open source oxygen concentrators were developed, locally manufactured – with prices below imported products – and used, especially during a COVID-19 pandemic wave in India.[73][74] Due to capacity limitations in the standard supply chains, some manufacturers are 3D printing healthcare material such as nasal swabs and ventilator parts.[75][76] In one example, when an Italian hospital urgently required a ventilator valve, and the supplier was unable to deliver in the timescale required, a local startup received legal threats due to alleged patent infringement after reverse-engineering and printing the required hundred valves overnight.[77][78][79]