European recomendations on Non Pharmaceutical Interventions
On 2006-10-12, the European Centre of Diseases Control has published "Personal (non-Pharmaceutical) Public Health Measures for Reducing Transmission of Human Influenza - Interim ECDC Recommendations". (The US has a similar document, called "Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic".)
It makes a reference to two documents by the World Health Organisation (one on National and Community Measures and another on International Measures). My short summary: local measures will work to a certain extent and we should prepare for them, but international measures probably won't do much. Of course, don't take my word for it: go read the reports.
The ECDC document doesn't yet acknowledge the publication of very important data on "modeling community containment" by the Institute of Medicine (US).
A number of things are pretty obvious:
- There won't be a vaccine for the first many months after the beginning of a pandemic. Antivirals will be available to some and not to others. So we need to explore "non pharmaceutical interventions" (NPI) and get used to that term.
- Closing schools will mean less exposure to children, a flattening of the curve for all, and possibly less cases overall.
- Adding other "social distance" measures will provide aditional benefit. (There seems to be no substitute for closing schools early.)
- For it to work, school closure and other measures must be carried out really early in the pandemic, which means proactively. (If the pandemic is bad enough, schools will close reactively anyway. Accept it and get over it: schools will close, now what?.)
- Proactive things are acceptable if teachers and parents and employeers talk about it openly, now.
- For these measures to work, there's some preparation that needs to be carried out on many levels: how do communities (and businesses and essential services and families) deal with absentee rates due to parents taking care of children at home? Who needs to cross-train (how many people at your office can fix a computer problem)? Who needs to stock-up on food, water and other essential items?
Tell your family, friends, colleagues and citizens about it:
- Schools will close.
- It's better to close them proactively.
- They may be closed for more than two months.
- If things are bad we will need to add more "social distance" layers (closing schools will be the right thing to do but may not be enough).
- What will be the effects in our community?
- What should we do to prepare?
- Why wait, really?