The Swiss Cheese Model of Pandemic Defense

The Swiss Cheese Model of Pandemic Defense


A. Distance is the most effective intervention; the virus doesn’t have legs, so if you are physically distant from people, you avoid direct contact and droplets. Then you have to consider inside spaces, which are especially in play during winter or in hotter countries during summer: the bus, the gym, the office, the bar or the restaurant. That’s because we know SARS-CoV-2 can remain infectious in aerosols (small floaty droplets) and we know that aerosol spread explains Covid-19 superspreading events. Try not to be in those spaces with others, but if you have to be, minimize your time there (work from home if you can) and wear a mask. Don’t go grocery shopping as often. Hold off on going out, parties, gatherings. You can do these things later.

We don’t talk about eye coverings much, but we should, because we don’t know enough about the role of eyes in transmission. We do know that eyes are a window to the upper respiratory tract.

A. The misinformation mouse can erode any of those layers. People who are uncertain about an intervention may be swayed by a loud and confident-sounding voice proclaiming that a particular layer is ineffective. Usually, that voice is not an expert on the subject at all. When you look to the experts — usually to your local public health authorities or the World Health Organization — you’ll find reliable information.

An effect doesn’t have to be perfect to reduce your risk and the risk to those around you. We need to remember that we’re all part of a society, and if we each do our part, we can keep each other safer, which pays off for us as well.

Another example: We look both ways for oncoming traffic before crossing a road. This reduces our risk of being hit by a car but doesn’t reduce it to zero. A speeding car could still come out of nowhere. But if we also cross with the lights, and keep looking as we walk, and don’t stare at our phone, we drastically reduce our risk of being hit.

We’re already used to doing that. When we listen to the loud nonexperts who have no experience in protecting our health and safety, we are inviting them to have an impact in our lives. That’s not a risk we should take. We just need to get used to these new risk-reduction steps for today’s new risk — a respiratory virus pandemic, instead of a car.

A. We each need to do our part: stay apart from others, wear a mask when we can’t, think about our surroundings, for example. But we can also expect our leadership to be working to create the circumstances for us to be safe — like regulations about the air exchange inside public spaces, creating quarantine and isolation premises, communicating specifically with us (not just at us), limiting border travel, pushing us to keep getting our health checks, and providing mental health or financial support for those who suffer or can’t get paid while in a lockdown.



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