Preventative measures introduction
Preventative measures mean the things that you can do to reduce your risk of catching and spreading COVID-19. You can find clear and helpful advice on how to protect yourself and other people on the following websites:
WHO – preventative measures advice: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
WHO – COVID-19 information for the public: https://www.who.int/westernpacific/emergencies/covid-19/information
Africa CDC COVID-19 information: https://africacdc.org/covid-19/
Your country will have local or national rules, and these should be followed first. You may feel you want to add other precautions on top of the national guidelines, and that’s fine.
The questions we are going to look at in this/these session(s) are:
- What can I do to protect myself and others?
- What are country’s putting in place to try and prevent COVID-19?
- Why do some prevention methods work better that others, especially in certain countries?
What can I do to protect myself and others?
How does physical distancing work?
- According to the Centres for Disease Control, COVID-19 spreads mainly among people who are in close contact (within about 6 feet) for a prolonged period. Spread happens when an infected person coughs, sneezes, or talks, and droplets from their mouth or nose are launched into the air and land in the mouths or noses of people nearby. The droplets can also be inhaled into the lungs. Remember that not all people who have COVID-19 will know that they have it, but they are still able to pass it on to you, so it’s wise to practice physical distancing with everybody you meet outside your household (the people you live with) https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html
- The WHO recommends that you maintain at least a 1-metre distance between yourself and others to reduce your risk of infection when they cough, sneeze or speak. This distance should be increased indoors (there’s less ventilation indoors). The further away, the better.
Wear a face mask
How do face masks work?
- Masks are used to prevent or reduce the release of virus-containing droplets and tiny airborne particles responsible for the pathogen’s spread. This image from Gannawarra Shire Council’s website shows that the more people wearing masks (correctly), the less the risk of catching or spreading COVID-19: https://www.gannawarra.vic.gov.au/files/assets/public/image-galleries/media-releases/face-masks.jpg?dimension=pageimage&w=480
- This video shows how different types of mask can reduce the number of droplets coming from a person’s mouth, compared to someone not wearing a mask at all: https://www.youtube.com/watch?time_continue=22&v=DNeYfUTA11s&feature=emb_logo
- Whilst scientific evidence says that asking people to wear masks does reduce the spread of COVID-19, there is evidence suggesting they may not be the most effective method. This is most likely because:
- People often don’t wear them properly. This article from the New York Times shows you how NOT to wear a mask! https://www.nytimes.com/2020/04/08/well/live/coronavirus-face-mask-mistakes.html
- People may feel that they don’t have to adhere to other preventative measures e.g. social distancing
- People touch their faces more than they realise. If they touch their mask with contaminated hands, they raise their risk of inhaling the virus.
- Governments aren’t enforcing mask-wearing
- This article from Nature looks at the research that has been done on the effectiveness of masks: https://www.nature.com/articles/d41586-020-02801-8
- WHO videos on face masks: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks
- How to make a fabric face mask (CDC): https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-make-cloth-face-covering.html
Good personal hygiene
The most important part of personal hygiene when it comes to protecting yourself and others from COVID-19 is good hand washing practice! If you have COVID-19 and you touch your face, you could transfer some of the virus particles onto your hands. When you touch something else, such as a door handle, you can transfer those virus particles onto the door handle. The people touching that handle after you will then pick up the virus particles and if they then touch their faces (e.g. nose, mouth or eyes), they risk the virus entering into their body and becoming sick with COVID-19.
Of course, you can’t stop people touching things, so we need to make sure that their hands are clean first, and this is where hand washing is very important. Hand washing is especially important, because it can also prevent the spread of other diseases, such as flu and stomach bugs and more serious disease such as cholera.
WHO guide – how to use hand rub: https://www.who.int/docs/default-source/infection-prevention-and-control/how-to-handrub-poster.pdf?sfvrsn=f5e8bfb1_2
WHO guide – how to wash your hands with soap: https://www.who.int/docs/default-source/infection-prevention-and-control/how-to-handwash-poster.pdf?sfvrsn=8ab212f0_2
The WHO hand hygiene guide for healthcare workers: https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf
Watch this video from the UK’s National Health Service for a guide to how to wash your hands: https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/
This handwashing technique guide from the UK’s National Health Service shows you how to ensure you wash all parts of your hands: https://www.hey.nhs.uk/patient-leaflet/hand-hygiene-information/
Some important points on how to effectively wash your hands:
- You can use alcohol rub or soap (both are effective against COVID-19, but soap should be used if your hands are physically dirty)
- You should aim to wash your hands for at least 20 seconds (sing ‘happy birthday’ to yourself twice!)
- It’s important to make sure all parts of your hands (front, back, in between your fingers and around your nails)
This research paper found that when it comes to changing people’s behaviour, getting people to change their hand washing practices was more effective than getting them to wear a mask: https://www.qeios.com/read/OJXD82
Making your environment safer
It is impossible not to go into indoor environments, such as an office, shop or even your own home, where you are potentially more likely to catch COVID-19 due to poor air circulation and close proximity to others. There are a number of things you can do to make where you live and work safer:
- Regularly disinfect things and areas that people touch often (e.g. door handles, light switches, taps and toilets)
- Try to ensure there is good ventilation. Keep windows and doors open if possible
- Check the air conditioning units. It is likely to suck in air from the room, cool it and then blow it back out again (recirculating). Try to avoid staying in areas with recirculating air conditioners for too long, as any air containing COVID-19 particles will be blown back into the room, rather than outside, when you open a window
- Try to avoid crowded spaces. This may be difficult if you live or work in close contact with lots of people.
- Wear a mask if you can
BBC advice for staying safe in indoor environments: https://www.bbc.co.uk/news/explainers-53917432
What should I do if I think I have COVID-19?
The WHO have published a list of potential COVID-19 symptoms here: https://www.who.int/health-topics/coronavirus#tab=tab_3
It usually takes around 5-6 days from being infected, to becoming sick, although it can take up to 14 days and in some cases, people do not become ill at all (asymptomatic).
If you think you may have COVID-19, your country will have a website with a list of instructions to follow (e.g. get a COVID-19 test, self isolate), but in general, you should:
- If you have mild symptoms, you should stay at home and self-isolate (avoid contact with other people). You should ask someone to buy supplies for you so you don’t have to leave your house. You should try and avoid contact with those that live with you
- Clean common areas of your home more often (e.g. the bathroom). If you live with lots of other people in close quarters, there is advice here: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/living-in-close-quarters.html and here: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/shared-housing/index.html
- Make sure you stay hydrated and keep track of any symptoms that may develop
- If your symptoms get worse, contact your medical centre. Different countries have different protocols for looking after COVID-19 patients, be sure to check with your local health centre.
The CDC has a helpful web page explaining what to do if you think you may have COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html
What are countries putting in place to try to prevent COVID-19?
Whilst many countries are requesting that people do the things we listed in the last question (wearing masks, social distancing etc.), some have added further measures to try to prevent the spread of the disease:
- Lockdowns are restrictions put in place by a country’s government which aims to reduce the amount of contact people have with each other and therefore to reduce the spread of the disease
- Lockdown restrictions may vary from country to country, but they might include combinations of the following:
- Closing of shops, restaurants and leisure venues
- Closing of schools, colleges and universities
- Restricting people to a certain area (e.g. their town, area of a city)
- Restricting people to their homes (unless leaving for legal reasons)
- Restricting the use of public transport for key workers
- Putting queuing systems in place outside shops/venues and limiting the number of people allowed in at any one time
- Requiring people to wear masks in public places/indoor spaces
- Putting physical/social distancing measures in place in public spaces (e.g. 2 metre spacer stickers, posters etc.)
- Restricting social gatherings (e.g. no indoor gatherings of more than 6 people, only meeting others from outside your home in outdoor spaces)
- Restricting travel into and out of a country
- The above measures may be put in place across the whole of a country (national lockdown) or only in parts of a country with high rates of infection (local lockdowns).
- There may be different types of restrictions in place in different parts of the country, depending on the rates of infection (for example the Tier system introduced to the UK: https://www.ageuk.org.uk/information-advice/coronavirus/coronavirus-guidance/local-lockdown-tiers/
This page from the Financial Times shows the current COVID-19 restrictions in place in countries across the world. Scientists can compare the measures put in place by each country by comparing lockdown measures and giving them a score out of 100. This is done over time to show how a country is increasing or decreasing lockdown measures. Pressing the play button will show how the countries of the world have responded to COVID-19 since 23rd January 2020 https://ig.ft.com/coronavirus-lockdowns/
Track, trace and support
- Many countries have put a ‘track, trace and support’ system in place. This includes:
- Track: Also known as ‘test’. Using a reliable nationwide testing system using the tests explained in our ‘Diagnostics’ videos to identify people with COVID-19 quickly.
- Trace: Once a person has tested positive for COVID-19, it’s vital to trace the people they have come into contact with in the last few days, because they may have passed the virus on to these people. Even if they don’t appear to be sick (yet), by getting the contacts of a sick person to also isolate, you can reduce the potential for them to spread the disease.
- Support: the isolation period for people who have COVID-19 (or those contacts who may have it) is usually 14 days. By putting in place support measures to help people stay at home, people are more likely to follow the isolation rules. These measures may be financial (as they may not be able to work from home), medical (e.g. a phone service to keep a record of your symptoms) or a network of volunteers who will collect food.
- A good track, trace and support system relies heavily on a strong laboratory and healthcare system, because if not enough people are tested, then many positive cases may be missed and people won’t self-isolate.
- The speed at which people with COVID-19 are identified is vital. The longer a person who is infected interacts with people, the more people will potentially catch the disease over time.
- A strong track, trace and support system requires a strong laboratory and healthcare infrastructure to cope with the thousands or millions of tests required. Widespread testing, tracing and support is also expensive, as large amounts of equipment, chemicals and people are required to make it work smoothly. For this reason, it is often, but not always high income countries who have the strongest systems.
There is a lot of research that says a strong, country-wide track and trace system is vital to help slow the spread of COVID-19 and also help countries reduce the lockdown restrictions safely. However, much of the research on track, trace and support systems come from high income countries in Asia, Europe and America, due to the cost and infrastructure requirements needed for a strong system (although some high income countries, such as the UK, were criticised for not putting a track, trace and support system in place fast enough. It is thought that this delay contributed to the large number of cases and deaths in the UK). The WHO has pledged to provide 120 million affordable COVID-19 tests to help low and middle income countries increase their testing: https://www.who.int/news/item/28-09-2020-global-partnership-to-make-available-120-million-affordable-quality-covid-19-rapid-tests-for-low--and-middle-income-countries
Some research papers explaining the effect of track, trace and support can be found below:
This article talks about the potential issues with test and trace in low and middle income countries, using Bangladesh as an example: https://blogs.bmj.com/bmj/2020/06/05/contact-tracing-for-covid-19-in-low-and-middle-income-countries/
There a some reports looking at the ability of low and middle income countries to respond to COVID-19. In the following papers, scientists point out that whilst a fragile healthcare systems and a lack of resources may hinder the response to COVID-19, the increasing number of mobile phones in low and middle income countries could help to improve track, trace and support systems:
Do lockdowns work and why are the more successful in some countries than others?
It is generally accepted that lockdown restrictions are vital to slow the spread of COVID-19, but how and when to reduce the restrictions once cases have decreased is strongly debated, even within governments in a country. It is often difficult to balance between reducing cases and protecting healthcare systems, and enabling people to earn a living (closing and restricting shops, restaurants, offices etc. may mean people are unable to work).
A piece of research published in The Lancet suggests that countries should have learned lessons from the first wave and that the most effective way to control COVID-19 in the long term is to slowly reduce the restrictions that they have put in place. The scientists also think it’s vital that a country has an effective track, trace and support system in place, so they can quickly identify COVID-19 cases, ensure they isolate and provide the support they need to do so. To read the full paper, you can follow this link https://www.thelancet.com/article/S0140-6736(20)32007-9/fulltext
Generally, low and middle income countries have seen a lower infection and death rate than some high income countries, but their restrictions have varied. There is much debate as to why this may be, but some theories about why lockdown/restrictions work in some countries better than others include:
- In many low and middle income countries, most people do not earn a stable monthly wage (e.g. working in an office), but live on what they can earn in a day (e.g. farmers and market sellers). This When you rely on what you can earn in a day, it makes any restrictions on going to work very hard to implement.
- Level of government support. If a government can afford to financially support people when isolating or not going to work, people are more likely to follow the guidance.
- Cultural compliance. An example of this is that people in Asia have been much better at wearing face masks than people in Europe, most likely because it was already part of their lives pre-COVID-19).
This article compares the COVID-19 response of a number of countries and regions: https://www.dw.com/en/coronavirus-why-some-countries-fare-better-in-the-pandemic-than-others/a-55744552
This article looks at the potential strengths and problems that low and middle income countries face when responding to COVID-19: https://www.nature.com/articles/d41591-020-00020-2
This research paper suggests that social/physical distancing and travel restrictions are the most effective at preventing the spread of COVID-19, whereas environmental measures (e.g. cleaning of shared surfaces), whilst still better than nothing, are less effective: https://www.nature.com/articles/s41562-020-01009-0