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PreviewAdvancedSpecial charactersHelpHeadingLevel 2Level 3Level 4Level 5FormatInsertLatinLatin extendedIPASymbolsGreekGreek extendedCyrillicArabicArabic extendedHebrewBanglaTamilTeluguSinhalaDevanagariGujaratiThaiLaoKhmerCanadian AboriginalRunesÁáÀàÂâÄäÃãǍǎĀāĂ㥹ÅåĆćĈĉÇçČčĊċĐđĎďÉéÈèÊêËëĚěĒēĔĕĖėĘęĜĝĢģĞğĠġĤĥĦħÍíÌìÎîÏïĨĩǏǐĪīĬĭİıĮįĴĵĶķĹĺĻļĽľŁłŃńÑñŅņŇňÓóÒòÔôÖöÕõǑǒŌōŎŏǪǫŐőŔŕŖŗŘřŚśŜŝŞşŠšȘșȚțŤťÚúÙùÛûÜüŨũŮůǓǔŪūǖǘǚǜŬŭŲųŰűŴŵÝýŶŷŸÿȲȳŹźŽžŻżÆæǢǣØøŒœßÐðÞþƏəFormattingLinksHeadingsListsFilesDiscussionReferencesDescriptionWhat you typeWhat you getItalic''Italic text''Italic textBold'''Bold text'''Bold textBold & italic'''''Bold & italic text'''''Bold & italic textDescriptionWhat you typeWhat you getReferencePage text.<ref>[https://www.example.org/ Link text], additional text.</ref>Page text.[1]Named referencePage text.<ref name="test">[https://www.example.org/ Link text]</ref>Page text.[2]Additional use of the same referencePage text.<ref name="test" />Page text.[2]Display references<references />↑ Link text, additional text.↑ Link text== Strategies == {{Main|Public health mitigation of COVID-19}} [[File:20200410 Flatten the curve, raise the line - pandemic (English).gif|thumb|upright=1.5|Goals of mitigation include delaying and reducing peak burden on healthcare (''[[flattening the curve]]'') and lessening overall cases and health impact.<ref name="Lancet2020Flatten" /><ref name="RnW59" /> Moreover, progressively greater increases in healthcare capacity (''[[raising the line]]'') such as by increasing bed count, personnel, and equipment, help to meet increased demand.<ref name="Vox_20200407">{{#invoke:cite news || vauthors = Barclay E, Scott D, Animashaun A |title=The US doesn't just need to flatten the curve. It needs to "raise the line." |url=https://www.vox.com/2020/4/7/21201260/coronavirus-usa-chart-mask-shortage-ventilators-flatten-the-curve |work=Vox |date=7 April 2020 |archive-url=https://web.archive.org/web/20200407155950/https://www.vox.com/2020/4/7/21201260/coronavirus-usa-chart-mask-shortage-ventilators-flatten-the-curve |archive-date=7 April 2020 |url-status=live}}</ref>]] Many countries attempted to slow or stop the spread of COVID-19 by recommending, mandating or prohibiting behaviour changes, while others relied primarily on providing information. Measures ranged from public advisories to stringent lockdowns. Outbreak control strategies are divided into elimination and mitigation. Experts differentiate between elimination strategies (known as "[[zero-COVID]]") that aim to completely stop the spread of the virus within the community,<ref name=Barcelona >Anna Llupià, Rodríguez-Giralt, Anna Fité, Lola Álamo, Laura de la Torre, Ana Redondo, Mar Callau and Caterina Guinovart (2020) ''[https://www.isglobal.org/documents/10179/7943094/26_ISGlobal+COVID19+y+COVIDCero+o+Maxima+Supresion+EN/0a4e83bb-6257-4f5d-8960-16c323b464b2 What Is a Zero-COVID Strategy] {{Webarchive|url=https://web.archive.org/web/20220103205923/https://www.isglobal.org/documents/10179/7943094/26_ISGlobal+COVID19+y+COVIDCero+o+Maxima+Supresion+EN/0a4e83bb-6257-4f5d-8960-16c323b464b2 |date=3 January 2022 }}'', Barcelona Institute for Global Health – COVID-19 & response strategy. "''The strategy of control and maximum suppression (zero-COVID) has been implemented successfully in a number of countries. The objective of this strategy is to keep transmission of the virus as close to zero as possible and ultimately to eliminate it entirely from particular geographical areas. The strategy aims to increase the capacity to identify and trace chains of transmission and to identify and manage outbreaks, while also integrating economic, psychological, social and healthcare support to guarantee the isolation of cases and contacts. This approach is also known as "Find, Test, Trace, Isolate and Support" (FTTIS)''"</ref> and mitigation strategies (commonly known as "[[flattening the curve]]") that attempt to lessen the effects of the virus on society, but which still tolerate some level of transmission within the community.<ref name=Livermore >{{#invoke:cite web||first=David|last=Livermore|author-link=David Livermore (microbiologist)|url=https://www.hartgroup.org/zero-covid-an-impossible-dream/|title='Zero Covid' – an impossible dream|date=28 March 2021|publisher=HART – Health Advisory & Recovery Team|access-date=2 January 2022|archive-date=2 January 2022|archive-url=https://web.archive.org/web/20220102070601/https://www.hartgroup.org/zero-covid-an-impossible-dream/|url-status=live}}</ref> These initial strategies can be pursued sequentially or simultaneously during the [[acquired immunity|acquired immunity phase]] through natural and [[COVID-19 vaccine|vaccine-induced immunity]].<ref name="Bhopal2020">{{#invoke:cite journal || vauthors = Bhopal RS | title = To achieve "zero covid" we need to include the controlled, careful acquisition of population (herd) immunity | journal = BMJ | volume = 370 | pages = m3487 | date = September 2020 | pmid = 32907816 | doi = 10.1136/bmj.m3487 | s2cid = 221538577 | eissn = 1756-1833 }}</ref> ''Nature'' reported in 2021 that 90 percent of researchers who responded to a survey "think that the coronavirus will become [[endemic (epidemiology)|endemic]]".<ref>{{#invoke:cite journal || vauthors = Phillips N | title = The coronavirus is here to stay – here's what that means | journal = Nature | volume = 590 | issue = 7846 | pages = 382–384 | date = February 2021 | pmid = 33594289 | doi = 10.1038/d41586-021-00396-2 | s2cid = 231945680 | bibcode = 2021Natur.590..382P }}</ref> === Containment === {{further| Zero-COVID}} Containment is undertaken to stop an outbreak from spreading into the general population. Infected individuals are isolated while they are infectious. The people they have interacted with are contacted and isolated for long enough to ensure that they are either not infected or no longer contagious. Screening is the starting point for containment. Screening is done by checking for symptoms to identify infected individuals, who can then be isolated or offered treatment.<ref name="f4SpW">{{#invoke:cite news||title=Fever Screening | IntelliSEC | Durban, Johannesburg, Cape Town|url=https://intellisec.co.za/fever-screening/|website=IntelliSEC}}</ref> The [[Zero-COVID]] strategy involves using public health measures such as [[contact tracing]], [[COVID-19 testing|mass testing]], [[Travel during the COVID-19 pandemic|border quarantine]], [[COVID-19 lockdowns|lockdowns]] and [[Use and development of software for COVID-19 pandemic mitigation|mitigation software]] to stop [[Transmission of COVID-19|community transmission]] of COVID-19 as soon as it is detected, with the goal of getting the area back to zero detected infections and resuming normal economic and social activities.<ref name=Barcelona /><ref name="Lancet-Li-2020">{{#invoke:cite journal || vauthors = Li Z, Chen Q, Feng L, Rodewald L, Xia Y, Yu H, Zhang R, An Z, Yin W, Chen W, Qin Y, Peng Z, Zhang T, Ni D, Cui J, Wang Q, Yang X, Zhang M, Ren X, Wu D, Sun X, Li Y, Zhou L, Qi X, Song T, Gao GF, Feng Z | title = Active case finding with case management: the key to tackling the COVID-19 pandemic | journal = Lancet | volume = 396 | issue = 10243 | pages = 63–70 | date = July 2020 | pmid = 32505220 | pmc = 7272157 | doi = 10.1016/S0140-6736(20)31278-2 }}</ref> Successful containment or suppression reduces [[Basic reproduction number#Effective reproduction number|Rt]] to less than 1.<ref name="ImpCollege16mar2020" /> === Mitigation === {{further|Flattening the curve}} Should containment fail, efforts focus on mitigation: measures taken to slow the spread and limit its effects on the healthcare system and society. Successful mitigation delays and decreases the epidemic peak, known as "flattening the [[epidemic curve]]".<ref name="Lancet2020Flatten" /> This decreases the risk of overwhelming health services and provides more time for developing vaccines and treatments.<ref name="Lancet2020Flatten" /> Individual behaviour changed in many jurisdictions. Many people worked from home instead of at their traditional workplaces.<ref>{{#invoke:cite web || author = US Census Bureau |title=Those Who Switched to Telework Have Higher Income, Education and Better Health |url=https://www.census.gov/library/stories/2021/03/working-from-home-during-the-pandemic.html |website=Census.gov |access-date=25 December 2021}}</ref> ==== Non-pharmaceutical interventions ==== [[File:04.02 總統視察「中央流行疫情指揮中心」 49726568957 66543b616e o.jpg|thumb|The CDC and WHO advise that masks (such as worn here by Taiwanese President [[Tsai Ing-wen]]) reduce the spread of SARS-CoV-2.]] [[Non-pharmaceutical intervention]]s that may reduce spread include personal actions such as wearing [[Face masks during the COVID-19 pandemic|face masks]], self-quarantine, and [[Hand washing|hand hygiene]]; community measures aimed at reducing interpersonal contacts such as closing workplaces and schools and cancelling large gatherings; community engagement to encourage acceptance and participation in such interventions; as well as environmental measures such as surface cleaning.<ref name="community mitigation" /> ==== Other measures ==== More drastic actions, such as quarantining entire populations and strict travel bans have been attempted in various jurisdictions.<ref name="RwmYm" /> The [[Chinese government response to COVID-19|Chinese]] and [[COVID-19 pandemic in Australia#Responses|Australian government approaches]] have included many lockdowns and are widely considered the most strict. The [[New Zealand government response to the COVID-19 pandemic|New Zealand government response]] included the most severe travel restrictions. As part of its [[K-Quarantine]] program, South Korea introduced mass screening and localised quarantines, and issued alerts on the movements of infected individuals. The [[COVID-19 pandemic in Singapore#Government response|Singaporean government's response]] included so-called "[[2020 Singapore circuit breaker measures|circuit breaker lockdowns]]" and financial support for those affected while also imposing large fines for those who broke quarantine.<ref name="shZdf" /> ==== Contact tracing ==== {{See also|Use and development of software for COVID-19 pandemic mitigation|Public health mitigation of COVID-19#Information technology}} [[Contact tracing]] attempts to identify recent contacts of newly infected individuals, and to screen them for infection; the traditional approach is to request a list of contacts from infectees, and then telephone or visit the contacts.<ref name="web" /> Contact tracing was widely used during the [[Western African Ebola virus epidemic]] in 2014.<ref>{{#invoke:cite journal ||last1=Webb |first1=Glenn |last2=Browne |first2=Cameron |last3=Huo |first3=Xi |last4=Seydi |first4=Ousmane |last5=Seydi |first5=Moussa |last6=Magal |first6=Pierre |title=A model of the 2014 ebola epidemic in west Africa with contact tracing |journal=PLOS Currents |date=30 January 2015 |volume=7 |pages=ecurrents.outbreaks.846b2a31ef37018b7d1126a9c8adf22a |doi=10.1371/currents.outbreaks.846b2a31ef37018b7d1126a9c8adf22a |doi-broken-date=31 January 2024 |pmid=25685636 |pmc=4323422 |issn=2157-3999 |doi-access=free}}</ref> Another approach is to collect location data from mobile devices to identify those who have come in significant contact with infectees, which prompted privacy concerns.<ref name="IngramWard20200407">{{#invoke:cite web||date=7 April 2020|title=Behind the global efforts to make a privacy-first coronavirus tracking app|url=https://www.nbcnews.com/tech/tech-news/behind-global-efforts-make-privacy-first-coronavirus-tracking-app-n1177871|access-date=10 April 2020|publisher=NBC News|vauthors=Ingram D, Ward J}}</ref> On 10 April 2020, Google and [[Apple Inc.|Apple]] announced an initiative for privacy-preserving contact tracing.<ref name="0DF25">{{#invoke:cite web || url=https://social.techcrunch.com/2020/04/10/apple-and-google-are-launching-a-joint-covid-19-tracing-tool/ |title=Apple and Google are launching a joint COVID-19 tracing tool for iOS and Android |website=TechCrunch |date=10 April 2020 |access-date=10 April 2020}}</ref><ref name="20200410apple">{{#invoke:cite web || url=https://www.apple.com/covid19/contacttracing/ |title=Privacy-Preserving Contact Tracing |date=10 April 2020 |website=Apple }}</ref> In Europe and in the US, [[Palantir Technologies]] initially provided COVID-19 tracking services.<ref name="0k3hR">{{#invoke:cite news ||title=Palantir provides COVID-19 tracking software to CDC and NHS, pitches European health agencies |url=https://techcrunch.com/2020/04/01/palantir-coronavirus-cdc-nhs-gotham-foundry/ |access-date=22 April 2020 |work=TechCrunch}}</ref> === Health care === {{Further|Flattening the curve|list of countries by hospital beds|Shortages related to the COVID-19 pandemic}} WHO described increasing capacity and adapting healthcare as a fundamental mitigation.<ref name="WHOEuropeResponse">{{#invoke:cite web || url=https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-technical-guidance/coronavirus-disease-covid-19-outbreak-technical-guidance-europe/hospital-readiness-checklist-for-covid-19 |title=Hospital readiness checklist for COVID-19 |date=25 March 2020 |publisher=World Health Organization |access-date=27 March 2020}}</ref> The ECDC and WHO's European regional office issued guidelines for hospitals and [[primary health care|primary healthcare services]] for shifting resources at multiple levels, including focusing laboratory services towards testing, cancelling elective procedures, separating and isolating patients, and increasing [[Intensive care unit|intensive care]] capabilities by training personnel and increasing [[ventilator]]s and beds.<ref name="WHOEuropeResponse" /><ref name="ECDCresponse">{{#invoke:cite report ||url=https://www.ecdc.europa.eu/en/publications-data/checklist-hospitals-preparing-reception-and-care-coronavirus-2019-covid-19 |title=Checklist for hospitals preparing for the reception and care of coronavirus 2019 (COVID-19) patients |date=26 February 2020 |publisher=European Centre for Disease Prevention and Control |access-date=27 March 2020}}</ref> The pandemic drove widespread adoption of [[telehealth]].<ref>Multiple sources: * {{#invoke:cite journal || vauthors = Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, Caffery LJ | title = Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19) | journal = Journal of Telemedicine and Telecare | volume = 26 | issue = 5 | pages = 309–313 | date = June 2020 | pmid = 32196391 | pmc = 7140977 | doi = 10.1177/1357633x20916567 }} * {{#invoke:cite journal || vauthors = Ohannessian R, Duong TA, Odone A | title = Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action | journal = JMIR Public Health and Surveillance | volume = 6 | issue = 2 | pages = e18810 | date = April 2020 | pmid = 32238336 | pmc = 7124951 | doi = 10.2196/18810 |doi-access=free}} * {{#invoke:cite journal || vauthors = Keshvardoost S, Bahaadinbeigy K, Fatehi F | title = Role of Telehealth in the Management of COVID-19: Lessons Learned from Previous SARS, MERS, and Ebola Outbreaks | journal = Telemedicine Journal and e-Health | volume = 26 | issue = 7 | pages = 850–852 | date = July 2020 | pmid = 32329659 | doi = 10.1089/tmj.2020.0105 | s2cid = 216111135 | doi-access = free }}</ref> ==== Improvised manufacturing ==== [[File:COVID-19 patient wearing scuba mask in absence of available artificial lung ventilation. Chernivtsi, Ukraine.jpg|thumb|A patient in Ukraine in 2020 wearing a [[Diving mask|scuba mask]] in the absence of [[artificial ventilation]]]] Due to [[supply chain]] capacity limitations, some manufacturers began [[3D printing]] material such as nasal swabs and ventilator parts.<ref name="technologyreview615420">{{#invoke:cite news || vauthors = Temple J |title=How 3D printing could save lives in the coronavirus outbreak |url=https://www.technologyreview.com/s/615420/3d-printing-coronavirus-covid-19-medical-supplies-devices/ |access-date=5 April 2020 |work=MIT Technology Review}}</ref><ref name="aCPem">{{#invoke:cite news || vauthors = Tibken S |title=3D printing may help supply more essential coronavirus medical gear |url=https://www.cnet.com/news/3d-printing-may-help-supply-more-essential-coronavirus-medical-gear/ |access-date=5 April 2020 |publisher=CNET}}</ref> In one example, an Italian startup received legal threats due to alleged [[patent infringement]] after reverse-engineering and printing one hundred requested ventilator valves overnight.<ref>Multiple sources: * {{#invoke:cite news ||title=[Updating] Italian hospital saves Covid-19 patients lives by 3D printing valves for reanimation devices |url=https://www.3dprintingmedia.network/covid-19-3d-printed-valve-for-reanimation-device/ |access-date=20 March 2020 |work=3D Printing Media Network |date=14 March 2020}} * {{#invoke:cite news || vauthors = Peters J |title=Volunteers produce 3D-printed valves for life-saving coronavirus treatments |url=https://www.theverge.com/2020/3/17/21184308/coronavirus-italy-medical-3d-print-valves-treatments |access-date=20 March 2020 |work=The Verge |date=17 March 2020}} * {{#invoke:cite web || url=https://globalnews.ca/news/6695286/coronavirus-italy-3d-print-valves/ |title=Engineers 3D-print patented valves for free to save coronavirus patients in Italy |website=Global News}}</ref> Individuals and groups of [[Maker culture|makers]] created and shared [[open source]] designs, and manufacturing devices using locally sourced materials, sewing, and 3D printing. Millions of [[face shield]]s, protective gowns, and masks were made. Other ad hoc medical supplies included shoe covers, surgical caps, [[powered air-purifying respirator]]s, and [[hand sanitizer]]. Novel devices were created such as [[ear saver]]s, [[non-invasive ventilation]] helmets, and ventilator splitters.<ref>{{#invoke:cite book || vauthors = Cavalcanti G, Cocciole C, Cole C, Forgues A, Jaqua V, Jones-Davis D, Merlo S |title=Design, Make, Protect: A report on the Open Source Maker and Manufacturer Response to the COVID-19 PPE Crisis |date=2021 |publisher=Open Source Medical Supplies & Nation of Makers |pages=18–22 |url=https://opensourcemedicalsupplies.org/wp-content/uploads/2021/01/Design-Make-Protect_21.01.27.pdf |access-date=17 June 2021}}</ref> === Herd immunity === In July 2021, several experts expressed concern that achieving [[herd immunity]] may not be possible because Delta can transmit among vaccinated individuals.<ref name=":1">{{#invoke:cite journal||vauthors=Dyer O|date=August 2021|title=Covid-19: Delta infections threaten herd immunity vaccine strategy|journal=BMJ|volume=374|pages=n1933|doi=10.1136/bmj.n1933|pmid=34340962|s2cid=236778544}}</ref> CDC published data showing that vaccinated people could transmit Delta, something officials believed was less likely with other variants. Consequently, WHO and CDC encouraged vaccinated people to continue with non-pharmaceutical interventions such as masking, social distancing, and quarantining if exposed.<ref name=":2">{{#invoke:cite news||date=13 August 2021|title=5 Things To Know About the Delta Variant|work=Yale Medicine News|url=https://www.yalemedicine.org/news/5-things-to-know-delta-variant-covid|access-date=18 August 2021|vauthors=Katella K}}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. If you do not want your writing to be edited mercilessly, then do not submit it here. You are also promising us that you wrote this yourself, or copied it from a public domain or similar free resource (see Christianpedia:Copyrights for details). Do not submit copyrighted work without permission! Cancel Editing help (opens in new window) Discuss this page