Difference between revisions of "Interventions"

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* “You can’t fight a virus if you don’t know where it is,” <ref name="Tedros13-03-2020">Dr Tedros Adhanom Ghebreyesus at a briefing on Friday 13 March.</ref>
 
* “You can’t fight a virus if you don’t know where it is,” <ref name="Tedros13-03-2020">Dr Tedros Adhanom Ghebreyesus at a briefing on Friday 13 March.</ref>
 
* “Find, isolate, test and treat every case to break the chains of Covid transmission. Every case we find and treat limits the expansion of the disease.” <ref name="Tedros13-03-2020"/>
 
* “Find, isolate, test and treat every case to break the chains of Covid transmission. Every case we find and treat limits the expansion of the disease.” <ref name="Tedros13-03-2020"/>
* "The real moral dilemma is [..] when a health worker faces a COVID19 patient and they do not have the PPE to protect them. Would you want to be that health worker?" <Ref name="Ryan-09-03-2020">Dr Mike Ryan at the Daily COVID19 Press Conference. https://www.pscp.tv/w/1nAJEdnnzEaGL</ref>
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* "The real moral dilemma is [..] when a health worker faces a COVID19 patient and they do not have the PPE to protect them. Would you want to be that health worker?" <Ref name="Ryan-09-03-2020">Dr Mike Ryan at the Daily COVID19 Press Conference, 9 march 2020, https://www.pscp.tv/w/1nAJEdnnzEaGL</ref>
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* "We cannot care about millions, when we do not care about an individual" <ref name="Tedros-09-03-2020">Dr Tedros, at the Daily COVID19 Press Conference, 9 March 2020. https://www.pscp.tv/w/1nAJEdnnzEaGL</ref>
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* "No white flag, no surrender. We must fight. Every life counts" <ref name="Tedros-09-03-2020"/>
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* "You need to make the first move, not react to each move the virus makes. Or you will not control this" <ref name="MRyan-13-03-2020">Dr Mike Ryan, at the Daily COVID19 Press Conference, 13 March 2020. https://www.linkedin.com/video/live/urn:li:ugcPost:6644258800868175872/</ref>
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* "if you have to 'be right' before you make a move, you will lose [control over the outbreak]" <ref name="MRyan-13-03-2020"/>
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* "The problem with so many countries now is: so many people are afraid to make a mistake." <ref name="MRyan-13-03-2020"/>
  
 
==ECDC==
 
==ECDC==

Revision as of 19:29, 18 March 2020

This page collects observations, interpretations, and consequences for action about the Interventions for SARS-CoV2 in general. Please observe the structure of the page, when you add your content. Please use references where possible. Remember to find the relevant page. For example, if your observation is about transmission routes, please use that page, instead of posting your content here.

What does Global health say?

WHO

  • “You can’t fight a virus if you don’t know where it is,” [1]
  • “Find, isolate, test and treat every case to break the chains of Covid transmission. Every case we find and treat limits the expansion of the disease.” [1]
  • "The real moral dilemma is [..] when a health worker faces a COVID19 patient and they do not have the PPE to protect them. Would you want to be that health worker?" [2]
  • "We cannot care about millions, when we do not care about an individual" [3]
  • "No white flag, no surrender. We must fight. Every life counts" [3]
  • "You need to make the first move, not react to each move the virus makes. Or you will not control this" [4]
  • "if you have to 'be right' before you make a move, you will lose [control over the outbreak]" [4]
  • "The problem with so many countries now is: so many people are afraid to make a mistake." [4]

ECDC

  • "Measures taken at this stage should ultimately aim at protecting the most vulnerable population groups from severe illness and fatal outcome by reducing transmission." [5]

What do we see in the European Member States?

Instructions

Please use the bullet points below, to share your observations of policy, preferably with reference to formal publication and date. I will transpose those to the table (WikiTables are a headache, and difficult to edit, so I want to make it as easy as possible for everyone). Please use the information fields from the table, as much as possible, so that data can be transposed easily. Since this is a Wiki, each change is logged, and you can always browse through the page history to see the snapshot in time.

Bullet point notes

  • AU: Social distancing measures: people are advised only to entertain strict necessary personal contacts and replace all others by phone, digital or defer altogether. Allowed are: professional contacts; elementary daily shopping; care for those in need; avoid indoor activities outside the home. Since 16 March, for 1 week. The area of Tirol has quarantined certain municipalities. The Skying season has been ended by 15 March. Large events are forbidden. All shops that do not supply basic necessities are closed. Restaurants and bars are closed. Universities, schools and kindergartens are closed.
  • BE: Belgium in LockDown as of 17 March.
  • BU: Bulgaria’s President and Prime Minister, Rumen Radev and Boyko Borissov met on Sunday (15 March) and announced that all doctors and nurses “on the first line” will receive an additional 1000 leva (EUR 500) per month, which is a substantial amount by Bulgarian standards. 12 March: proposed emergency measures. More drastic measures to enforce the decision to close restaurants and shops other than those selling food and medicaments are in preparation (on 13 March). kindergarten, schools and universities will be closed, and that nationals of countries with coronavirus outbreak will not be allowed to enter the country. Violation of quarantine is punishable by jail and a fine up to EUR 25000. The Ministry of Foreign Affairs advised Bulgarians not to travel abroad. Bulgarians returning from countries with major coronavirus outbreak such as Italy, but also France, are automatically assigned to quarantine.[6]
  • CY:
  • CZ:
  • DE: 17 March: RKI raised the threat level to high. Avoid travel, avoid public transport, try to work from home. Reduce all contacts to a bare minimum. Avoid gatherings or meetings. People over 70 years need pneumococcal vaccination. The 16 German federal autonomous states each can have their own Corona policy. 16 March: Federal agreement on measures: bars, clubs, theatres, musea, cinema, zoos, sporting facilities, playgrounds are closed. Meetings in clubs, leisure, sport, church, mosques, other religious orders are forbidden.[7]
  • DK:
  • EE:
  • ES:
  • FI:
  • FR: Containment. Full Lockdown for 2 weeks. Police enforcement of state of emergency
  • GR: Mitigation approach. Schools and universities, all department stores, restaurants, theaters, museums, cinemas, beauty salons, are closed, all events are cancelled, advise working at home, stay at home when symptomatic or hen having a close contact with a confirmed case. Also there was a decision yestarday 16/03/2020 churches to be aooly measures (and all celebrations / rituals as we are going towards the Easter period to be cancelled or performed following basic rules such as every person to have at least 2 meters distance from the other). There was also a law issued recently that says that whoever is advised to stay at home (case or contact) and is caught not to be following the instructions will face legal consequences (up to 2 years of prison)! The same applies for professionals that disobey the rules. Already there are some arrests of people that opened their restaurants and other services to serve clients. Doctors have been advised not to examine patients with fever at their private offices as much as they can.

Take away services, super-markets and pharmacies are open as well as other services that have to do with transportation of goods. An online number is available for employees to call and get information on their rights on sick leave and reimbursement. At supermarkets since they were overcrowded the first days of the measures there was the decision to have a queue and based on the size of the space to let a specific number of persons enter. Inside the supermarkets there are sanitizers available and people should keep A distance of more that 2 meters from each other. super-markets will remain open on the weekends to avoid overcrowding. These are in summary some of the measures on 17/03/2020 that Greece has 353 reported cases and 4 deaths. 18/03/2020: 418 cases and 5 deaths. Further social distancing measures: groups of more than 10 people are forbitten (fine of 1000 euros)

  • HU:
  • IT:
  • LT:
  • LV:
  • MT:
  • NL: (see below as per 15 March 2020). 17 March: Prime Minister advised Dutch not to travel abroad.
  • PO:
  • PT:
  • RO:
  • SE:
  • SK:

Table

Country AU BE BU CY CZ DE DK EE ES FI FR GR HU IT LT LV MT NL PO PO PT PT RO SE SK
Stay in when flu-like symptoms Yes Yes No Yes Yes Yes Yes
Stay in when no good reason to go out Yes Yes No Yes Yes Yes Yes
Requested medical students to do voluntary work No No Yes Yes Yes
Cancelled large scale events Yes Yes Yes Yes Yes Yes Yes
Cancelled all events Yes Yes Yes Yes Yes Yes
Closed cafes and restaurants Yes Yes Yes Yes Yes Yes No
Closed schools Yes Yes Yes Yes Yes Yes Yes Yes
Closed borders No Yes No No Yes Yes
Other national policies Outdoor sporting events are allowed State of Emergency. All frontline doctors and nurses receive 500 Euro per month additional salary. Violation of quarantine is punishable by jail and fine up to 25000 Euro. Church, Mosques, other religious gathersings: Forbidden religious gatherings such as weddings are forbidden Advise not to travel abroad (17 march) None None
Additional measures by local government Full Lockdown No 16 autonomous federal states have specific policies. None None Reduction of the business hours of cafes and bars
Since when 16 March 2020 17 March 2020 16 March after 11/03 schools were closed and more restrict measures in general 1-2 weeks ago 11 March 13 March
Implementation pace Gradually. Step by step, as the number of cases increased Step by step, as the number of cases increased Step by step, as the number of cases increased Step by step, as the number of cases increased Step by step, as the number of cases increased
For how long will these measures be effective? Until 23 March Until 5 April Closing schools until 20 April; other measures untill further notice untill further notice At least until 6 April At least until 27 March Until 9 April
Additions to the governmental policies Tirol province has municipalities in quarantine. Work from home promoted, not obligatory. Ban on gathering, except families Advise not to travel abroad None Work from home promoted, ban of gatherings of more than 10 people (18/03/2020) None None None

Variance in National Policies promotes anxiety

Observations

  • Discussions emerge on social media between citizens that are confused, anxious or downright upset because of the variance in policy.
    • For example, in the Netherlands, some parties ask for a total lockdown, since Belgium and France do the same. They claim the NL government is not doing enough
  • Polls on 17 March show unprecedented high confidence in the Dutch Prime Minister (Mark Rutte): 73%
  • People wonder about UK and why the chose a different policy. Anxiety that English approach will jeopardise the meaures in the rest of Europe.

Analysis and interpretation

  • As for the situation in the Netherlands: though the confidence in government is high, it may be vulnerable. When a minority keeps shouting that we still do not do enough and backs such statement with 'evidence', referring to countries that go further, this may undermind public confidence, and in general compliance with current policy

Consequences for action

  • Short term:
    • Keep explaining why policy for one country is appropriate, and why it is not obligatory to do what your neighbour does, simply because countries differ in health system and other relevant infrastructure. Measures also depend on the phase of the epidemic in each country (not all countries are at the same phase simultaneously)
  • Mid term:
    • Create discussion and debate on the need for EU coordination. This means practically: a political decision to give up national autonomy in matters of PHEIC and hand over competence to the EU
  • Long Term:
    • Expand ECDC mandate, when political support has reached a majority.

References

  1. 1.0 1.1 Dr Tedros Adhanom Ghebreyesus at a briefing on Friday 13 March.
  2. Dr Mike Ryan at the Daily COVID19 Press Conference, 9 march 2020, https://www.pscp.tv/w/1nAJEdnnzEaGL
  3. 3.0 3.1 Dr Tedros, at the Daily COVID19 Press Conference, 9 March 2020. https://www.pscp.tv/w/1nAJEdnnzEaGL
  4. 4.0 4.1 4.2 Dr Mike Ryan, at the Daily COVID19 Press Conference, 13 March 2020. https://www.linkedin.com/video/live/urn:li:ugcPost:6644258800868175872/
  5. Rapid risk assessment: Novel coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK – sixth update https://www.ecdc.europa.eu/en/publications-data/rapid-risk-assessment-novel-coronavirus-disease-2019-covid-19-pandemic-increased
  6. Euraktive 13 March 2020: https://www.euractiv.com/section/health-consumers/short_news/bulgaria-update-covid-19/
  7. Bundesregierung Website Corona: https://www.bundesregierung.de/breg-de/themen/coronavirus/coronavirus-1725960