One of the main issues in managing the #coronavirus is that there are so many things to do that govs don't know what they should or shouldn't do. It's simple.


[2/
There are 4 layers of defense against #COVID19
1. Keep infections out
2. When they do come in, prevent them from meeting others
3. When they do meet others, prevent them from infecting them
4. When that happens, identify and neutralize those infections

[3/
Some ppl that the Swiss Cheese Strategy, and it's an apt metaphor. Each layer is like a slice of holed cheese: imperfect, with holes. But the more slices you pile up, the more holes you cover, and the more you can stop the virus.
[4/
Many have already used this metaphor, including people like @MackayIM, @jkwan_md, @SiouxsieW, and others
https://twitter.com/MackayIM/status/1315414981127544832
All of us have been originally inspired by James T Reason's model of safety incidents
[5/
Let's go layer by layer.

The 1st one is Fences: Prevent infections from coming into your community.

Not a single country has controlled the virus without a Fence. Every country serious about this needs one.

No Fence, No Defence

[6/ https://twitter.com/tomaspueyo/status/1323180486223540224
2. Social Bubbles: Abstain from meeting other ppl
Simple: If you don't meet ppl, you don't get infected.
Problem: It's really nice to meet people. And we consume when we do, so we create jobs.

Social bubbles include measures like lockdowns, curfews, business closures...
[8/
Lockdowns are expensive. They should be avoided as much as possible, and only used if the situation is out of control and the community has a plan to dance.

I leave this here so that I have a go-to tweet for every time doomyellers accuse me of being a lockdown apologist
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3. Contrafection: How to reduce contagiousness when ppl do meet.
I created a word for this precise concept because none exists. I used the same structure as
Contraception ➡️ Contra-Conception
Contrafection ➡️ Contra-Infection
[10/
Whereas Layer 2 is super expensive, Layer 3 is very cheap. It's also made up of smaller layers that add up to each other and, together, can dramatically reduce the epidemic.

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4. Test–Trace–Isolate: Identify a neutralize infections.
Ppl focus so much on testing and contract tracing that they forget that's just the intelligence. The action comes when you actually isolate or quarantine ppl. And if you don't enforce that, ppl won't do it.
[11/
The cool thing is that not only govs can do this. In fact, any community can apply the same defense.

Eg, a uni campus can test & quarantine students on arrival (layer 1), split classes into teams (layer 2), have classes outdoors and wear masks (layer 3) & sewage tests (layer 4)
That's it.

With this framework, I hope we can all track exactly everything that needs to be done and keep our politicians and community leaders accountable.

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