Eight key points for reducing the spread of coronavirus
to maintain routine life.
Nearly one year ago, on March 11, 2020, the World Health Organization declared COVID-19 a global pandemic, saying it is “10 times deadlier than the 2009 flu pandemic”. Unlike during the H1N1 influenza pandemic in 2009, the world came to a halt with SARS-CoV-2. As we look back and analyse our experience with coronavirus crisis management, we observe that it can be possible to pursue daily life during a pandemic without the heavy costs of lockdowns.
1 – Continued empowerment of the local authorities in cutting chains of infections
a. Epidemiological investigations in the authority: Conducting epidemiological investigations within the local authority by qualified interrogators, and immediate detection of potential infections. The potential patients enter isolation immediately and the infection chains within the authority can be controlled.
b. Sampling operation in the local authority: Establishment of a headquarters that coordinates all the operational factors involved in cutting infection chains: Sampling, interrogation, isolation, and evacuation to hotels if necessary. The headquarters receives information from all sources — HMOs, hospitals, laboratories, various investigation routes — and coordinates it in systems that allow the control chains to be controlled and located locally and efficiently.
c. Direct connection of the chain’s cutting system from the Ministry of Education to the Authority: Sampling of educational institutions in the city to detect early morbidity among students and teaching staff is carried out by the Ministry of Education. The sampling, which is prioritized by the characteristics of the educational institution, allows for the detection of asymptomatic and pre-symptomatic identification, as well as early morbidity prior to the outbreak in the institutions. The sampling system in the educational institutions is directly connected to the chain’s cutting system in the authority and makes it possible to cut off infection chains that originate in the educational institutions.
d. Empowerment of aid organizations: Training of medical and rescue organizations within the authority to sample the community according to the guidelines of the Ministry of Health, and the establishment of small and fast teams to perform sampling in the homes of the patients. The more samples are performed, the faster the infection chains can be controlled.
2 – Creating a new parameter R according to households counting
The infection of Covid-19 usually occurs in indoor spaces where people gather for a long time, therefore infection within the family is one of the most common forms of infection. In certain sectors in Israel, where living and routine conditions are more crowded, infection within households is becoming a factor affecting infection in the entire environment, and the rise in parameter R.
Due to the danger of this infection, when one of the family members is identified as verified patient, the entire household has to isolate to avoid a wide infection that spreads outside the family. When the household is in isolation, it becomes “one unit”. The ability of the family members to infect the environment is neutralized, thus interrupting the chain of infection in the community. This shows that it is not as important to count the verified patients, but rather to count the households in which there is at least one verified patient as “units”. Therefore, a new parameter R suggests counting the households, in addition to counting the individual verified patients.
The households graph will make it possible to measure how the virus spreads in the community, outside the households — which is significant and more difficult to identify, control and cut — and will show the rates of infection clearly.
3 – Technology as an assistance tool in enforcement and information
The visual dimension:
- Use of technology in shopping centers: In the public spaces and shopping centers, the potential for the use of the visual dimension is obvious, due to the thousands of cameras already present in them. Combining cameras with advanced technologies can significantly help in two fields: Firstly, with assisting in epidemiological research and monitoring of contacts in an efficient, rapidly and accurately. This allows immediate alert of crowded areas, through which enforcement teams can locate areas that require attention and address them in a targeted, effective way.
- Use of technology in resorts and hotels: Use of security cameras deployed at the resorts, to activate the enforcement forces for a specific mission: Full control of the public space at the resorts, identification of gatherings, indication for masks. This way epidemiological contacts can be investigated accurately and immediately.
Command and control system integrating various technologies in educational Institutions:
- Code scanning: The students and staff of the educational institution scan codes when entering and leaving the institution, in order to create a database that helps monitor contacts among students and staff.
- A multi-layered control and monitoring system which enables control at the level of the individual educational institution, based on the structures and spaces of the educational institution, and the management of all the nation’s educational institutions by the district’s authorities.
- Use of a smart wristband that monitors movement and builds a digital database for identifying and recording contacts between students and staff of the educational institution, which is used for accurate epidemiological investigations.
- An app that integrates a quick corona test for weddings and mass events: Use of the app as a condition for the guests to enter the event. The app combines a health statement signed by the guests, a quick corona test and body temperature measurement, a code scan at the entrance and exit of the event, wearing a smart bracelet for monitoring contacts.
4 – Approval of outlines for living during the pandemic
In order to enable a routine of life during the pandemic, outlines that adapt the daily activities in the State of Israel to the limitations of the virus have been written. Outlines agreed upon by the population are preferred, even if less epidemiologically ideal, which dictate the limitations legally.
The outlines adopted by the population constitute a significant step in adapting lifestyles to the reality that exists during the pandemic, and enable the public to maintain its lifestyles without endangering its health and the health of those around.
- The mikvah outline allows immersion in the mikveh for women who have been infected with the virus, under restrictions to prevent infection in the mikvahs. Arrival at the mikveh will be arranged in advance, at regular intervals, and will be done by ambulance.
- The wedding outline allows events to take part in the open air as well as in indoor spaces. The number of guests is determined by the size of the space and the “color” of the authority (according to the traffic light model). The weddings will be held in capsules while the guests are monitored in the days after the wedding, in order to locate verified patients and cut off potential infection chains at events.
- The winter prayers outline allows praying in indoor spaces when the cold and rainy weather prevents from praying outside. In synagogues, the number of participants in prayer is limited, the guests are divided into capsules and must wear masks.
5 – Effective information campaigns
Public information effort is a significant part when dealing with the pandemic, with the main goal of engaging the public by raising awareness, reflecting risks and spreading guidelines. A variety of methods and means of information must be used to reach the entire population.
Information in the local authority
Building an information system in the local authority that is designed to the target audience in terms of content, platform and language. Access to a unified message that complies with the government guidelines and the other bodies operating in the authority. Identification of information gaps and issues of discussion that arise from the residents of the authority.
Strategy
A short-term and dynamic strategy that varies according to the guidelines and gaps that arise from the public. The topics will vary depending on the relevant news (lockdowns, vaccinations, holidays and special events) and depending on the feedback coming from the public (e.g., loosening of guidelines in a particular area).
In addition, the information system will try to anticipate and predict future events, and will conduct specific information related to the events (e.g., holidays and festivals, weddings and other gatherings). Information is provided on all platforms: Digital media, print press, signage, and in many languages to reach as wide a public as possible.
Community-adapted information
To reach to the entire public, information must be designed for unique communities with different characteristics. The information effort to the ultra-Orthodox public was adapted to the characteristics of the unique public. The public is not connected to digital media and usually does not use smartphones, so the platforms on which the messages were distributed were printed signs, newspapers, radio, public transport vehicles and automatic text messages to the residents’ cell phones. The ultra-Orthodox communities are led by rabbis.
Dedicated information was provided in collaboration with the rabbis and medical authorities. After these meetings, the rabbis conveyed the common messages and guidelines to the entire public. This delivers value messages, which correspond to the values of the ultra- Orthodox public, and are described with the local terms. Receiving feedback from the public, and adapting the information content to topics that concern the public (Torah study, vaccinations, prayers and events) becomes possible.
6 – Enforcement efforts
The enforcement effort is reflected in local and national forces to ensure compliance with the relevant guidelines of the region, and carry out public information. The goals of the enforcement effort are to increase the sense of security among the public, to prevent infection and to ensure compliance with the guidelines of the Ministry of Health.
Enforcement efforts must be dynamic and vary according to the morbidity situation in the area, to the vulnerabilities and to the events known in advance. It should be strengthened in areas where adherence to the guidelines is low, and in the weak points where multiple cases of infection often occur (such as shopping centers, synagogues, playgrounds).
- Disperse gatherings immediately and efficiently, and contain spot events that may lead to infection (weddings and celebrations, etc.), while informing the public about the guidelines and restrictions.
- Preparation for events known in advance (holidays, festivals, special events, etc.)
- Enforcement of home insulation.
- Enforcement of guidelines among businesses: Masks, guidelines for businesses, and closing non-essential businesses.
- The enforcement effort will include the municipal and national police, supervisory forces, as well as the authority employees and volunteers.
7 – Public transportation
The spread of Covid-19 is caused by a number of major infectious agents, all are characterized by prolonged stay in indoor spaces. These factors include: Infection within the family, due to the joint stay in a closed space for a long time and due to the physical closeness. Infection in workplaces, schools and synagogues, which are visited on a daily basis for a long time. And public transportation, in which passengers are in a closed space for varying periods of time. In workplaces, schools and synagogues, the rules can be observed almost completely, masks, social distance and rules of hygiene must be observed.
In public transport, on the other hand, it is very difficult, and sometimes impossible, to adhere to these rules because of the overcrowding, high passenger turnover, proximity of passengers and lack of enforcement measures. However, in some sectors public transport is the primary, and sometimes the only, means of mobility. Guidelines on public transportation during the Corona period set the number of lines to be reduced by 50%, and sometimes by 25%, but these guidelines led to greater density in public transport, which immediately leads to an increase in infections.
The method to make public transportation safe and prevent infection is to significantly increase the number of bus and train lines, which will decrease the number of passengers on each vehicle, minimize contact between passengers and prevent potential infection chains.
8 – Surveys to detect latent morbidity using mass sampling
Mass sampling is carried out in the local authority in order to reduce morbidity and allow the continuation of a routine of life without the need to close institutions, by performing tests for the entire population in a short period of time. The tests will be performed on all residents of the city over the age of 17, except for the recovering and students of boarding schools.
Goals: creating a complete morbidity map in the authority within 5 days, and isolating the verified households, identifying latent morbidity, preventing outbreaks and immediate control while maintaining the continuation of the routine of life in the city.
The urban sampling mechanism consists of three parts:
- An immediate set of tests for all relevant city residents.
- Isolation of verified households.
- Welfare support system for the isolated households.
Steps:
- Information and incentive campaign for residents, recruiting public figures to support the sampling operation.
- Sampling of all city residents in several centers in the city within a few days.
- Isolation of verified households.
- Conducting an epidemiological investigation for the verified patients.
- Isolating potential patients, Welfare Assistance for Insulators.
