From World health Organisation (WHO)

The purpose of this note is to outline public health and social measures useful for slowing or stopping the spread of COVID-19 at national or community level. Guidance for case finding and management, personal and environmental measures, travel measures, and mass gatherings is available on the WHO website available here.

Public health and social measures are measures or actions by individuals, institutions, communities, local and national governments and international bodies to slow or stop the spread of COVID-19. These measures to reduce transmission of COVID-19 include individual and environmental measures, detecting and isolating cases, contacttracing and quarantine, social and physical distancing measures including for mass gatherings, international travel measures, and vaccines and treatments. While vaccines and specific medications are not yet available for COVID-19, other public health and social measures play an essential role in reducing the number of infections and saving lives.

Social and physical distancing measures aim to slow the spread of disease by stopping chains of transmission of COVID-19 and preventing new ones from appearing. These measures secure physical distance between people (of at least one metre), and reduce contact with contaminated surfaces, while encouraging and sustaining virtual social connection within families and communities. Measures for the general public include introducing flexible work arrangements such as teleworking, distance learning, reducing and avoiding crowding, closure of non-essential facilities and services, shielding and protection for vulnerable groups, local or national movement restrictions and staying-at home measures, and coordinated reorganization of health care and social services networks to protect hospitals. The measures are used in conjunction with individual protective measures against COVID-19 such as frequent hand washing and cough etiquette.

All public health measures to stop disease spread can be balanced with adaptive strategies to encourage community resilience and social connection, protect incomes and secure the food supply. Countries should balance the possible benefits and negative consequences of each intervention and deploy strategies to encourage community engagement, gain trust and limit social or economic harm. There are many strategies that can support community resilience and mental health, protect access to essential goods and services, and limit the economic impact of stayat-home measures where these are deemed necessary. For example, organizing work-sites to ensure physical distance between persons, such as staggering shifts over time, or converting on-site service to home delivery may help to keep more businesses open. Tele-working and tele-schooling strategies in different contexts demonstrate innovation and the role of technology in supporting business continuity and sustaining social connection within families and communities. In general, implementation of distancing measures should also aim to sustain personal and professional community connections by virtual means and technology, including widely accessible means such as radio and mobile phones.

Alongside all these measures remains there is the critical to test all suspected cases of COVID-19 wherever possible, promptly isolate cases, trace contacts to the widest extent possible, and ensure quarantine of contacts for the duration of the incubation period. This goes for any context or level of spread of the pandemic in a country, in order to deepen the benefits of social measures. Social measures should make the task of contact tracing much easier as the number of contacts rapidly dwindles and eventually the number of cases declines as well. As social measures are lifted, it is essential to continue to strengthen case-finding, isolation for COVID-19 cases and quarantine of contacts, in order to respond to resurgent or imported cases. Coordinated reorganization of health and social services is essential to assess and test persons rapidly, treat patients effectively, and protect hospitals and health personnel.

WHO has described four levels of COVID-19 transmission. These are countries or local areas with: 1. No cases reported. 2. Sporadic cases. 3. Clusters of cases (grouped in place and time), or 4. Community transmission. Countries are putting in place a range of public health and social measures in different combinations and at varying times in the local evolution of the COVID-19 pandemic. The alignment of public health measures to levels of transmission in a community is not fixed in stone. Countries may wish to specify which measures are to be taken at each level and review the situation regularly. A package of measures may be applied at local, regional or national level and adjusted as needed, considering aspects such as culture, living environments, terrain and access to needed resources. Essential services should remain operational and governments should put in place social and economic policies to limit the longer term economic impact, support community resilience and enable rapid recovery. Most importantly, the ultimate aim is to ‘walk back’ community transmission to clusters, sporadic cases, and down to no cases at all, and to begin gradually lifting social measures as soon as it is safe to do so. Guidance for lifting measures is being developed.

To be effective, public health measures must be implemented with the full engagement of all members of society, including communities and professional groups. All measures should be accompanied with clear, accessible and regular risk communication to explain the response strategy and enable people to make informed decisions to protect themselves and help achieve the public health goal of ending the outbreak.

A table summarizing public health and social measures to support control of COVID-19 will be available shortly at www.who.int/epi-win.

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