Containment of COVID-19: Recommendations and Contradictions
COVID-19 is transmitting from person to person through close contact. As of May 28, 2020, COVID-19 has attacked more than 5.85 million people worldwide and caused more than 359,000 deaths.
Each country develops recommendations to curb the spread of COVID-19 and reduce morbidity and mortality among medicals and others who have close contacts with potentially infected people.
These recommendations are often contradictory: Many countries have quite different preferences for social distance and PPE norms of use for common people and medicals.
Additionally, the lack of personal protective equipment complicates the optimal use of face masks in medical organizations.
WHO has ordered a systematic review to determine the optimal social distance norms to prevent infection when caring for infected with SARS-CoV-2, SARS-CoV, or MERS-CoV. The purpose is to investigate the impact of physical distance, masks, and eye protection on virus transmission in medical and non-healthcare settings.
Sources
Previous randomized studies were aimed at common respiratory viruses, such as seasonal flu. But a systematic review of these studies is not suitable for extrapolating results to COVID-19.
The current review is included with 172 non-randomized studies in 16 countries on six continents and 44 comparative studies in health and non-medical care settings (total of 25,697 patients).
All studies have evaluated the impact of social distance, wearing a PPE on preventing transmission of COVID-19 viruses and related diseases: Severe Acute Respiratory Syndrome [SARS] and Middle East Respiratory Syndrome [MERS].
The Newcastle-Ottawa scale was used to assess the quality of comparative non-randomized studies.
Results
Physical distancing prevents transmission and reduces the number of adverse outcomes of COVID-19 disease. A social distance of at least 1m reduces the risk of infection while a distance of 2m or more significantly lowers your chances of being infected.
Wearing face masks protects both medical staff and common people from being infected with coronavirus as well as eye protection can provide additional benefits. But neither the mask, visor, or glasses provide complete protection from the infection.
The review results show that N95 respirators protect medical personnel from the virus interference more reliably than surgical masks. Both N95 respirators and surgical masks offer greater protection compared to single-layer masks. Using eye protection also increases your safety.
For common people, this data shows that a physical distance of more than 1m together with mask-wearing is very effective even in the day-to-day environment. For protection, you can use both respirators and disposable surgical and reusable 12-16-layer cotton masks.
Other basic measures (such as hand hygiene) are still needed in addition to physical distancing and PPE use.
The aerosol spread of coronavirus
COVID-19 is spreading via large droplets and closed contacts. It has not yet been decided whether the virus can spread through aerosols from respiratory drops.
Some studies show that viral RNA can be detected in the air samples. However, detecting a virus RNA does not necessarily imply replication and infection.
Meta-analysis results suggest that even in the absence of aerosolization, respirators may simply be more effective at preventing infection than masks.
Prevention – a key for deterrent of COVID-19
While new data is being generated on pharmacological treatments, vaccines, and other protective strategies, measures of prevention are the best ways to contain COVID – 19.
Effective protection – Social distancing not less than 1m, wearing a mask or respirator, and eye protection.
In it necessary to conduct further researches, including randomized studies, to find an optimal physical distance and to estimate the effectiveness of various types of masks for the medical staff and common people.
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