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- Page navigation anchor for RE: Rotating quarantines for containing outbreaks while relaxing physical distancingRE: Rotating quarantines for containing outbreaks while relaxing physical distancing
Perhaps we could do better than to modulate degrees of physical distancing and case finding in response to the occupancy of ICUs. The chief objective should surely be to contain any outbreaks as rapidly as possible, whatever the state of the health-care system. Given the delays inherent in incubation and detection, and the contagiousness of individuals for days prior to the appearance of symptoms, that objective of rapid containment suggests that policy should not be purely reactive. Here is a rough sketch of a protocol with the proactive feature of 'rotating quarantines.' It could potentially contain outbreaks even before they are detected, and might safely allow activities that would have to be prohibited under a purely reactive strategy.
The population is divided into two cohorts, with each household contained entirely within one cohort or the other. (Simple means of partitioning might be based on residential addresses -- e.g., even and odd street numbers.) At a given moment, one cohort can engage in 'normal activity’ while the other is quarantined. 'Normal activities’ are those permitted by the current regime of physical distancing; quarantine means that individuals remain within their households. Every one or two weeks, say, the cohorts change roles.
Most infections that arise during normal activity should come to light during the subsequent quarantine, if not earlier. Indeed, testing might focus on the quarantined cohort...
Show MoreCompeting Interests: None declared.References
- Ashleigh R. Tuite, David N. Fisman, Amy L. Greer. Mathematical modelling of COVID-19 transmission and mitigation strategies in the population of Ontario, Canada. CMAJ 2020;10.1503/cmaj.200476.
- G.Stewart, K van Heusden K, GA Dumont. Coronavirus: policy design for stable population recovery. IFAC Blog; 2020. http://blog.ifac-control.org/control/coronavirus-policy-design-for-stable-population-recovery
- NM Ferguson, D Laydon, G Nedjati-Gilani, N Imai, K Ainslie, M Baguelin et al. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College London; 2020.