A Swiss cheese approach to pandemic safety

Lately, I’ve been enthusiastic about pandemic safety and Swiss cheese. It’s an uninspiring cheese, but it surely’s a superb visible metaphor for a layered approach to an infection management.

This ‘Swiss Cheese Model’ has been round since no less than the 1990’s, when it was proposed as a mind-set about how accidents occur. During the pandemic, it’s been pressed into a distinct form of service, used to visualize illness prevention as a substitute of accidents.

In a pandemic as widespread as this one, no single motion can preserve an individual from getting sick. There will at all times be flaws (holes) in any approach. Washing your arms gained’t preserve you from respiration within the virus — and sporting a fabric masks gained’t utterly shield you in case you’re caught in a stuffy room with an contaminated particular person. But stack them along with some layers of air flow and strong testing, and also you’ve acquired your self a sport plan. (Or a very boring cheese plate. Either means.)

The hope is that the holes in a single approach will likely be coated by the strengths of the others. Some layers have extra holes than others, and a few, like vaccines, don’t exist but.

The drawback is that we appear to preserve holding out for a single, stable piece of cheese as a substitute of accepting our hole-y actuality. Here within the United States, we simply set a document for variety of day by day instances, including 99,000 instances in a single day to a complete that’s now greater than 9 million. At this level, we want all the pieces, something that we’ve acquired to beat again this factor that’s stolen all our lives.

It’s not straightforward. We’ve been at this for months and we’re all deeply fatigued. We’re prepared to see our pals, or go exterior with no masks, or work out at a health club, and as a substitute we’re juggling the masks, hand sanitizer, filtration techniques, psychological tape measures, and Zoom. Having a single factor to do or bear in mind as a substitute of layering up can be simpler than operating by way of our lengthy record of COVID calculations day by day.

It’s even worse as a result of every of these Swiss cheese layers we’re wrapping ourselves in solely get us to safer. They nonetheless don’t get us to protected. There’s no straightforward app to price your own home’s air flow, no strict record of guidelines for forming a pandemic pod, no choose to rule when COVID disputes crop up between pals, or households, or co-workers. The endlessly irritating reply to seemingly all pandemic-related questions is ‘it depends.’

Scientists are working to work out extra concrete solutions. But as speedy as analysis is, it’s nonetheless not going to have the option to satiate our deep starvation for certainty “in these uncertain times”. Until that is over, we’re going to have to snack on all of the layers we will, stacking each new intervention collectively till we discover a mixture that sticks.

Here’s what else is going on this week.


A room, a bar and a classroom: how the coronavirus is unfold by way of the air
This is a unbelievable visualization of how the coronavirus may unfold in numerous settings, and with totally different interventions. Unsurprisingly, the extra layers of precautions, the higher. (Javier Salas, Heather Galloway/El Pais)

Why You Shouldn’t Worry About Studies Showing Waning Coronavirus Antibodies
There’s been a number of discuss antibodies just lately. This story breaks down what’s helpful in these research — and what isn’t. (Apoorva Mandivalli/The New York Times)

Low danger or dicey? Two new experiences paint totally different photos of COVID-19 hazard whereas flying
“The danger (of contracting COVID-19 on a flight) is low, but it surely’s not zero,’’ Christopher Sanford, a founding father of the journey medication clinic on the University of Washington Medical Center instructed USA Today. “The reply is a giant fats ‘it depends,’’
(Dawn Gilbertson/USA Today)


Gilead’s Covid-19 Drug Is Mediocre. It Will Be a Blockbuster Anyway.
Veklury, the drug previously generally known as Remdesivir was accredited by the FDA final week. But approval doesn’t carry the identical efficiency that many individuals suppose it does. “F.D.A. approval doesn’t guarantee a certain level of benefit — all it says is that there is some benefit,” Aaron S. Kesselheim, a professor of medication at Harvard Medical School instructed The New York Times. The drug isn’t the silver bullet many have hoped for. But it’s nonetheless going to promote extraordinarily properly. (Katie Thomas/The New York Times)

Regeneron halts trial of antibody therapy in critically unwell Covid sufferers
Both Regeneron and Eli Lilly have now stopped testing their antibody therapies on critically unwell COVID-19 sufferers. They will proceed testing these therapies in sufferers with milder instances, the place the medication should still have some profit. (Hannah Kuchler/Financial Times)

It could also be time to reset expectations on after we’ll get a Covid-19 vaccine
Experts are discovering it more and more unlikely that we’ll see a vaccine that’s protected, efficient, licensed and extensively obtainable by subsequent spring. That’s not a nasty factor — with one thing that may have an effect on billions of lives, it pays to be cautious. (Helen Branswell/STAT)

Moderna says it’s getting ready international launch of Covid vaccine because it takes in $1.1 billion in deposits
Even as timelines get pushed, drug firms are urgent ahead with manufacturing their vaccines in anticipation of approval. That’s additionally not a nasty factor — if the drug is protected and efficient, being ready for an approval may assist ease demand and get extra individuals vaccinated sooner. (Berkeley Lovelace Jr./CNBC)

Temperature sensors will assist preserve COVID-19 vaccines potent
Take a peek contained in the tech that can assist safely distribute whichever vaccine is finally accredited. (Nicole Wetsman/The Verge)


What We’re Voting for: Public Health
There’s an election within the US subsequent week. The consequence issues to any variety of causes, from platform regulation to democracy itself — and in the midst of a worsening pandemic, the way forward for public well being within the US will likely be determined on the poll field. Nicole Wetsman has an editorial at The Verge about what’s at stake for public well being on this election.

Additional studying:

America Is About to Choose How Bad the Pandemic Will Get
(Ed Yong / The Atlantic)

More than numbers

To the greater than 45,683,708 individuals worldwide who’ve examined optimistic, might your street to restoration be clean.

To the households and pals of the 1,190,516 individuals who have died worldwide — 229,710 of these within the US — your family members usually are not forgotten.

Stay protected, everybody

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