By Víctor Ladero, Emilio Muñoz Ruiz and Jesús Rey Rocha - The Conversation
In these days of pandemic that have changed social relationships, there is a debate on how to save Christmas, how to maintain our social customs and family contacts.
But we have not yet been able to convey to the public that our actions and behaviors during these holidays
will translate into the evolution of the curve of admitted and deceased in January, as it already happened in the United States after Thanksgiving.
If we do not want to add the pressure of care to the classic January slope - caused by spending excesses at this time - we must spend these holidays with one word in mind: prevention.
The arrival of vaccines, the most effective tool to prevent infectious diseases, is just beginning in these last days of 2020. But they are only available in some countries and will be applied to specific groups of the population, although its distribution is foreseeable throughout the year 2021. Until then, and thinking about Christmas, we must continue taking preventive measures.
[USA. faces an atypical Christmas with record deaths from coronavirus and amid fear of the new strain]
Two areas can be distinguished in the exercise of prevention: that of the responsibility of individuals, both on their individual and citizen levels, and that of institutional responsibility.
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In order to demand responsibility on the part of the public in complying with preventive measures, we must ensure that there is adequate communication that allows us to understand these measures, how they work and what their usefulness is.
In the case of infectious diseases of the respiratory tract, such as COVID-19,
the first prevention objective is to avoid contagion among the population
, that is, transmission from one person to another.
We know that the SARS-CoV-2 virus particles are expelled by infected people through the tiny droplets of saliva that are emitted when sneezing or speaking, screaming and singing.
It is important to know that the heaviest droplets fall faster and at a shorter distance, settling on nearby objects, while the smaller ones, called aerosols, remain floating in the air for longer and can go further.
Prevention measures that depend on our individual or collective action as citizens include physical mechanisms (such as masks) and chemical mechanisms (such as disinfectant compounds): they are behavioral measures, not pharmacological.
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[Infections with a new strain of the coronavirus cause a Christmas lockdown in the UK]
Individual protection measures
First of all, social distance.
Maintaining a prudent separation (safety distance) from the people around us will prevent aerosols and drops that contain viruses from reaching us.
Secondly, the use of masks that, in case those droplets reach us, find a barrier that hinders their entry through our nose or mouth when we breathe.
Social distance and a mask are also collective prevention measures.
Because wearing a mask prevents the excretion of respiratory droplets, which, together with maintaining a safe distance, reduces the risk of infecting other people.
As a third precautionary measure, we must not forget hygiene.
Sanitizing agents and soap destroy viruses on surfaces and on our hands
, our means of interacting with objects around us and which can carry the virus from surfaces and objects to our mouth, nose and eyes when we touch.
That is why it is so important to take care of hand hygiene, washing them frequently and correctly with soap and water, or using hydroalcoholic gel.
In short: stop the virus using
the rule of the three Ms: (mask, meters of distance, and hands)
.
All this, with large doses of P for Caution and R for Responsibility, to protect ourselves and help protect others.
But, in addition, this individual commitment is a collective measure, a responsibility of both citizens (avoiding crowds) and those responsible for public spaces and premises who must ensure that low capacity is maintained in well-ventilated spaces.
And, finally, it is also the responsibility of the institutions and public authorities in charge of establishing the appropriate regulations and ensuring their compliance.
As individuals we are responsible for trying to reduce, as far as possible, our mobility, our circle of contacts, as well as that our meetings take place in open or well ventilated spaces.
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The preventive utility of these measures requires the consequent application of the values of
empathy, solidarity, generosity and commitment.
Prevention methods in the field of individual responsibility are also dependent on such actions being provided to us (availability of gels or masks in shops, signaling of capacity, information transparency, clear provisions).
A principle of cooperation between individuals and institutions is needed.
[Fauci warns that Thanksgiving trips will make the pandemic worse but that "it is not too late to do something"]
Public health measures
However, from the field of public health, responsibilities are essentially transferred to the institutions.
In the clinical field, diagnostic tests are a fundamental tool for controlling the spread of the disease.
Currently, thanks to the speed with which science has turned to the characterization of this coronavirus, we have different tools in their application and suitability for diagnosis, which can help to establish effective sanitary measures to control the pandemic.
These include both tests and newer monitoring tools, such as mobility analysis (Big Data) or the detection of SARS-CoV-2 in wastewater, which could give an indication of those urban areas where the infection is taking place. expanding, moments of low infection, or if the measures applied are effective in moments of high contagion.
Of the current SARS-CoV-2 detection methods, we will focus on those that detect the direct presence of the virus (PCR and antigen tests), since antibody tests, although useful to know the percentage of the population that has already after the disease, they do not serve as a diagnostic tool and therefore continue to raise serious doubts as a preventive strategy.
PCR, which detects the presence of virus RNA, is the most sensitive and specific tool, making it the gold standard.
But
it is an expensive test, which requires qualified personnel, and the result of which is not obtained until several hours or days after the sample is collected.
Antigen tests, which detect proteins on the surface of the virus, have a specificity similar to that of PCR, but their sensitivity is much lower, which increases the probability of false negatives.
This last aspect is of vital importance when it is intended to be used for mass screening, since asymptomatic, but contagious, people could obtain a negative result, which represents a risk of disease spread, accentuated by the false sense of security in these false negatives.
It has recently been pointed out, perhaps under the influence of the results in the Community of Madrid, still pending real temporal verification, that these tests "are changing the pandemic."
Thinking about Christmas (family holidays in which mobility and closeness to our loved ones, including our elders, increases), it is necessary to correctly use these tests as a prevention tool, to avoid having to regret a third wave of hospital admissions and deaths that accompany the January slope.
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The use of antigen tests in pharmacies and even at home (self-testing) has been proposed in a kind of attempt to prevent based on a game of chance, like a paper ship war, testing citizens without criteria, hoping to hear “touched” instead of the more likely "water".
These diagnostic instruments will only be useful if they are carried out with rational, scientific criteria, and accompanied by a follow-up of the results
that allows an effective tracing of contacts, only possible with an increase in the personnel dedicated to these tasks and with the establishment of mandatory communication of the results.
Risks (or challenges) and values
The zero risk society does not exist.
Thus, the response to the uncertainty and fear generated by the COVID-19 pandemic will depend on our understanding of the nature and magnitude of the risks, challenges and challenges we face.
To recognize the need for an individual and collective response based on the values of responsibility, empathy, solidarity and generosity;
of commitment, individual and collective.
And we appeal to these values so that the administrations put the necessary measures and means to avoid the dreaded third wave in January, but above all so that
each of us understand the need to maintain precautionary and prudent measures
when we enjoy these parties with our relatives, so as not to have to mourn any loss in January.
This text is based on two articles previously published in Sistema Digital.