Reply to CORONAVIRUS/COVID-19 NEW MEGA THREAD

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[quote=Anonymous][quote=Anonymous]
It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

[b]first, people likely to be incubating the infection must be efficiently and effectively identified[/b];

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "[b]focused only on persons who had contact with an actively ill SARS patient[/b]" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada
[/quote]

Given that we've clearly botched step 1 and allowed COVID-19 to spiral out of control, I don't really see the point about not quarantining. Cluster containment works ONLY when you've tested early and widely to pinpoint hotspots. We missed that opportunity big time.[/quote]

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