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Lockdown and social distancing are inadequate: to mitigate the Covid-19 pandemic we need to return to primary and secondary prevention

Dec 11, 2020

A recent international partnership between researchers from Europe, USA, UK and Russia has investigated the effects of the pandemic mitigation strategies. Community and home care are the only viable strategies that could achieve the goal of pandemic mitigation

Link: https://www.sciencedirect.com/science/article/pii/S2214750020304431

Catania, 10 December 2020– Over 25 researchers, divided into more than 15 labs published a new study that analyzes the most common pandemic mitigation strategies, mainly focused on social distancing and the healthcare system reinforcement. However, many countries in Europe implemented strict, horizontal lockdowns that led to various unintended adverse social, economic and health effects.

THE STUDY

At the beginning of the pandemic, many governments adopted strategies to stop the rapid viral transmission, such as social distancing measures and the healthcare system reinforcement. However, the rapid spread of the pandemic required more strict measures, such as strict. Horizontal lockdowns which have adverse social, economic and health effects which have not been fully considered.

These measures could be used only as temporary measures to “buy time” and reorganize the healthcare and public health response and empower the population to develop an appropriate societal response. However, strict lockdowns could result in more deaths long-term because the pandemic is prolonged and COVID-19 related mortality is highly skewed towards older age groups.

Unintended adverse effects of lockdowns have already been observed: the treatments of other pathologies are compromised, because of patients’ fear of being exposed to an environment with high risk. In the UK, approximately 1 million mammograms have been skipped, resulting in an estimated 8600 women who could be living with undetected breast cancer because of their diagnosis being delayed.

THE RESULTS

What are the mitigation measures that could help to deal with such a virulent pandemic?

· Activation, expansion and support of primary health care

· Implementation of the community care, thanks to the identification of the most vulnerable social groups

· Pharmaceutical control of comorbidities which are risk factors for covid-19

· Managing the most efficient strategies to mitigate the health inequalities

Researchers also suggest the development of a health network engaged in the phone and online (using eHealth technologies) support for patients with COVID-19, with provisions for home visits by healthcare professionals, if needed. They also recommend the disengagement of hospitals from the responsibilities of sample collection, diagnostic testing, treatment and isolation of people infected with SARS-CoV-2 who are ambulatory and do not need hospitalized care.

“To mitigate the Covid-19 pandemic we have to develop a strategy that recognizes the role of primary, community and home care and we need to adopt measures that support the role of doctors and mitigate the effects of multiple lockdowns”, explained Prof. Riccardo Polosa, Founder of the CoEHAR.

It now seems clear that such a pandemic has revealed to be hard to deal with especially for the healthcare workers. Alongside the mitigation measures already adopted, we should consider the idea to ease the pressure on hospitals to allow the health structures to deal with the most serious cases.

Title. Improved strategies to counter the COVID-19 pandemic: Lockdowns vs. Primary and Community Healthcare