What Escandón and his colleagues urge is finding a balance between lockdowns and unlimited reopening , with the recognition that “ Rather than posing an all-ornothing dilemma , striking a balance between continuing indefinite shutdowns and returning to pre-COVID-19 normality is needed .
• one , is transmitted via an evolutionary effective route ( respiratory ) into completely susceptible individuals in a globalized world with huge socioeconomic inequities , intolerance to uncertainty and illiteracy .”
In the paper with his colleagues , Escandón articulates the harmful effect of stringent public health measures : “ Many models designed to predict the benefits of public health interventions ignored the potential harms . This occurred because the earliest research on COVID-19 predominantly focused on the immediate and direct consequences of interventions such as reducing SARS-CoV-2 transmission . Currently , a growing number of reports substantiate the socioeconomic and psychological impact of both the COVID-19 pandemic and response , in addition to competing health risks . The unintended consequences of several stringent public health interventions are massive and risk turning one public health crisis into many others . Stringent measures deeply aggravate hardship for the poor and those whose economy depends on daily informal work . Unfortunately , amid the pandemic , lockdowns and mobility restrictions were implemented globally and for extended periods , without appropriate communication to allow for public health preparedness . Furthermore , social , mental , and financial support to alleviate the negative impact of lockdowns was not provided to citizens in many countries . As a result , these unmitigated repercussions fueled calls and marches to demand the lift of lockdowns . Adverse effects of stringent public health measures include financial downturn , unemployment , mental illness , child abuse , domestic violence , hunger , and disruption to education , child development , immunization programs , contraception , and family planning . Discontinuation of clinical services and prevention efforts regarding chronic non-communicable diseases and infectious diseases other than COVID-19 ( e . g ., HIV infection , tuberculosis , malaria ) has been reported . Because the current pandemic is risking decades of progress in other infectious diseases and existing public health threats , strengthening of healthcare systems and a reassessment of global health funding and policies are urgently needed .”
What Escandón and his colleagues urge is finding a balance between lockdowns and unlimited reopening , with the recognition that “ Rather than posing an all-or-nothing dilemma , striking a balance between continuing indefinite shutdowns and returning to pre-COVID-19 normality is needed . A stepwise , cautious lifting of lockdowns and loosening of other restrictions that help economies and social life continue are possible through the implementation of multipronged non-pharmaceutical interventions ( NPIs ) with lesser economic , societal , and quality-of-life costs . Tens of NPIs have been described in the pre-COVID-19 literature and have been reassessed during this pandemic as countries have tailored their response plans . Examples of NPIs are physical distancing , mask wearing , natural or mechanical ventilation of indoor spaces , limiting non-essential social contact , avoiding crowded indoor spaces , hand hygiene , respiratory etiquette , avoiding touching the face , cleaning and disinfection of surfaces , air filtration , robust testing ( with short turnaround times ), rigorous contact tracing , isolation of infected individuals , quarantine of close contacts , mass gathering bans , travel restrictions ( e . g ., entry and exit restrictions , travel advice and warnings ), temperature and health checks , staggered work shifts , rotational groups , telework initiatives , and redesign of living , teaching , and working environments to prevent crowding .”
Importantly , Escandón and his colleagues emphasize that transmission dynamics should inform policy decisions about risk mitigation strategies and recommendations for safer socializing and reopening . As they explain , “ Targeted policies should consider the scenarios where transmission is more likely . Contact tracing provides valuable information about transmission dynamics . SARS- CoV-2 infection risk depends on physical proximity , location , type of activity , and duration of contact , with transmission dominated by superspreading events ( SSEs ) or contexts , crowded spaces , indoor venues , and unventilated places . There is solid evidence on the clustering and superspreading potential of SARS-CoV-2 , which suggests that a small part of cases ( 5 percent to 29 percent ) is responsible for most transmission events ( about 80 percent ). The transmission heterogeneity or superspreading of SARS-CoV-2 is both the Achilles ’ heel and the cornerstone of COVID-19 control efforts . Higher-risk scenarios include residential congregate settings ( e . g ., nursing homes , homeless shelters , correctional facilities , university dormitories ), high-density workplaces ( e . g ., meat and poultry processing plants , warehouses , manufacturing and distribution companies ), public transportation , family / friend / work gatherings in indoor settings , mass gatherings ( especially indoors ), entertainment and leisure venues , religious events , and any other unventilated places . All these scenarios are relevant to risk communication and mitigation efforts . Conversely , low-risk settings and activities , such as outdoor and uncrowded environments where physical distancing and ventilation may be ensured , do not drive SARS-CoV-2 transmission in significant ways .”
The hypocrisies of highly visible politicians locking down their constituents but engaging in the very behaviors prohibited by their very edicts were on display throughout the pandemic , stirring discord among communities . As Escandón , et al . ( 2020 ) affirm , “ Public health agencies and policymakers can educate people about the spectrum of risk and how to differentiate between higher-risk and lower-risk activities … On the other hand , misguided policies can undermine public trust and jeopardize engagement in effective public health measures . Inaccurate accounts of transmission can lead to harmful policies and may cause individuals to fixate on inefficient or unnecessary interventions . Amid the pandemic , many outdoor activities and settings ( e . g ., parks , beaches , hiking trails , playgrounds , skiing spots , other outdoor recreational spaces ) have been discouraged or even prohibited . In 2020 , it was common that some politicians and the media called out seemingly dangerous behavior by spotlighting people frolicking on beaches , picnicking in parks , or participating in protests . Also , overcautious people picked some studies and media reports to warn against going outdoors and spark alarm about walkers , runners , and cyclists spreading the virus via a slipstream effect over long distances . These claims were mainly based on studies with no virological considerations and limited environmental assumptions . All these aspects greatly influence viral transmission .”