Social separation stops flu spread, but must be started soon
April 30, 2009A disease spread simulation has emphasized that flu interventions must be imposed quickly, if they are to be effective. Researchers writing in the open access journal BMC Public Health have shown that staying at home, closing schools and isolating infected people within the home should reduce infection, but only if they are used in combination, activated without delay and maintained for a relatively long period.
Professor George Milne and his colleagues from the University of Western Australia (UWA) simulated the effect of social distancing on the spread of a flu virus within a small town. Their research used a detailed, individual-based model of a real community with a population of approximately 30,000 (Albany, Australia) using simulation software engineered by UWA's Dr Joel Kelso. Milne said, "Our results suggest a critical role of combined social distancing measures in the potential control of a future pandemic. Non-pharmaceutical social distancing interventions are capable of preventing less-infectious influenza epidemics and of significantly reducing the rate of development and overall burden of the worst epidemics".
The research investigated the effects, alone and in combination, of workplace non-attendance, school closure, isolating infected family members inside the home and reducing contact within the wider community. According to Milne, "While such draconian measures seem unlikely to be mandated given their impact on personal freedom, they appear to have a key role to play in delaying the development of a 'worst case' influenza epidemic. They may be critical in holding back an epidemic until vaccines are deployed on a sufficient scale that subsequent relaxation of these rigorous measures will not result in a consequential acceleration in the scale of the outbreak".
The measures described must, however, be employed as soon as possible after the first individuals within the population have been infected, if not preemptively. This study found that, for an outbreak of influenza approximately as infectious as the 1918 Spanish Flu pandemic, the combination of all intervention measures must be introduced within 2 weeks of the first case appearing in a town or city, to prevent an epidemic developing. Delays of 2, 3 and 4 weeks resulted in final attack rates of 7%, 21% and 45% respectively.
Milne concludes, "Social distancing interventions are important as they represent the only type of intervention measure guaranteed to be available against a novel strain of influenza in the early phases of a pandemic. They may be readily activated and thought of as a first line of defence in developing and developed countries alike".
More information: Simulation suggests that rapid activation of social distancing can arrest epidemic development due to a novel strain of influenza, Joel K Kelso, George J Milne and Heath Kelly, BMC Public Health 2009, 9:117 doi:10.1186/1471-2458-9-117. Article available at journal website: http://www.biomedcentral.com/1471-2458/9/117/abstract
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Someone should write a piece combining insights from the two.
Realizing that Mexicans are more outgoing, sociable and extroverted, it's not surprising that the swine flu we're experiencing currently would spread more quickly and be stronger in Mexico than the U.S. One of the social psychologists conducting the sociable research emphasized that in Mexico people are outside a lot more and are in groups more than Americans.
Americans are being advised by our government's health experts to practice some isolation -- don't go to work, don't send kids to school -- to keep the flu from spreading. The advice most often given by medical folks (and President Obama) is WASH YOUR HANDS FREQUENTLY. That is the most important measure we can take.
But it is physicians who do not follow their own advice. The chances are only 50-50 that the doctor treating you has washed his/her hands. The odds are the same as flipping a coin. Actually, it's worse. According to the National Quality Forum, hand-washing compliance rates at U.S. hospitals are generally LESS THAN 50 percent.
Hospitals are desperate to get doctors to simply wash their hands so that they will stop spreading infections and are taking extraordinary means to try and influence them -- including termination threats, loss of hospital priviledges and hidden cameras. Ethic Soup as a good article on this at:
http://www.ethics...nds.html
Getting doctors to wash their hands was a big problem BEFORE the current swine flu epidemic.
Sharon McEachern