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COVID-19 Update World Health Organization Directives on Preventing COVID-19 TransmissionAs Canada begins to emerge from strict lockdown measures and enters a phase of loosening the restrictions which served to flatten (though not yet reverse) the infection curve, international experience and the advice of the World Health Organization (WHO) hold importance for us going forward. In his July 13 coronavirus situation briefing, the Director General of WHO characterized, in broad strokes, four stages of the pandemic and said what "we're seeing is countries that overcame the first peak of the outbreak, but having eased restrictions, are now struggling with new peaks and accelerating cases. In several countries across the world, we are now seeing dangerous increases in cases, and hospital wards filling up again. It would appear that many countries are losing gains made as proven measures to reduce risk are not implemented or followed." WHO has set out recommendations, including measures to keep COVID 19 transmission in check. Its recommendations contained in its Scientific Brief entitled "Transmission of SARS-CoV-2: implications for infection prevention precautions" dated July 9 are based on a detailed review of dozens of recent scientific studies of how COVID-19 infection is transmitted. "Based on what we currently know, transmission of COVID-19 is primarily occurring from people when they have symptoms, and can also occur just before they develop symptoms, when they are in close proximity to others for prolonged periods of time. While someone who never develops symptoms can also pass the virus to others, it is still not clear to what extent this occurs and more research is needed in this area."[1] The July 9 report outlines transmission factors in detail and from the scientific evidence to date reached definite conclusions which resulted in the formation of the following recommendations on how to keep COVID 19 transmission in check: - Identify suspect cases as quickly as possible, test, and isolate all cases (infected people) in appropriate facilities; - Identify and quarantine all close contacts of infected people and test those who develop symptoms so that they can be isolated if they are infected and require care; - Use fabric masks in specific situations, for example, in public places where there is community transmission and where other prevention measures, such as physical distancing, are not possible; - Use of contact and droplet precautions by health workers caring for suspected and confirmed COVID-19 patients, and use by health care workers of airborne precautions when aerosol generating procedures are performed; - Continuous use of a medical mask by health workers and caregivers working in all clinical areas, during all routine activities throughout the entire shift; - At all times, practice frequent hand hygiene, physical distancing from others when possible, and respiratory etiquette; avoid crowded places, close-contact settings and confined and enclosed spaces with poor ventilation; wear fabric masks when in closed, overcrowded spaces to protect others; and ensure good environmental ventilation in all closed settings and appropriate environmental cleaning and disinfection.[2] On July 13 the Director General concluded his briefing with these words: "I want to be straight with you: there will be no return to the "old normal" for the foreseeable future. But there is a roadmap to a situation where we can control the disease and get on with our lives. But this is going to require three things: "First, a focus on reducing mortality and suppressing transmission. "Second, an empowered, engaged community that takes individual behaviour measures in the interest of each other. "And third, we need strong government leadership and coordination of comprehensive strategies that are communicated clearly and consistently. "It can be done. It must be done. I have said it before and I will keep saying it." Working people do not have control over what measures are taken by governing authorities but they are speaking out -- front line health care workers, transit workers, teachers and education workers, miners and industrial workers, retail, hospitality and child care workers, migrant workers in farm and meat packing industries and many more. TML Weekly and Workers' Forum report on the experiences of workers who have organized when employers refused to do it, which now includes contact tracing; of mine workers in Quebec whose union played a key role in determining health and safety measures for return to work underground; of transit workers speaking out for mandatory use of masks on mass transit; of teachers speaking out for government to implement safe working conditions for reopening of schools; of migrant workers demanding status as key to achieving safe working and living conditions. It is the working people taking up social responsibility and advocating for constructive measures they know will protect themselves and society at large that is the decisive element as we go forward. Notes1. WHO Director General Briefing, July 13, 2020. 2. "Transmission of SARS-CoV-2: implications for infection prevention precautions, WHO, July 9, 2020.
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