Shelter-in-place decrees and other public health and social measures, like closures of schools and restrictions on gatherings, can be used to slow the spread of COVID-19. Once these policies have been implemented, it is critical to monitor their impacts, especially among vulnerable and minority groups. Compliance can be maximized and sustained by tailoring policies to local contexts and balancing them with countermeasures, such as food distribution and income support, to support affected communities. More information can be found here.
We must look at data, not dates. Three preconditions must be met before a city can begin to gradually loosen restrictions. They are (1) falling case and death rates; (2) a health care system that can withstand a small outbreak without risk to health care workers and patients; and (3) public health capacity to test widely. More information on our “Box It In” strategy, which provides more detail on these preconditions, can be found here.
Cities worldwide are encouraged to follow guidance from the U.S. Centers for Disease Control and Prevention (CDC), which now recommend the use of face masks or coverings for the general public. If used properly and in conjunction with physical distancing techniques, cloth masks can help slow the spread of the virus in the general population. Importantly, the U.S. CDC does not recommend individuals wear surgical masks or N-95 respirators, as this would divert critical supplies away from health care workers and first responders. The U.S. CDC has posted instructions for making and using cloth masks here. Cities should additionally review WHO guidance on when and how to use masks here.
The COVID-19 pandemic is a stressful time for many people. Promoting effective coping strategies and scaling up mental health services can make your city and its residents stronger. Simple, straightforward messages using empathetic language should be used when communicating about the mental health effects of COVID-19. Further guidance from the World Health Organization can be found here.
At this time, there is insufficient scientific evidence to support the use of immunity passports. Numerous questions remain on what amount of antibody is needed for protection or how long any such immunity lasts. Furthermore, immunity certificates pose significant practical and legal challenges. Additional guidance can be found in a recent WHO scientific brief, a comment in The Lancet and the Prevent Epidemics Weekly Science Review: May 10–17, 2020.
Sanitizing or disinfection tunnels—pass through tunnels where a fine disinfectant mist is sprayed from head to toe—are believed to be a poor public health intervention to stop the spread of COVID-19. On-the-ground interventions must be informed by the virus’ underlying characteristics and potential to control spread from one person to another. Hand hygiene and disinfecting of high-touch surfaces are the only sanitizing measures recommended at this time. Additional guidance from the CDC can be found here.
To our knowledge, no specific guidance from the World Health Organization (WHO) or the U.S. Centers for Disease Control and Prevention (U.S. CDC) exists on the utility of temperature checks at subway, bus or metro entry points to stop the spread of COVID-19, though the WHO does state that temperature checks alone are “not an effective way to stop [the] spread” of the virus. Implementing mass transit temperature checks would likely be relatively ineffective and expensive. Additional guidance from the National Association of City Transportation Officials can be found here.
The timing of school reopenings should be guided by local data. Decision makers should consider the local situation and epidemiology of COVID-19 along with each school district's ability to maintain COVID-19 prevention and control measures. Once it has been determined that a school can safely reopen, key actions should be implemented among teachers and school administration, parents and caregivers, and the students themselves. Cleaning and disinfecting protocols, education, hand washing, and engineering controls such as increasing space between desks should all be considered when reopening schools. A checklist of relevant protective measures by group can be found here. Additional guidance from the World Health Organization can be found here.
COVID-19 can exacerbate risks of violence for cisgender and transgender women and girls in your city. As distancing measures are put in place, the risk of intimate partner violence is likely to increase. Fortunately, there are strategies to mitigate the effects of violence on women and children. Local governments should include essential services to address violence against women in preparedness and response plans, and health facilities should provide information about local available services. You can access additional suggestions from the World Health Organization here and from UN Women here.
The COVID-19 pandemic has been accompanied by a massive "infodemic": an overabundance of information, much of which is inaccurate. This could make it difficult for residents in your city to find trustworthy and scientifically valid guidance when they need it. The best way to remedy the infodemic is to share consistent and easy-to-understand messages from reliable and trustworthy sources. The U.S. Centers for Disease Control and Prevention and Johns Hopkins Medicine both have pages dedicated to identifying and correcting common COVID-19 myths. For more information, you can reference this report from the Pan American Health Organization.
Some countries have conducted population knowledge and attitude surveys to surface and respond to misunderstandings and myth-based beliefs. Often the best approach to countering misinformation and conspiracy theories is to flood social media with correct, authoritative information. The World Health Organization has developed a number of resources to help in this regard, including a mythbusters page as well as a Facebook chatbot and alert service to combat misinformation in real-time.
In general, laws that apply differently to different groups should be avoided as these can be discriminatory. Restrictions and other curtailments of rights must be based on scientific evidence and neither written nor imposed arbitrarily. You can find more information on how to appropriately use public health and social measures to reduce COVID-19 transmission in your city here.