Ter info hieronder de verschillende scenarios die het ECDC (European Centre for Disease Prevention and Control ) hanteert bij deze uitbraak. In NL zitten wij nog in scenario 1 omdat we vooralsnog een gelimiteerde lokale transmissie hebben en je ziet ook dat het RIVM in principe precies de richtlijnen van het ECDC volgt en niet zelf wat bedenkt. Italie zit in scenario 2 en waarschijnlijk is dat ook het geval net over de grens in DL.
bron: Rapid Risk assessment van de ECDC van 2 maart.
https://www.ecdc.europa.e...ion-globally-COVID-19.pdfThe following five scenarios, adapted from ECDC’s strategic analysis, are used to describe the possible progression of the COVID-19 outbreak in EU/EEA countries. Currently, countries worldwide and in the EU/EEA are in different scenarios and could move rapidly from one scenario to another due to the evolving situation, particularly if there is widespread local transmission in another country or countries , and/or when testing for COVID-19 in the country increases. Current epidemiology suggests scenario 1 for EU/EEA level, which may be rapidly evolving to scenario 2.
Scenario 0 describes a situation with no reported cases in the country and multiple introductions and/or community transmission elsewhere in Europe. At this stage, the main objective for public health measures should be to enable rapid detection and isolation of individual cases to prevent domestic transmission chains, and to prepare for the response once cases are detected in the country. As of 2 March 2020, several EU/EEA countries had not reported cases and are therefore presumed to be in this scenario.
Scenario 1 describes a situation with multiple introductions and limited local transmission in the country. Despite the introductions there is no apparent sustained transmission (only second generation cases observed or transmission within sporadic contained clusters with known epidemiological links). In this situation, the objective is containment of the outbreak by blocking transmission opportunities, through early detection of imported and locally-transmitted COVID-19 cases in order to try to avoid or at least delay the spread of infection and theassociated burden on healthcare systems. Delaying the start of local transmission will allow the current influenza season to end, freeing up some healthcare capacity. As of 2 March 2020, several EU/EEA countries had reported limited local transmission and were considered to be in this scenario.
Scenario 2 describes a situation with increasing number of introductions and of more widespread reports of localised human-to-human transmission in the country (more than two generations of cases outside of sporadic clusters with known epidemiological links). In this situation, the objective remains to contain where practicable and otherwise slow down the transmission of the infection. This will increase the time available for development, production and distribution of PPE and effective therapeutic options, and would play a crucial role in reducing the burden on the healthcare system and other sectors, particularly if wider transmission of COVID-19 is delayed beyond the ongoing influenza season. A reduced burden would also allow for more time to increase laboratory capacity, and increase surge capacity in healthcare services. All these measures will facilitate effective treatment of infected patients [44]. Rapid collection and analysis of epidemiological and virological data will enable targeting of measures in this scenario and later. Within EU/EEA countries, Italy is currently in this scenario. Other countries in the EU/EEA might also be in this scenario, which may have undetected transmission ongoing due to lower level of case detection.
Scenario 3 describes a situation with localised outbreaks, which start to merge becoming indistinct. In this scenario, there is sustained human-to-human transmission in the country (more than two generations of cases outside of sporadic clusters with known epidemiological links) and an increasing pressure on healthcare systems.The objective at this stage is to mitigate the impact of the outbreak by decreasing the burden on healthcare systems and protect populations at risk of severe disease. At the same time, operational research should guide developing better and more efficient diagnostic and treatment options.
Scenario 4 describes a situation with widespread sustained transmission where healthcare systems are over-burdened due to a large demand for emergency healthcare services, a strained ICU capacity, overworked healthcare workers and reduced staff availability due to illness, lack of PPE and lack of diagnostic testing capacity. The objective at this stage is still to mitigate the impact of the outbreak, decrease the burden on healthcare services, protect populations at risk of severe disease and reduce excess mortality.
Dit document is het sowieso waard om een keer door te lezen want er staat van alles in zoals een stukje over scholen:
School and day care measures or closure
Evidence originating from seasonal and pandemic influenza modelling studies have shown that proactive school closures before the peak of influenza virus activity have had a positive impact in reducing local transmission and delaying the peak of the influenza activity [60]. COVID-19 does not appear to cause important illness or severity in children; however, it is not known if children play an important role in transmission of the virus. Therefore,proactive school closures to reduce the transmission of COVID-19 should be carefully considered on a case-by-case assessment, weigh the expected impact of the epidemic against the adverse effects of such closures on the community. If influenza is circulating in the community, proactive school closures may be considered to reduce the burden of influenza cases on healthcare systems, and thereby create capacity for managing cases of COVID-19 in scenarios 2 and 3. Before or instead of closures, health authorities should also plan to reduce transmission opportunities within schools, while children continue to attend with other measures, which may include smaller school groups, increasing physical distance of children in the class, promotion of washing of hands and outdoor classes. In the event of illness, strict isolation of sick children and staff at home or healthcare facilities is advisable in all the scenarios.
RAPID RISK ASSESSMENTOutbreak of novel coronavirus disease 2019 (COVID-19): increased transmission globally – fifth update13 Reactive closures of schools may be necessary as a consequence of widespread virus transmission in the community and educational settings in scenario 4. Reactive school and day-care closures will probably not reduce the impact of the epidemic, but may be needed, due to high absenteeism and operational issues, especially if the spread of COVID-19 coincides with the ongoing influenza season.
Of bv dit stukje:
Current estimates suggest a median incubation period from five to six days for COVID-19, with a range of up to 14 days. A recent modelling study confirmed that it remains prudent to consider the incubation period of at least 14 days [26,27]. The current estimates of R0 are between two and three [6,26,28]. Estimates of these parameters are likely to be revised as more information becomes available. There remains no strong evidence of transmission preceding symptom onset.
Geadviseerde maatregelen bij de verschillende scenarios:
Scenario 1
Scenario 2 (hier zie je pas scholen sluiten als optie terugkomen)
De situatie kan natuurlijk heel snel veranderen en ik heb er vertrouwen in dat het RIVM dat zeer nauwgezet volgt en zal opschalen naar scenario 2 als dat nodig is en dan de nodige extra maatregelen zal adviseren.
I accept no liability for the content of this post, or for the consequences of any actions taken on the basis of the information provided.
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Die vraag benadruk ik juist elke keer weer, maar niemand kan mij vertellen waarom we het bij twee weken houden en wat de positieve effecten zijn. Ik kan die vraag natuurlijk blijven herhalen, maar het blijft stil. Dat je hem nu spiegelt is prachtig,:strip_icc():strip_exif()/u/118633/index.jpg?f=community)
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