Physical distancing, also known as social distancing, is being used as a strategy to delay the progression of COVID-19 by reducing direct transmission of infection. The three most used methods are:
Physical Distancing,
Isolation,
Quarantine

Physical Distancing to Prevent the Spread of COVID-19

 - Implementation of control strategies decreased R$_t$ in  China
 - Decreased effectiveness of COVID-19 prevention efforts in African American/Black and Latino populations
 - Association between decreased hospitalizations and stay-at-home orders in four states in U.S.
 - International travel restrictions have little-to-no effect on local COVID-19 epidemics
- Survey in Singapore reveals important information regarding public's adherence to COVID-19 preventative policies

Effectiveness of Control Strategies for COVID-19

- Decreased accessibility to routine healthcare 
- Decreased usage of hospitals for emergency conditions

Consequences of Control Strategies for COVID-19

Face masks are thought to reduce or prevent transmission of the viral particles through aerosol transmission. The usage of face masks is a controversial topic whose efficacy is disputed by governments, researchers, and the public. Health officials in the early stages of the pandemic advised against the use of face masks for various reasons, although recent developments in the area of research may influence their perspectives.

Face Masks to Prevent the Spread of COVID-19

1. Washing your hands
2. Maintain distance
3. Avoid touching eyes, nose and mouth
4. follow good respiratory hygiene
5. Stay home if you feel unwell
6. Keep up to date on the latest COVID-19 hotspots
7. Disinfecting your home if someone is sick

Individual Protection Measures for Preventing the Spread of COVID-19

Weekly surveillance testing along with isolation would more effectively limit COVID-19 outbreaks than the slow and expensive (yet precise) qPCR (quantitative polymerase chain reaction) testing method that is currently employed.

Testing Strategy for Controlling COVID-19 Outbreaks

- Social distancing
- Stay at home orders
- Maximum persons to group gatherings
- Mass testing
- Disinfectant protocols
- Personal protective equipment (PPE)
- International/national travel restrictions


List of social (and prevention) policies related to the COVID-19 pandemic

- Governments around the world have responded to SARS-CoV-2 with unprecedented policies designed to slow the growth of infections.
- Many policies impose large and visible costs on society, but their benefits cannot be directly observed and are only currently understood through process-based simulations. 
- The objective of this study is to measure the direct health benefits of anti-contagion policies, specifically, how much of these policies slowed the growth rate of  infections. 

Effectiveness of Large-Scale Anti-contagion Policies

- BioRxiv
- Health Affairs 
- JAMA
- Journal of Clinical Nursing
- Nursing Education in Practice 
- The BMJ
- The Lancet
- Nature
- New York Times
- Proceedings of the National Academy of Sciences (PNAS)


References for Control Strategies of COVID-19 by Journal and News Outlets

Celum, C., Al., E., Interview with Dr. Anthony Fauci on progress made during the past four decades of the HIV/AIDS pandemic and ongoing efforts to end this threat.&nbsp;(18:44), Author AffiliationsFrom the Departments of Global Health (C.C., Interview with Dr. Anthony Fauci on progress made during the past four decades of the HIV/AIDS pandemic and ongoing efforts to end this threat. (18:44), J. H. Beigel and Others, . . . M. J. Mina and Others. (2020, May 22). Covid-19, Ebola, and HIV - Leveraging Lessons to Maximize Impact: NEJM. Retrieved October 09, 2020, from https://www.nejm.org/doi/full/10.1056/NEJMp2022269?query=featured_coronavirus

The New England Journal of Medicine 

Countries have implemented multiple control strategies for reducing the spread of COVID-19, such as closing schools and businesses to enforce social distancing.

Struggle pertaining to controlling the virus:
The epidemiology of the respiratory virus changes rapidly. Reponses have to be nimble. Given that everyone is susceptible to for which we lack effective biologic interventions, the response has required large-scale behavior change, including social distancing and public masking.

University of Michigan - Ann Arbor

Syracuse University

- Economic Policies
- Education Policies
- Medical policies
- Policies by Countries
- Public Health Policies
- Social (and prevention) policies


Types of COVID-19 related policies

- Case Demographics of Patients
- Categorized by Geographic Location
- Communicable Period
- Control Strategies
- Disparate COVID-19 Outcomes
- Fatality
- Interventions
- Patient Comorbidities
- Patient Laboratory Results
- Psychological effects
- Recovery & Rehabilitation
- Re-opening of Childcare/ Educational Environments
- Secondary Infections
- Signs
- Symptomology
- Time from Onset to Reporting
- Telehealth (telemedicine)
- Transmission
- Risk Factors
- COVID-19 Vaccination Uptake

Focuses of Epidemiological studies on COVID-19

Control Strategies for COVID-19

- Current lack of understanding of the prevalence and efficacy of antibodies in individuals exposed to both milder and more acute COVID
- If there is immunity from antibodies, the duration of immunity is unknown
- Subsequent inability to determine how much current herd immunity is in a population or is required to safely reopen economies 
- Present medical and public policy nuances and challenges associated with safe and effective development and distribution of a vaccine to populations

Key Public Health Considerations for COVID-19 Related Policy

- Germany
- Italy
- Russia
- South Korea
- Vietnam

COVID-19 Related Policies by Countries

- Global Economic Policies (High-Income Countries, NATO, EU)

- Global Economic Policies (Lower- and Middle-Income Countries)

- U.S. Economic Policies


Economic Policies in Response to COVID-19

- Nursing Students Working Before Graduation Policy 
- Telemedicine Policies Changes Due to COVID-19
- Covax: An International Vaccine Effort

Medical Policies in Response to COVID-19

Paul Cairney & Adam Wellstead (2021) COVID-19: effective policymaking depends on trust in experts, politicians, and the public, Policy Design and Practice, 4:1, 1-14, DOI: 10.1080/25741292.2020.1837466

https://www.tandfonline.com/doi/pdf/10.1080/25741292.2020.1837466?needAccess=true

COVID-19: effective policymaking depends on trust in experts, politicians, and the public

Due to differences in testing and case definitions, as well as how new COVID-19 is, the fatality of the virus is not well-defined yet.

Fatality of COVID-19

- Age
- Education
- Employment
- Ethnicity
- Gender
- Income
- Marital status
- Race





Case Demographics of Patients with COVID-19

- Asia
- Africa 
- North America
- South America
- Europe
- Australia & Oceania 

Epidemiological studies on COVID-19 Categorized by Continents

The progression of COVID-19 varies greatly by individual and demographic, as do many of the factors related to the disease. Studies have been analyzing the disease progression timeline, or the time frames before patients feel symptoms, are admitted to the hospital, are admitted to the ICU, are put on a mechanical ventilator, experience acute respiratory distress syndrome, etc. Not every COVID-19 case will reach each of these events.

COVID-19 Clinical Disease Progression Timeline

- 0-19 (n=123): 0%
- 20-44 (n=705): 0.1–0.2%
- 45-54 (n=429): 0.5–0.8%
- 55-64 (n=429): 1.4–2.6%
- 65-74 (n=409): 2.7–4.9%
- 75-84 (n=210): 4.3–10.5%
- greater than or equal to 85 (n=144): 10.4–27.3%
- Total (n=2,449): 1.8–3.4%

Case-Fatality Among COVID-19 Patients in the United States by Age

Following a primary infection of SARS-CoV-2, some patients acquire a secondary infection of SARS-CoV-2, or a co-infection with a different bacteria or virus

Secondary/Co-Infections of COVID-19

COVID-19 patients have gone through laboratory testing to determine the impact and extent of SARS-CoV-2 on the body.

COVID-19 Laboratory Results

The spread of the SARS-CoV-2 virus has produced or highlighted disparate outcomes of different types between population groups all over the world. Health disparities can highlight inequitable access, treatment, etc. within a country or state and often indicate the need for public health intervention.

Disparate COVID-19 Outcomes

Due to the varying experiences for those with COVID-19, recovery and rehabilitation look different for many individuals. As a baseline, "for persons recovered from COVID-19 illness, CDC recommends that isolation be maintained for at least 10 days after illness onset and at least 3 days (72 hours) after recovery. Illness onset is defined as the date symptoms begin. Recovery is defined as resolution of fever without the use of fever-reducing medications with progressive improvement or resolution of other symptoms. Ideally, isolation should be maintained for this full period to the extent that it is practicable under rapidly changing circumstances."

COVID-19 Recovery & Rehabilitation

- Resuscitation
- Convalescent Plasma (CP) Transfusion

COVID-19 Patient Interventions

The seroprevalence of COVID-19 is the measurement of the level of the pathogen in a population. There have been difficulties with estimating the seroprevalence in large populations because of the unknown qualities of COVID-19, expense in widespread population collection, asymptomatic infection, etc.

Seroprevalence of SARS-CoV-2 (COVID-19) 

A communicable period is defined as the interval from the first day of positive ribonucleic acid test to the first day of continuous negative test. For COVID-19, the communicable period has been established as two days before onset of symptoms until three days of symptom relief and no fever. 

Communicable Period of COVID-19

- Fever (when high temperature is measured)
- Laboratory confirmation of illness via viral testing
- Radiological lung abnormalities such as ground-glass chest and stripe shadowing


Clinical Characteristics of Asymptomatic COVID-19 Patients

Telehealth are health-related services and information through electronic communication technologies to help patients with or people influenced by COVID-19. It allows long-distance patient and clinician care, education, and monitoring. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. 

Telehealth (telemedicine) and COVID-19

Presence and severity of symptoms of COVID-19 depend largely on individual characteristics. COVID-19 produces both symptomatic and asymptomatic infection.

Symptomology of COVID-19 

The psychological effect COVID-19 is having on the populations affected by the pandemic

Psychological Effects of COVID-19 Pandemic

COVID-19 comorbidities are high risk conditions that put patients at greater risk for infection and negative outcomes. Some COVID-19 comorbidities have been found to be: 
- Cancer 
- Cardiovascular Disease
- Diabetes
- Digestive Diseases
- HIV
- Hypertension
- Immunological Disease
- Liver Injury
- Obesity
- Renal disease
- Respiratory System Disease

COVID-19 Patient Comorbidities

- Schools (K-12)

- Universities/Colleges

- Summer Camps

- Daycares

- Nurseries

Re-opening Childcare/ Educational Environments

COVID-19 is spread through person-to-person transmission. The virus spreads mainly through close personal contact (such as when people are within 6 feet of one another) and through the respiratory droplets of someone infected with COVID-19.  Aerosol transmission is also likely, but the relative contribution of these smaller respiratory particles is not completely understood. While less common, spreading can also occur when people touch contaminated objects or surfaces and then their faces, eyes, or mouth. 

Transmission of COVID-19

- smoking
- high BMI
- old age
- congregate housing
- environmental conditions
- Immune system conditions

Risk Factors For COVID-19

We can explore factors that affect the uptake of established adult vaccinations to inform efforts of COVID-19 vaccine acceptance. 

- Social Factors 
- Knowledge, Attitudes, and Beliefs
- Racial Factors
- Age

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