Altmann, Daniel M., Douek, Daniel C., Boyton, Rosemary J. What policy makers need to know about COVID-19 protective immunity. The Lancet, 395, 10236, 1527-1529 (2020). https://doi.org/10.1016/S0140-6736(20)30985-5 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30985-5/fulltext#articleInformation

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- 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

Determining this has critical implications: 

If primarily spread via droplets, then masks, distancing rule (6ft), etc. are effective in preventing transmission. Conversely, if primarily spread via aerosols, then preventative measures become less effective and thus need to be modified. 

Examining the source of transmission for both types of respiratory particles are crucial.



Aerosol versus Droplet Debate

References for Control Strategies of COVID-19 by Newspaper/Organization

- The authority of the government to mandate public health actions, including quarantine, isolation, immunization, contact tracing, property seizures, and environmental regulation are justified by three factors
- Factors include when the health of the population is threatened, when government action is more efficient or more likely to produce an effective intervention, and when the government has unique powers and expertise related to an essential aspect of public health
- The government’s role is to strike a balance between autonomy and paternalism to eliminate a threat to the public’s health

Justifications for Government Public Health Intervention

- Public Health plays a role scientific, ethical, legal, and social structures 
- A greater understanding and consensus on the meaning of public health could lead to “more efficient and effective public health interventions as well as increased public and political support for public health activities” 
- Many definitions classify public health as population health rather than individual 
- Definitions vary in who is viewed as responsible for public health, we as a society vs the government



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