Adam Kucharski
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[How can we control the coronavirus pandemic?]

[From infectious disease expert Adam Kucharski]

[Question 1: What does containment mean when it comes to outbreaks?]

Containment is this idea that you can focus your effort on control very much on the cases and their contacts. So you're not causing disruption to the wider population, you have a case that comes in, you isolate them, you work out who they've come into contact with, who's potentially these opportunities for exposure and then you can follow up those people, maybe quarantine them, to make sure that no further transmission happens. So it's a very focused, targeted method, and for SARS, it worked remarkably well. But I think for this infection, because some cases are going to be missed, or undetected, you've really got to be capturing a large chunk of people at risk. If a few slip through the net, potentially, you're going to get an outbreak.

[Question 2: If containment isn't enough, what comes next?]

In that respect, it would be about massive changes in our social interactions. And so that would require, of the opportunities that could spread the virus so these kind of close contacts, everybody in the population, on average, will be needing to reduce those interactions potentially by two-thirds to bring it under control. That might be through working from home, from changing lifestyle and kind of where you go in crowded places and dinners. And of course, these measures, things like school closures, and other things that just attempt to reduce the social mixing of a population.

[Question 3: What are the risks that we need people to think about?]

It's not just whose hand you shake, it's whose hand that person goes on to shake. And I think we need to think about these second-degree steps, that you might think you have low risk and you're in a younger group, but you're often going to be a very short step away from someone who is going to get hit very hard by this. And I think we really need to be socially minded and think this could be quite dramatic in terms of change of behavior, but it needs to be to reduce the impact that we're potentially facing.

[Question 4: How far apart should people stay from each other?]

I think it's hard to pin down exactly, but I think one thing to bear in mind is that there's not so much evidence that this is a kind of aerosol and it goes really far — it's reasonably short distances. I don't think it's the case that you're sitting a few meters away from someone and the virus is somehow going to get across. It's in closer interactions, and it's why we're seeing so many transmission events occur in things like meals and really tight-knit groups. Because if you imagine that's where you can get a virus out and onto surfaces and onto hands and onto faces, and it's really situations like that we've got to think more about.

[Question 5: What kind of protective measures should countries put in place?]

I think that's what people are trying to piece together, first in terms of what works. It's only really in the last sort of few weeks we've got a sense that this thing can be controllable with this extent of interventions, but of course, not all countries can do what China have done, some of these measures incur a huge social, economic, psychological burden on populations. And of course, there's the time limit. In China, they've had them in for six weeks, it's tough to maintain that, so we need to think of these tradeoffs of all the things we can ask people to do, what's going to have the most impact on actually reducing the burden.

[To learn more, visit: Centers for Disease Control and Prevention]

[World Health Organization]