2021_Book_TextbookOfPatientSafetyAndClin

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Phases 3 and 4, strong emphasis should have
been placed on ensuring proper coordination
between the various actors involved in order to
effectively engage the pandemic threat. The
waves of the contagion could have been kept at
bay by efficient identification and check of outbreaks,
and the sharing of appropriate instructions,
additional resources, and simple and
immediate guidelines. Instead, the exchange of
information between neighboring countries and
the international coordination of emergency
responses have happened too late. During Phase
5, which rapidly precipitated into Phase 6,
attempts were made to remedy the mistakes
made, learning from the most affected countries.
It is precisely the lessons learnt which will allow
us to prevent such a worldwide tragedy from happening
again in the future.
34.5.2 Situation Monitoring
and Assessment
Monitoring must be continuous and adopt a
transversal approach, integrating and analyzing
information systems data, in order to make an
effective assessment.
The lack of information on the epidemiological
and virological monitoring from China in
the early stages of the disease and the subsequent
delay in taking appropriate actions to
assess the risk of a pandemic will certainly be
analyzed worldwide at the end of the emergency.
The various levels of responsibility, with
subsequently difficult international solutions,
will be also identified. The Western countries
did not prepare themselves adequately because
they did not have on hand, especially in the
early stages, reliable and accurate information
on the new viral strain and on the epidemiological
trend of the disease. Yet the national and
international objectives and actions of the aforementioned
framework stated precisely what to
do and how to do it. Unfortunately, the wasted
time has resulted in tens of thousands of deaths.
Thankfully, after a period of recovery, scientific
communities across the globe have been quick
to share data on new viral strains, develop a
M. Tanzini et al.
diagnosis, experiment with new therapeutic protocols,
and work towards the production of a
vaccine.
34.5.3 Prevention and Containment
Prevention and containment measures include
actions aimed to avoid or slow down the spreading
of infection, such as non-pharmaceutical
Public Health Measures (PHM), vaccines, and
antivirals [2].
PHMs include individual protective measures
for the target community [3], such as:
• Hand-hygiene.
• Face masks.
• Respiratory etiquette.
• Environmental measures.
• Surface and object disinfection.
• Travel restrictions such as border closure,
tourism restrictions, entry and exit screening
at airports and ports.
• Social distancing to reduce crowding and
potential restrictions on nonessential activities;
for example, in many workplaces and
schools, “key-workers” may continue to work
with extra precautions, while other employees
should work from home wherever possible.
• Contact tracing, self-isolation of exposed individuals,
and quarantine of those infected. The
length of time suggested for quarantine and
self-isolation will depend on the estimated
period of infectivity of the pathogen.
These measures aim to delay and reduce the
size of the “peak” of an infection trend and to
slow transmission, so that the impact of the pandemic
is mitigated and hospitals are not
overwhelmed. Cultural, socioeconomic, regulatory,
and political factors can affect or limit the
application of PHMs with serious, preventable
consequences for the entire population.
First of all, updated national guidance on
PHMs should be available in the interpandemic
period (Phases 1 and 2). Included interventions
must be planned and shared with decision- makers
from sectors other than healthcare (e.g., transpor-