Editing Pandemic (section)

== Pandemic management strategies ==
{{See also|Mathematical modelling of infectious disease}}
[[File:Social distancing queueing for the supermarket J. Sainsbury's north London Coronavirus Covid 19 pandemic - 30 March 2020.jpg|thumb|Social distancing in public]]
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| image1            = 20200410 Flatten the curve, raise the line - pandemic (English).gif
| caption1          = Goals of mitigation include delaying and reducing peak burden on healthcare (''[[flattening the curve]]'') and lessening overall cases and health impact.<ref name=Lancet2020Flatten/><ref name="community mitigation">{{cite journal |url=https://stacks.cdc.gov/view/cdc/45220 |title=Community Mitigation Guidelines to Prevent Pandemic Influenza—United States, 2017 |journal=Recommendations and Reports |volume= 66 |number= 1 |date=12 April 2017|publisher=Centers for Disease Control and Prevention }}</ref> Also, increasing healthcare capacity (''[[raising the line]]'', as by increasing bed count, personnel, and equipment) helps to meet increased demand.<ref name=Vox_20200407>{{cite news | vauthors = Barclay E, Scott D, Animashaun A |title=The US doesn't just need to flatten the curve. It needs to "raise the line." |url=https://www.vox.com/2020/4/7/21201260/coronavirus-usa-chart-mask-shortage-ventilators-flatten-the-curve |work=Vox |date=7 April 2020 |archive-url=https://web.archive.org/web/20200407155950/https://www.vox.com/2020/4/7/21201260/coronavirus-usa-chart-mask-shortage-ventilators-flatten-the-curve |archive-date=7 April 2020 |url-status=live }}</ref><ref name="ACAIM-WACEM COVID-19 Consensus Paper">{{cite journal | vauthors = Stawicki SP, Jeanmonod R, Miller AC, Paladino L, Gaieski DF, Yaffee AQ, De Wulf A, Grover J, Papadimos TJ, Bloem C, Galwankar SC, Chauhan V, Firstenberg MS, Di Somma S, Jeanmonod D, Garg SM, Tucci V, Anderson HL, Fatimah L, Worlton TJ, Dubhashi SP, Glaze KS, Sinha S, Opara IN, Yellapu V, Kelkar D, El-Menyar A, Krishnan V, Venkataramanaiah S, Leyfman Y, Saoud Al Thani HA, Wb Nanayakkara P, Nanda S, Cioè-Peña E, Sardesai I, Chandra S, Munasinghe A, Dutta V, Dal Ponte ST, Izurieta R, Asensio JA, Garg M | display-authors = 6 | title = The 2019–2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College of Academic International Medicine-World Academic Council of Emergency Medicine Multidisciplinary COVID-19 Working Group Consensus Paper | journal = Journal of Global Infectious Diseases | volume = 12 | issue = 2 | pages = 47–93 | year = 2020 | pmid = 32773996 | pmc = 7384689 | doi = 10.4103/jgid.jgid_86_20 | s2cid = 218754925 | doi-access = free }}</ref>
| image2            = 20200409 Pandemic resurgence - effect of inadequate mitigation.gif
| caption2          = Mitigation attempts that are inadequate in strictness or duration—such as premature relaxation of physical distancing rules or stay-at-home orders—can allow a resurgence after the initial surge and mitigation.<ref name=Lancet2020FlattenNoQuote>{{cite journal | vauthors = Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD | title = How will country-based mitigation measures influence the course of the COVID-19 epidemic? | journal = Lancet | volume = 395 | issue = 10228 | pages = 931–934 | date = March 2020 | pmid = 32164834 | pmc = 7158572 | doi = 10.1016/S0140-6736(20)30567-5 }}</ref>
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| image3            = 20200609 Effect of pandemic containment measures.gif
| caption3          = Without pandemic containment measures—such as social distancing, vaccination, and use of face masks—pathogens can spread exponentially.<ref name=Science_20200515>{{cite journal | vauthors = Maier BF, Brockmann D | title = Effective containment explains subexponential growth in recent confirmed COVID-19 cases in China | journal = Science | volume = 368 | issue = 6492 | pages = 742–746 | date = May 2020 | pmid = 32269067 | pmc = 7164388 | doi = 10.1126/science.abb4557 | arxiv = 2002.07572 | bibcode = 2020Sci...368..742M }} ("...initial exponential growth expected for an unconstrained outbreak.")</ref> This graphic shows how early adoption of containment measures tends to protect wider swaths of the population.
| image4            = 19180927 Gauze Mask to Halt Spread of Plague (Spanish flu) - The Washington Times.jpg
| caption4          = The Red Cross recommended two-layer gauze masks to contain the Spanish flu (1918).<ref name=WashTimes_19180927>{{cite news |title=Gauze Mask to Halt Spread of Plague |url=https://newspaperarchive.com/washington-times-sep-27-1918-p-3/ |work=The Washington Times |date=27 September 1918 |page=3}}</ref>
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The basic strategies in the control of an outbreak are '''containment''' and '''mitigation'''. Containment may be undertaken in the early stages of the outbreak, including [[contact tracing]] and isolating infected individuals to stop the disease from spreading to the rest of the population, other public health interventions on infection control, and therapeutic countermeasures such as [[vaccination]]s which may be effective if available.<ref>{{cite book |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK54163/ |title=Ethical and Legal Considerations in Mitigating Pandemic Disease: Workshop Summary |chapter=3. Strategies for Disease Containment |year=2007 |publisher=National Academies Press (US) }}</ref> When it becomes apparent that it is no longer possible to contain the spread of the disease, management will then move on to the mitigation stage, in which measures are taken to slow the spread of the disease and mitigate its effects on society and the healthcare system. In reality, containment and mitigation measures may be undertaken simultaneously.<ref>{{cite magazine |url=https://www.newyorker.com/news/news-desk/what-it-means-to-contain-and-mitigate-the-coronavirus |title=What It Means to Contain and Mitigate the Coronavirus| vauthors = Baird RP |date=11 March 2020 |magazine=The New Yorker}}</ref>

A key part of managing an infectious disease outbreak is trying to decrease the epidemic peak, known as "[[flattening the curve]]".<ref name="Lancet2020Flatten" /><ref name="ACAIM-WACEM COVID-19 Consensus Paper" /> This helps decrease the risk of health services being overwhelmed and provides more time for a vaccine and treatment to be developed.<ref name="Lancet2020Flatten">{{cite journal | vauthors = Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD | title = How will country-based mitigation measures influence the course of the COVID-19 epidemic? | journal = Lancet | volume = 395 | issue = 10228 | pages = 931–934 | date = March 2020 | pmid = 32164834 | pmc = 7158572 | doi = 10.1016/S0140-6736(20)30567-5 | quote = A key issue for epidemiologists is helping policymakers decide the main objectives of mitigation—e.g., minimizing morbidity and associated mortality, avoiding an epidemic peak that overwhelms health-care services, keeping the effects on the economy within manageable levels, and flattening the epidemic curve to wait for vaccine development and manufacture on the scale and antiviral drug therapies. | doi-access = free }}</ref><ref name="ACAIM-WACEM COVID-19 Consensus Paper" /> A broad group of [[Non-pharmaceutical intervention (epidemiology)|non-pharmaceutical interventions]] may be taken to manage the outbreak.<ref name="ACAIM-WACEM COVID-19 Consensus Paper" /> In a flu pandemic, these actions may include personal preventive measures such as hand hygiene, wearing face-masks, and self-quarantine; community measures aimed at [[social distancing]] such as closing schools and canceling mass gatherings; community engagement to encourage acceptance and participation in such interventions; and environmental measures such as cleaning of surfaces.<ref name="community mitigation" />

Another strategy, '''suppression''', requires more extreme long-term non-pharmaceutical interventions to reverse the pandemic by reducing the [[basic reproduction number]] to less than{{nbsp}}1. The suppression strategy, which includes stringent population-wide social distancing, home isolation of cases, and household quarantine, was undertaken by [[China]] during the [[COVID-19 pandemic]] where entire cities were placed under lockdown; such a strategy may carry with it considerable social and economic costs.<ref name="ImpCollege16mar2020">{{cite news |title=Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand |date=16 March 2020 |work=[[Imperial College]] COVID-19 Response Team |url=https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf}}</ref>