Prevention

Prevention

Massive Media Messaging

Cellphones, radio, and other communication channels can be used to rapidly inform and educate the public about COVID-19

Cell phone messaging is a powerful tool for reaching a population. Widespread SMS texting has been used across the globe to communicate COVID-19 information at national, regional, and local levels. The WHO published a set of recommended messages that can be tailored to fit local needs.

In South Korea, SMS texts have been used to alert citizens to daily case counts, local case burdens, and even the gender, age, and locations recently visited by COVID-19 patients. Vietnam has also employed regular SMS messaging to portray the virus as a common enemy for the people to fight back against. A cartoon-based video clip on how and why to guard against COVID-19 went viral in Vietnam.

In Rwanda, radio shows that highlight the importance of handwashing, stay-at-home orders, and social distancing have played a key role in disseminating COVID-19 information. In regions with low literacy rates, radio can facilitate the spread of information to large populations. The international charity WaterAid partnered with local station Radio Ishingiro to produce the informational shows.

In India, incoming cell phone calls played a message about COVID-19 and preventive measures before parties to the call were connected. An app called Arogya Setu was developed for smartphones that provided callers guidance on COVID-19 symptoms and options for medical care. A lighter version was developed for inexpensive feature phones used by the majority of the population. 

Twitter has also served as a megaphone for Ministries of Health, public officials, scientists, and other key players in national COVID-19 response systems.

Potential Contacts: WaterAid

Related Ideas: COVID-19 Mapping Apps, Safe Handwashing

Traveler Screening

Screening international travelers through surveys, temperature scanning, testing, and quarantining can minimize the risk of “importing” COVID-19

The UN World Tourism Organization (UNWTO) announced in an April 2020 report that an unprecedented 100% of countries had imposed travel restrictions in response to COVID-19. The UNWTO report provided a detailed timeline of travel policies around the world (as of April). This free online interactive map, created by the International Air Transport Association (IATA), is updated every day to provide accurate up-to-date information related to restrictions and screening procedures. Some countries have established, or are currently working to develop, so-called “travel bubbles“, or safe travel corridors between specific countries (See Related Idea below)

Taiwan started early – on January 6, 2020 – when the country's CDC announced that it would screen all travelers from Wuhan, China for pneumonia, fever, and other symptoms of yet unknown SARS-CoV-2 infection. Later, it created an Entry Quarantine System and issued passengers a health declaration pass via SMS that was shared with hospitals, pharmacies, and public health officials.

By late January, Vietnam developed similar screening measures for arrivals from China. All travelers from China were required to submit a health declaration and undergo institutional quarantine for 14 days; these requirements were later expanded to travelers from the United States, South Korea, and EU countries. Travelers were tested before and after the quarantine period, and all services were provided free of charge. Vietnam continues to update its travel policies, with up-to-date information reported on this site.

As the virus slowed in China by late February, China tightened its screening procedures to prevent reinfection from abroad. Some areas of China have also implemented additional quarantine requirements. Chinese airports, subways, and other highly trafficked locations, have experimented with AI to screen travelers for high body temperatures and mask adherence. This page has updated information regarding travel policies specific to China.

Other governments in Asia have similarly issued restrictive travel policies. An American visiting South Korea described in detail on Twitter his experience from the moment he landed at Seoul airport; it is a must-read for anyone interested in understanding what an especially thorough traveler screening system looks like. Travelers to Hong Kong (HK) are quarantined in a convention center while the results of a self-administered spit test are processed. Airport officials collect each traveler's address and method of transit, and instruct them to download an app and wear a bracelet that supports HK's e-fencing policy.

Traveler screening policies have also been adopted in countries across Africa. Kenya, Rwanda, and Tanzania all reopened for international travel by August, with differing screening strategies.

Potential Contacts: International Air Transport Association

Related Ideas: International Safe Travel Corridors; E-Fencing; Strict Isolation and Quarantining; AI-Based Temperature Scanning; Leveraging Speed

Access to Masks

Locally-sourced or government-supplied, masks have become part of a daily global uniform

Singapore has rolled out over 400 vending machines to dispense free reusable masks to its citizens. With the swipe of an identification card, citizens were given one of six million reusable masks being dispensed as part of a three-week mask distribution exercise. In other East Asian countries where masking is a common part of daily life, rules were implemented to prevent panic buying and hoarding. In February 2020, Taiwan developed a rationing protocol to protect the nation's stock of masks. By presenting a national health insurance card at a drugstore or pharmacy, Taiwanese citizens could buy two masks for approximately US$10 every week. A “Mask Map” site was also developed in collaboration between Taiwan's government and community-based engineers to show which stores have masks available

In sub-Saharan Africa, organizations across Nigeria, Kenya, Rwanda, Liberia, and Ghana have harnessed numerous tailors to make masks for the masses. Nigeria's government provided grants to 100 tailors to increase production capacity. In Kibera, Kenya's largest informal urban settlement, local tailors provided affordable masking options long before public health officials began distributing them.

Related Ideas: Managing Outbreaks in Congested Areas; Encouraging Mask Usage

Encouraging Mask Usage

Mask usage can be encouraged by public education, free provision, and threat of punishment

Masks are believed to be effective at slowing the spread of COVID-19. In places like Hong Kong and Taiwan, they are widely used by the public. Exhortation by national leaders, e.g. by South Korea's prime minister or health care experts, can encourage mask usage. In South Korea, one ministry used hundreds of drones for a dazzling display of the value of wearing masks and observing social distancing. The informational site Fight COVID Taiwan, developed by students to educate the public, has dedicated a section to proper mask usage, including how to ensure a good fit, how to take off, and how to dispose.

Singapore also put notable effort toward encouraging masks, organizing a national “Stay Masked” campaign to educate the public on the importance of masks. The campaign has coordinated several rounds of mask distribution, funded by the Singapore state nonprofit organization Temasek. Masks are often distributed through dedicated vending machines, where residents scan their ID cards to collect two free reusable masks (per round); residents may also purchase additional masks to be collected from the machines. Like many places, masks became a requirement for entering malls or supermarkets. To improve access, a nonprofit volunteer group called Masks for All SG started a program in Singapore to supply an additional 500,000 free masks to the isolated elderly, the poor, and migrant workers. Some have argued that even after Covid-19 passes, Singaporeans should routinely use masks when they are sick or in crowded places, such as subways.

In the Democratic Republic of Congo, which has battled several epidemics, failure to wear masks can lead to fines or even arrest – another way to promote compliance.

Starting in March 2020 a few countries, such as Vietnam and Venezuela, mandated masks, but most countries started requiring masks in public settings, such as public transportation or markets, in April 2020. By mid-August, about 50 countries mandated mask wearing in public settings.

Potential Contacts: Temasek Foundation; Masks For All SG

Related Ideas: Access to Masks

Safe Handwashing

Innovative contraptions for dispensing water can ensure safe handwashing in vulnerable communities

Agencies such as the WHO and CDC have emphasized the importance of handwashing as a critical measure to help prevent the spread of COVID-19. With an estimated 3 billion people around the world lacking access to handwashing facilities (40% of world population), there is an urgent need for improved water, sanitation, and hygiene (WASH) services to fight the pandemic and prevent various other infectious diseases. Several innovative low-tech handwashing solutions have been developed to address this issue; these ideas often emerge from lower-income countries but have the potential to be deployed in high-income countries as well.

Originating from Ghana, the Veronica Bucket is an innovative handwashing solution developed by local biologist Veronica Bekoe. Commonly found in schools and hospitals, these large, free-standing plastic buckets with spigots make sure that water runs off into another container so that no one washes their hands in contaminated water. First developed and used during the ebola outbreak in Ghana, these devices now regularly appear throughout other countries in West Africa. 

HappyTap Co, a social business operating in South and Southeast Asia, has designed a mass-produced portable handwashing station called the “HappyTap”. The low-cost station was developed to make handwashing more convenient and user-friendly. A lightweight, portable design allows for the station to easily be moved around, an added benefit when used in schools, as it is able to move throughout different areas such as entrances, classrooms, and lunch areas. In response to COVID-19, HappyTap has greatly expanded its production and has established various partnerships and response campaigns. 

The Hand Hygiene for All Global Initiative, launched by the WHO and UNICEF, brings together regional and global partners to ensure affordable, sustainable services and solutions for these vulnerable communities. The initiative supports the development of national roadmaps to ensure lasting WASH infrastructure and promote healthy hygiene practices. The World Bank is also notably involved with handwashing projects around the world, improving handwashing accessibility in places like Ghana, Sri Lanka, Nicaragua, Yemen, and Indonesia.

Potential Contacts: 

Individuals: Veronica Bekoe

Organizations: HappyTap Co

Related Ideas: Managing Outbreaks in Congested Areas

Tech-Based Social Distancing

Digital technologies, including robots, can be used to promote social distancing

In the parks of Singapore one might come across a four-legged robotic dog, developed by Boston Dynamics, that uses sensors and a 360-degree camera to play prerecorded messages when people violate social distancing rules. Some countries are also using technology to remind people about social distancing without actual surveillance. For example, the Kenyan Red Cross used drones with speakers to play messages about COVID-19 prevention while delivering food to families.

In a quasi-form of social distancing, China rolled out a QR code platform that marks people as green, yellow, or red depending on their isolation/quarantine status. Public spaces and venues now have QR scanners and people can be denied access based on their code status, thereby separating the sick from the healthy.

In the U.S., construction sites are using wearable technology to simplify site check-ins and alert others of emergencies. A new device working off the same platform, Proximity Trace, developed by Triax, beeps when employees come within six feet of each other and documents interactions between workers and equipment.

As in other instances, using digital technologies creates concerns about what data is being gathered, where it is being stored, and who has access to it. In the US, drone surveillance for social distancing created a backlash in a small town over concerns about privacy. Drone surveillance in New York City also has not been well-received.

Potential Contacts: Boston Dynamics; Triax

Related Ideas: Digital Contact Tracing; Individual QR Codes

Robots and Drones for Disinfection

Drones and robots can be used to disinfect public spaces with disinfectants and UV-light

Robots are increasingly used for disinfection by shining UV-C light or spraying disinfectant. Many robots are able to navigate independently using sensors to detect when people are nearby. Robots have been created by the Danish company UVD, which plans to supply over 2,000 medical facilities in China. Similar technology has been locally developed in China and Singapore, where disinfection robots are routinely deployed in hospitals, malls, and other public spaces. The Chinese firm TMiRob distributed AI-guided robots to Wuhan hospitals to support disinfection efforts. Company executives have said that the demand for robots has increased significantly, both in China and internationally, and has exposed potential customers to the benefits of AI-guided robots in healthcare settings. In Hong Kong, the Mass Transit Railway (MTR) deployed robots, developed by Avalon Biomedical, to disinfect public transportation. In the United States, disinfection robots are expected to play a critical role in the travel industry. Startups, such as Ava Robotics, are developing UV-based robots to disinfect large spaces such as food banks, factories, supermarkets, and schools.

Drones have also been deployed for wide-scale disinfection, and are particularly useful for rural areas that are harder to reach. Agricultural drones developed by XAG have been repurposed to spray disinfectant in China. In India and South Korea drones have been used for large-scale disinfection campaigns. However, there has been concern regarding the possible impacts of disinfectant sprays on human health and the environment, with some cities like Mumbai rejecting the method because it is viewed as lacking scientific support.

Potential Contacts: UVD Robots; TMiRob; Ava Robotics; XAG; Avalon Biomedical

Related Ideas: Tech-Based Social Distancing; Robot-Based Patient Care

COVID-19 Mapping Apps

Mapping apps can inform public health officials and the public about infection hot spots, but at the risk of discrimination and invasion of privacy

Apps that anonymously track people with confirmed infections of COVID-19 have been launched in South Korea, China, and other countries around the world. In South Korea, cell phone data, credit card information, and other data points are used to backtrack where an infected person has been. Citizens who have come into contact with or been in the area at the same time as the infected person are alerted via SMS. Critics have spoken out about issues of privacy and confidentiality, and the government has responded by announcing that they would limit the amount of information published about persons infected.

The 100m app in South Korea takes published data on COVID-19 positive patients and warns users when they come within 100 meters of a location where that person had been. Corona Map, another similar app shows users locations in South Korea that COVID-19 positive patients have visited within the previous 72 hours. An entrepreneur developed a similar app for Singapore.

Related Ideas: Individual QR Codes; Massive Media Messaging; Capturing and Reporting Data; Digital Contact Tracing

Disease Severity Indicator

Singapore's national color-coded framework informs the public about epidemic status and offers behavioral guidelines

Following its experience with SARS in 2003, Singapore established the Disease Outbreak Response System Condition (DORSCON) as a national framework for epidemic response. The framework is color- coded and divided into four levels (green, yellow, orange, red) based on disease severity. For each level, there are descriptions of the nature of disease and outbreak status within Singapore, the expected impact on daily life, and recommendations for the public.

DORSCON levels are primarily determined by the Minister of Health (MOH) and Ministry for Home Affairs to guide and coordinate a centralized response. After locally transmitted cases were first identified, the DORSCON was raised on February 7th to the Orange level, which indicates the disease is severe and highly transmissible but has not spread within Singapore. As of this writing, Singapore remains at the orange level and is likely to remain so for some time. Red indicates the infection is severe and spreading widely, requires school closures and work-from-home practices, and asks the public to follow social distancing and avoid crowded places.

Related Ideas: COVID-19 Command Centers; Strict Isolation and Quarantining

Capturing and Reporting Data

Capturing data on cases, deaths, and other statistics and reporting that data to local, national, and international stakeholders can help fight COVID-19

Public and private data sites for COVID-19 have built robust systems for information gathering and sharing. Ministries of Health other government bodies have primarily served as repositories of COVID-19 data, for example in Taiwan and Singapore.

The government of Vietnam built a real time data reporting and aggregating tool in 2009 that has facilitated the country's exemplary COVID-19 response.

Contact tracing and testing initiatives have provided significant data at a national level. For example, Singapore's TraceTogether initiative captures data from positive COVID-19 cases by using bluetooth connections between cell phones. This data is only accessed when a case is confirmed, but the information can be used to identify clusters.

IBM has partnered with the Indian Council for Medical Research on an AI-based platform for reporting COVID-19 data and answering public health worker queries. The system, which was launched in May, could be applied to a wide range of datasets and diseases to create a more robust portal for information sharing and analysis.

Related Ideas: Digital Contact Tracing; Human Contact Tracing; COVID-19 Mapping Apps

Everyone Can Help

Policymakers, leaders of private companies, and citizens, can all help fight Covid-19

People from all walks of life can contribute valuable insight, experience, and energy to the fight against COVID-19, making the job of public health officials that much easier.

In India, a civil servant from Bilwhara developed in April 2020 a COVID-19 strategy for his region that came to be known as the Bilwhara model. The successful implementation of the strategy, which included lockdowns, border-closures, contact tracing, and testing, became a model for the rest of India.

Cottage industries to make masks have cropped up to support both livelihoods and public health. By making masks, tailors in many parts of the world have supported public health efforts while also making a living. Organizations such as Migrant Offshore Aid Station (MOAS) and Grevy's Zebra Project have launched mask-making projects in Bangladesh and Kenya, respectively, where tailors are hired to produce masks for the local communities. Similarly, an initiative called African Masks raises money and coordinates with communities to produce and distribute free masks, employing local tailors in Kenya, Nigeria, Senegal, Benin, and the DRC.

Hong Kong's successful COVID-19 response has been attributed by some to its citizens, not just to its government. Activist networks established to protest the central government were able to use their networks to disseminate information on social distancing, mask availability, and hospital wait times. Learning from the outbreaks in Singapore's migrant dormitory communities, volunteers in Hong Kong launched disinfecting campaigns for similar communities in their own city.

Businesses worldwide have redeployed their assets to help fight COVID-19, e.g. by using manufacturing lines for perfume to make hand sanitizer instead or using hotels as isolation centers.

Potential Contacts: Migrant Offshore Aid Station (MOAS); Grevy's Zebra Trust; African Masks

Related Ideas: Access to Masks