Community Mitigation Activities by Epidemiologic Scenario
Potential mitigation activities according to transmission scenario
Personal protective measures 5,6,7
Scenario 1: No cases
- Provide guidance on implementation of personal protective measures (e.g., staying home when sick unless to seek medical care, handwashing or using alcohol-based sanitizer**, covering mouth and nose when coughing or sneezing, use of cloth face coverings, cleaning frequently touched surfaces daily, maintaining a distance of 2 meters/6 feet from others ).
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Direct community members to continue practicing personal protective measures.
- Provide guidance on how to implement physical distancing measures such as reducing the frequency of and participation in large gatherings, altering schedules or operating hours to reduce mixing, increasing physical space between individuals.
- Provide guidance on source control measures (e.g., face mask, if available, or covering), as appropriate based on context.
- Provide guidance on how to take care of sick people and self at home.
Scenario 4: Community transmission
- Direct community members to continue practicing personal protective measures.
- Provide guidance on how to implement physical distancing measures such as cancelling gatherings, altering schedules or operating hours to reduce mixing, increasing physical space between individuals.
- Continue to provide guidance on source control measures (e.g., face mask, if available or covering), as appropriate based on context.
- Continue to provide guidance on how to take care of sick people and self at home.
Water, sanitation, and hygiene 8
Scenario 1: No cases
- Identify mechanism for making water, soap, and cleaning and disinfection supplies available to the public.
- Identify at-risk community settings and ensure supply chains are available to enable rapid establishment of handwashing stations or provision of alcohol-based sanitizer**.
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Prioritize availability of water, soap, and cleaning and disinfection supplies to the public.
- Provide guidance for establishing handwashing stations that include soap and water, alcohol-based hand sanitizers, or chlorine solution**.
- Require every person to wash their hands before entering community settings.
Scenario 4: Community transmission
- Prioritize availability of water, soap, and cleaning and disinfection supplies to the public.
- Continue to provide guidance for establishing handwashing stations that include soap and water, alcohol-based hand sanitizers, or chlorine solution**.
- Require every person to wash their hands before entering community setting.
Cleaning and disinfection 9,10,11
Scenario 1: No cases
- Provide guidance on cleaning and disinfecting frequently touched surfaces and the importance of ensuring water, soap, and cleaning and disinfection supplies are readily available.
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Continue to provide guidance on cleaning and disinfecting frequently touched surfaces and importance of ensuring water, soap, and cleaning and disinfection supplies are readily available.
- Provide guidance on how to clean and disinfect home when someone is sick.
- Require thorough cleaning and disinfection of closed community settings.
Scenario 4: Community transmission
- Continue to provide guidance on cleaning and disinfecting frequently touched surfaces, and importance of ensuring water, soap, and cleaning and disinfection supplies are readily available.
- Continue to provide guidance on how to clean and disinfect home when someone is sick.
- Require thorough cleaning and disinfection of closed community settings.
Case investigation and contact tracing 12,13,14,15,16
Scenario 1: No cases
- Identify and train contact tracing workforce
- Develop guidance for monitoring close contacts and implementing movement restrictions, including quarantine
- Determine methods to streamline contact tracing through simplified data collection and monitoring and allocating additional resources if needed (including staffing through field epidemiology training programs, technology etc.).
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Conduct contact tracing and managing and monitoring of contacts as advised in MOH guidance to maximize containment around cases.
- Monitor close contacts through culturally appropriate and community-based efforts to the extent possible, based on local priorities and resources.
- Isolate confirmed COVID-19 cases until no longer considered infectious according to MOH guidance.
- Consider movement restrictions and physical distancing based on exposure risk level of close contacts of a confirmed COVID-19 case.
Scenario 4: Community transmission
- May reduce contact tracing if resources are limited, prioritizing those in high-risk settings (e.g. critical infrastructure, vulnerable populations)
- Isolate confirmed COVID-19 cases until no longer considered infectious according to MOH guidance.
Risk communication 17,18
Scenario 1: No cases
- Develop, test, and distribute to community settings COVID-19 risk communication materials (e.g. printed materials, banners, loudspeaker announcements, radio messages).
- Develop, test, and distribute messaging to address rumors and misinformation
- Establish feedback loop on messages and material to refine and adapt.
- Establish clearance process for material before sharing with communities, making sure the materials are appropriate for the community literacy and education levels
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Continue to develop, test, and distribute COVID-19 risk communication materials that address the change in epidemiologic scenarios and associated community mitigation activities
- Continue to develop, test and distribute messaging to address rumors and misinformation, updating the messaging as rumors and misinformation changes
- Continue to seek feedback on messages and material
Scenario 4: Community transmission
- Continue to develop, test, and distribute COVID-19 risk communication materials that address the change in epidemiologic scenario and associated community mitigation activities
- Continue to develop, test. And distribute messaging to address rumors and misinformation, updating the messaging as rumors and misinformation changes
- Continue to seek feedback on messages and material
Disease education
Scenario 1: No cases
- Educate community members on the signs and symptoms of COVID-19 (i.e. fever, cough, difficulty breathing), what to do if they develop symptoms.
- Provide information on the epidemiology of COVID-19.
- Educate community members on groups at increased risk of severe illness and what additional measures they should take to prevent infection.
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Continue to provide and update information about COVID-19 disease and epidemiology.
Scenario 4: Community transmission
- Continue to provide and update information about COVID-19 disease and epidemiology.
Community action plans
Scenario 1: No cases
- Provide guidance to community members on how to create and adjust community setting-specific action plans in case of illness in the community or disruption of daily activities due to COVID-19 transmission in the wider community (e.g. implementation of physical distancing measures, securing necessary supplies, special considerations for individuals at increased risk of severe illness).
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Direct community members to implement the established action plan and adjust as needed based on the epidemiologic situation.
- Provide guidance for provision of services and supplies to individuals at increased risk of severe disease (e.g. medical care, food, and water) while limiting close contact and group gatherings
- Provide guidance for establishing screening (e.g., for temperature, respiratory symptoms, exposure history) of persons entering the community setting.
- Direct community members to limit non-essential travel (personal and work- related).
Scenario 4: Community transmission
- Direct community members to continue following the established action plan and adjust as needed based on epidemiologic situation.
- Direct communities that all individuals should limit community movement, not participate in social gatherings or community events, and adapt to disruptions in routine activities (e.g. school, work, business closures) according to guidance from local officials.
- Direct community members to cancel non-essential travel and non-essential gatherings
- Instruct communities to limit or restrict the number of people allowed to visit the community settings (refer to Section 4 above).
- Provide guidance for provision of services and supplies to individuals required to shelter in place (e.g. medical care, food, and water) while limiting close contact or group settings and exposures
Schools and workplaces 19,20
Scenario 1: No cases
- Educate community members on the need to stay home when sick.
- Educate administrators on the need for sick leave allowance, and provision of distance learning or working from home, if possible.
Scenarios 2 and 3: Sporadic cases and clusters of cases*
- Provide guidance to implement short-term closures as needed (e.g. if cases in schools) for cleaning and contact tracing.
- Instruct administrators to implement distance learning or work from home arrangements (if possible) for individuals at increased risk of severe illness or those with close family or household members at increased risk of severe illness.
Scenario 4: Community transmission
- Instruct administrators to implement broader or longer- term closures.
- Direct administrators to implement extended distance learning and work from home arrangements (when possible) or ensure appropriate physical distancing between staff at workplaces deemed essential.
- Direct administrators to ensure flexible leave or work schedules for those who need to stay home due to school closures, childcare dismissals, or to care for elderly or ill persons.