What does Swiss cheese have to do with controlling the COVID-19 pandemic?
Quite a lot, as it turns out. Experts have adapted the Swiss cheese model of risk reduction first described by James Reason in 1990 to the coronavirus pandemic.
The concept is simple….
Each strategy to mitigate the spread of the virus is visualized as a slice of Swiss cheese. No one layer offers perfect protection, vaccines are at best 90% effective, mask-wearing, and social distancing somewhat less so, and widespread testing, contact tracing, and public health messaging provide additional measures of protection. Holes in each slice of cheese represent the risks inherent in each strategy. When the slices are stacked, and multiple strategies are employed, the holes don’t align, and risk is minimized. This theory was applied to COVID-19 by Ian Mackay, PhD, Associate Professor of Virology at the University of Queensland in Australia, and his version quickly went viral.
The New York Times published an article on Mackay’s infographic in December. As the Times explained: “Multiple layers of protection, imagined as cheese slices, block the spread of the new coronavirus, SARS-CoV-2, the virus that causes COVID-19. No one layer is perfect; each has holes, and when the holes align, the risk of infection increases. But several layers combined — social distancing, plus masks, plus handwashing, plus testing and tracing, plus ventilation, plus government messaging — significantly reduce the overall risk. Vaccination will add one more protective layer.”
In a recent social media post, Bill Hanage, PhD, an epidemiologist at the Harvard T.H. Chan School of Public Health, noted that the model includes both personal and collective measures, as well as a “misinformation mouse” eating new holes to allow the virus to spread. In an interview with the Times, Dr. Mackay noted that the real power of the infographic is that it de-emphasizes individual measures, instead focusing on the additive effect of multiple layers of defense. “To be as safe as possible, and to keep those around you safe, it’s important to use more slices to prevent those volatile holes from aligning and letting virus through,” Mackay said.
While masking up, social distancing, and vaccines will remain at the forefront of initiatives to help control the spread of COVID-19, widespread testing, monitoring, and tracing are critically important steps as well. According to the National Institutes of Health, testing remains vital because it saves lives by identifying those carrying the virus, including asymptomatic carriers, and allows them to quarantine rather than unknowingly spreading illness to others. Testing also permits those with COVID-19 to obtain appropriate medical care. As new coronavirus variants emerge, testing becomes an even more critical tool in the fight against the disease, both from an individual and epidemiological perspective.
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Contact us to learn how your organization can do its part – becoming one more slice of Swiss cheese – to contribute to the ongoing effort to control the spread of COVID-19.