Pandemic guidance from the world B.C. (Before Covid)

Surely the politicians were just following the guidance of the World Health Organization when they decided to SHUT IT ALL DOWN in March? Ok, perhaps we can agree that they panicked and over-reacted; but surely the stay-at-home orders, business closures and banning of gatherings, affecting billions of people around the planet, were just standard procedure during a pandemic of unknown severity?

Well, interesting that you should ask, because the WHO’s guidance on these matters is freely available on its website, and it’s not exactly what we’ve been led to believe. Here is a document from October 2019 that should be of interest:

Available for download on the WHO site, and I’ve also uploaded it here (PDF).

Chapter 6: Social Distancing Measures has the goods. After recommending that mildly sick people stay home (“voluntary isolation at home of sick individuals with uncomplicated illness”) during a flu epidemic or pandemic, the chapter addresses the issue of quarantining “exposed individuals”:

RECOMMENDATION:

Home quarantine of exposed individuals to reduce transmission is not recommended because there is no obvious rationale for this measure, and there would be considerable difficulties in implementing it.

Population: People who have had contact with infected cases

When to apply: N/A (p. 47)

Seems pretty straightforward! So, stay-at-home orders applied to the general population are out.

But what does the WHO’s document say about school closures? Here the recommendation is more subtle:

RECOMMENDATION:

School measures (e.g. stricter exclusion policies for ill children, increasing desk spacing, reducing mixing between classes, and staggering recesses and lunchbreaks) are conditionally recommended, with gradation of interventions based on severity. Coordinated proactive school closures or class dismissals are suggested during a severe epidemic or pandemic. In such cases, the adverse effects on the community should be fully considered (e.g. family burden and economic considerations), and the timing and duration should be limited to a period that is judged to be optimal.

Population: Students and staff in childcare facilities and schools

When to apply: Gradation of interventions based on severity; school closure can be
considered in severe epidemics and pandemics (p. 52)

On workplace closures (emphasis added):

RECOMMENDATION:

Recommendation: Workplace measures (e.g. encouraging teleworking from home, staggering shifts, and loosening policies for sick leave and paid leave) are conditionally recommended, with gradation of interventions based on severity. Extreme measures such as workplace closures can be considered in extraordinarily severe pandemics in order to reduce transmission.

Population: Selected workplaces

When to apply: Gradation of interventions based on severity. Workplace closure should be a last step that is only considered in extraordinarily severe epidemics and pandemics

Here’s what the WHO had to say about religious gatherings. Does this sound like a blank check for governments to ban or severely limit all religious gatherings for a long period of time – such in the state of New Jersey, where religious gatherings are STILL (as of August 3) limited to 25% of capacity or 100 people, whichever number is lower?*

RECOMMENDATION:

Avoiding crowding during moderate and severe epidemics and pandemics is conditionally recommended, with gradation of strategies linked with severity in order to increase the distance and reduce the density among populations.

Population: People who gather in crowded areas (e.g. large meetings, religious pilgrimages, national events and transportation hub locations).

When to apply: Moderate and severe epidemics and pandemics. (p. 59)

Moreover:

Ethical considerations

Avoiding crowding may have cultural or religious implications (209). Gatherings are important places to share information during influenza, which can comfort people and reduce fear. The abolition of religious gatherings may violate the devout faith of the participants and make them feel morally guilty. The guideline development group suggested that it would not be possible to cancel some events (e.g. the Hajj). (p. 59)

But I thought that going to church was the moral equivalent of “killing people”? Guess the WHO disagrees!

Bonus recommendation on contact tracing:

RECOMMENDATION:

Active contact tracing is not recommended in general because there is no obvious rationale for it in most Member States. This intervention could be considered in some locations and circumstances to collect information on the characteristics of the disease and to identify cases, or to delay widespread transmission in the very early stages of a pandemic in isolated communities.

Population: Individuals who have come into contact with an infected person

When to apply: N/A (p. 38)

*Note – some facts about the Garden State:

Total reported COVID-19 deaths in New Jersey as of Aug 15: 14,071

Share of deaths that were of residents 80 or older (as of June 4): 47%

Share of deaths that were in long-term care facilities, such as nursing and veterans homes (as of June 4): 43%