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What is the Swiss Cheese Model of Defence in the COVID Pandemic?

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As vaccine news continues to dominate our discussions, there’s hope that 2021 will see the end of the COVID pandemic. But is it really that simple? Are vaccines the end-all of defence against the novel virus?

Put simply, no. Well, not quite - because while the vaccines are an undeniably huge surge forward in protection, we need a multi-pronged approach towards tackling the virus.

Enter the ‘swiss cheese model of defence’.

What is the Swiss Cheese Model?

With a delicious sounding name, the swiss cheese model is a framework for understanding the different kinds of interventions needed to protect ourselves from a virus. Multiple layers, like the layers of the cheese, are needed to block COVID. Like Swiss cheese, each layer has certain holes and limitations, and thus by deploying all 10 layers - or interventions - we can be best protected.

In other words, the vaccine is not our only tool for protection - and we are not completely helpless without it.

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The several layers include:

  • social distancing,
  • and masks,
  • and hand-washing,
  • and avoiding face touching
  • and voiding crowds
  • and testing and tracing,
  • and ventilation,
  • and clear government messaging and financial support
  • and isolation and quarantining
  • and finally vaccines.

Notice how each layer is incomplete on its own, and we are best protected when we follow all 10 steps. The vaccine is the tip of the protective iceberg to help reduce our risk.

The important thing to note is that protection against COVID requires all 10 steps - so even if we have a vaccine on the market, don’t forget to mask up and wash your hands frequently.

The model works by using the metaphor of the holes in the Swiss cheese - so the more layers and interventions in use, the less likely it is that the virus will pass through the holes of the cheese. So to be safe and to keep those around you safe, use all 10 layers and reduce the possibility of the holes aligning, i.e. of the virus getting through.

Personal and Collective Responsibility

Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, retweeted an infographic of the Swiss cheese model saying there are “different steps to reduce the risk of transmission add up, including things that are personal *and* collective responsibility - note the 'misinformation mouse' busy eating new holes for the virus to pass through.”

Health misinformation in a pandemic can be deadly, and it is up to government bodies and respected science journals and institutions to steer the public health discourse in an accurate, fact-based way. Besides, we personally should be fact-checking our sources from verified sites like the World Health Organisation, MayoClinic and the Ministry of Health and Family Welfare portal and listening to expert advice from health care professionals. Another resource would be The Quint’s Webqoof page, where we regularly bust fake news about COVID.

Has the Model Been Used Before?

The Swiss Cheese model is an oft-used framework for safety in many industries. In October of this year, Ian M. Mackay, a virologist at the University of Queensland, in Brisbane, Australia, saw a version of the model on Twitter and added more slices and information to create the 10 slice model most accepted by the global scientific community for battling COVID.

How Can We Use the Model?

By understanding and following it! Since the pandemic hit the world, we have all adjusted to our new normals. We have learnt a lot more about the virus - like how it can stay on surfaces and therefore its best to sanitize our phones if we go out as well or how distancing and isolation, especially when sick, can help reduce transmission or even how it can remain infectious in aerosols and thus its important to ventilate properly.

So we know that that fighting COVID requires a multi-pronged approach, and the model helps us recognise our own responsibilities and what we can expect from communities and governments. We already know that we need to follow all these steps to reduce our risk, and the model makes that clear through a distinctive and clear infographic.

So we can make the model stick by adhering to all 10 layers even when a vaccine hits because it will take some time for its effects to percolate in society. Besides, its good for all of us, and can even help reduce the risk of flus and colds - not just COVID-19.

(At The Quint, we question everything. Play an active role in shaping our journalism by becoming a member today.)

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