Prevención

Traducción:
Anisha Gualani Gualani
Jesús García-Rosales Delgado

Encontrará las figuras en el PDF gratuito.

 

En la 5ª edición de COVID Reference de Stefano Lazzari, se presentará un debate exhaustivo sobre la prevención del SARS-CoV-2. Mientras tanto, aquí tiene este simple esquema con temas clave y referencias. En la actualidad, sobre la base de la comprensión actual de la transmisión SARS-COV-2 presentada en el capítulo 2, se pueden considerar varias medidas de prevención a nivel personal, institucional, comunitario y social:

1. Medidas de prevención a nivel personal frente a la infección

• Promover la higiene de manos (lavado o desinfección).
• Practicar una buena higiene respiratoria y “etiqueta de tos” (cómo aprender a toser adecuadamente).
• Uso de mascarillas.
• Distanciamiento físico y social y evitar espacios abarrotados.
• Hablar con tono bajo, no gritar ni cantar.
• Fortalecer la salud general personal y la inmunidad.
• Higiene de hogar.
• Autoconfinamiento en casa.
• Usar quimioprofilaxis (aún no disponible).

 

2. Medidas preventivas a nivel comunitario y social

• Mascarillas obligatorias.
• Prohibir las reuniones multitudinarias (eventos deportivos, discotecas, bares llenos de gente, celebraciones religiosas, etc.).
• Confinamiento local y nacional.
• Prohibiciones de viaje / cierre de fronteras.
• Pruebas generalizadas, seguimiento intensivo de contactos (con o sin aplicaciones para teléfonos inteligentes).
• Cuarentena y aislamiento de casos sospechosos o confirmados.
• Higiene ambiental y desinfección.
• Vacunar contra la gripe estacional y para COVID-19 (aún no disponible).

 

3. Medidas preventivas a nivel institucional

• Instalaciones de enfermería.
• Instituciones de cuidados a largo plazo.
• Lugares de trabajo.
• Cárceles.
• Refugios para personas sin hogar.

Prevención a nivel personal

Buena higiene respiratoria y “etiqueta de tos”

• Chavis S, Ganesh N. Respiratory Hygiene and Cough Etiquette. Infection Control in the Dental Office. 2019;91-103. Published 2019 Nov 18. Full-text: https://doi.org/10.1007/978-3-030-30085-2_7

Higiene de manos

• Kratzel A, Todt D, V’kovski P, et al. Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 by WHO-Recommended Hand Rub Formulations and Alcohols. Emerg Infect Dis. 2020 Apr 13;26(7). PubMed: https://pubmed.gov/32284092 Full-text: https://doi.org/10.3201/eid2607.200915
• WHO Interim recommendations on obligatory hand hygiene against transmission of COVID-19. 1 April 2020
• Guide to Local Production: WHO-recommended Handrub Formulations. WHO 2020.

Mascarillas

• Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ. COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. 2020 Jun 1. PubMed: https://pubmed.gov/32497510. Full-text: https://doi.org/10.1016/S0140-6736(20)31142-9
• Meselson M. Droplets and Aerosols in the Transmission of SARS-CoV-2. N Engl J Med. 2020 May 21;382(21):2063. PubMed: https://pubmed.gov/32294374. Full-text: https://doi.org/10.1056/NEJMc2009324
• Prather KA, Wang CC, Schooley RT. Reducing transmission of SARS-CoV-2. 2020 May 27: eabc6197. PubMed: https://pubmed.gov/32461212. Full-text: https://doi.org/10.1126/science.abc6197
• Chan JF, Yuan S, Zhang AJ, et al. Surgical mask partition reduces the risk of non-contact transmission in a golden Syrian hamster model for Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2020 May 30:ciaa644. PubMed: https://pubmed.gov/32472679. Full-text: https://doi.org/10.1093/cid/ciaa644
• WHO Advice on the use of masks in the context of COVID-19. Interim guidance, 5 June 2020

Practicar distanciamiento físico y social y evitar espacios abarrotados

• Zhang J, Litvinova M, Liang Y, et al. Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China. 2020 Apr 29. PubMed: https://pubmed.gov/32350060. Full-text: https://doi.org/10.1126/science.abb8001
• Kissler SM, Tedijanto C, Goldstein E, Grad YH, Lipsitch M. Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period. 2020 May 22;368(6493):860-868. PubMed: https://pubmed.gov/32291278. Full-text: https://doi.org/10.1126/science.abb5793

¡Hablar en voz baja, no gritar (o cantar)!

• Asadi S, Wexler AS, Cappa CD, Barreda S, Bouvier NM, Ristenpart WD. Aerosol emission and superemission during human speech increase with voice loudness. Sci Rep. 2019 Feb 20;9(1):2348. PubMed: https://pubmed.gov/30787335. Full-text: https://doi.org/10.1038/s41598-019-38808-z

Higiene de hogar

• Radhika Gharpure; Candis M. Hunter; Amy H. Schnall; Catherine E. Barrett; Amy E. Kirby; Jasen Kunz; Kirsten Berling; Jeffrey W. Mercante; Jennifer L. Murphy; Amanda G. Garcia-Williams. Knowledge and Practices Regarding Safe Household Cleaning and Disinfection for COVID-19 Prevention — United States, MMWR Morb Mortal Wkly Rep. May 2020 Early Release, June 5, 2020/9. Full-text: https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e2.htm
• Chang A, Schnall AH, Law R, et al. Cleaning and Disinfectant Chemical Exposures and Temporal Associations with COVID-19 – National Poison Data System, United States, January 1, 2020-March 31, 2020. MMWR Morb Mortal Wkly Rep. 2020 Apr 24;69(16):496-498. PubMed: https://pubmed.gov/32324720. Full-text: https://doi.org/10.15585/mmwr.mm6916e1
• Chin AWH, Chu JTS, Perera MRA, et al. Stability of SARS-CoV-2 in different environmental conditions. Lancet 2020: April 02, 2020. Full-text: https://doi.org/10.1016/S2666-5247(20)30003-3

Quimioprofilaxis

La profilaxis post-exposición (PEP) con medicamentos antivirales después de la exposición documentada puede reducir el riesgo de infección. En el futuro, SARS-CoV-2-PEP podría utilizarse para reducir el desprendimiento viral en casos sospechosos y como tratamiento profiláctico de los contactos.

Prevención a nivel comunitario y social

Mascarillas obligatorias

• Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission, US CDC 2020
• WHO Advice on the use of masks in the context of COVID-19, Interim guidance, 5 June 2020
• European Centre for Disease Prevention and Control. Using face masks in the community. Stockholm: ECDC 2020

Prohibición de reuniones masivas

• McCloskey B, Zumla A, Ippolito G, et al. Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma. 2020 Apr 4;395(10230):1096-1099. PubMed: https://pubmed.gov/32203693. Full-text: https://doi.org/10.1016/S0140-6736(20)30681-4
• Ebrahim SH, Memish ZA. COVID-19 – the role of mass gatherings. Travel Med Infect Dis. 2020 Mar-Apr;34:101617. PubMed: https://pubmed.gov/32165283. Full-text: https://doi.org/10.1016/j.tmaid.2020.101617

Confinamiento local y nacional

• Cowling BJ, Ali ST, Ng TWY, et al. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020 May;5(5):e279-e288. PubMed: https://pubmed.gov/32311320. Full-text: https://doi.org/10.1016/S2468-2667(20)30090-6

Prohibición de viajes/cierre de fronteras

• #COVID19 Government Measures Dataset, ACAPS, 2020
• Updated WHO recommendations for international traffic in relation to COVID-19 outbreak, WHO 29 February 2020
• Habibi R, Burci GL, de Campos TC, et al. Do not violate the International Health Regulations during the COVID-19 outbreak. 2020 Feb 29;395(10225):664-666. PubMed: https://pubmed.gov/32061311. Full-text: https://doi.org/10.1016/S0140-6736(20)30373-1
• Devi S. Travel restrictions hampering COVID-19 response. 2020 Apr 25;395(10233):1331-1332. PubMed: https://pubmed.gov/32334692. Full-text: https://doi.org/10.1016/S0140-6736(20)30967-3
• Mateus AL, Otete HE, Beck CR, Dolan GP, Nguyen-Van-Tam JS. Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review. Bull World Health Organ. 2014 Dec 1;92(12):868-880D. PubMed: https://pubmed.gov/25552771. Full-text: https://doi.org/10.2471/BLT.14.135590

Hacer pruebas. Tratar. Rastreo.

• Contact tracing for COVID-19: current evidence, options for scale-up and an assessment of resources needed. ECDC, April 2020
• Contact tracing in the context of COVID-19: Interim guidance, WHO 10 May 2020
• Steinbrook R. Contact Tracing, Testing, and Control of COVID-19-Learning From Taiwan. JAMA Intern Med. 2020 May 1. PubMed: https://pubmed.gov/32356871. Full-text: https://doi.org/10.1001/jamainternmed.2020.2072
• Cheng HY, Jian SW, Liu DP, Ng TC, Huang WT, Lin HH; Taiwan COVID-19 Outbreak Investigation Team. Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset. JAMA Intern Med. 2020 May 1:e202020. PubMed: https://pubmed.gov/32356867. Full-text: https://doi.org/10.1001/jamainternmed.2020.2020
• Salathé M, Althaus CL, Neher R, et al. COVID-19 epidemic in Switzerland: on the importance of testing, contact tracing and isolation. Swiss Med Wkly. 2020 Mar 19;150:w20225. PubMed: https://pubmed.gov/32191813. Full-text: https://doi.org/10.4414/smw.2020.20225. eCollection 2020 Mar 9

Aplicaciones de rastreo

• Jia JS, Lu X, Yuan Y, Xu G, Jia J, Christakis NA. Population flow drives spatio-temporal distribution of COVID-19 in China. 2020 Apr 29. PubMed: https://pubmed.gov/32349120. Full-text: https://doi.org/10.1038/s41586-020-2284-y
• Oliver N, Lepri B, Sterly H, et al. Mobile phone data for informing public health actions across the COVID-19 pandemic life cycle ScienceAdvances 5 June. Full-text: https://advances.sciencemag.org/content/6/23/eabc0764
• Ferretti L, Wymant C, Kendall M, et al. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. 2020 May 8;368(6491). PubMed: https://pubmed.gov/32234805. Full-text: https://doi.org/10.1126/science.abb6936

Cuarentena y asilamiento de casos sospechosos o confirmados

• Little P, Read RC, Amlôt R, et al. Reducing risks from coronavirus transmission in the home-the role of viral load. 2020 May 6. PubMed: https://pubmed.gov/32376669. Full-text: https://doi.org/10.1136/bmj.m1728
• Bi Q, Wu Y, Mei S, et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. Lancet Infect Dis. 2020 Apr 27:S1473-3099(20)30287-5. PubMed: https://pubmed.gov/32353347. Full-text: https://doi.org/10.1016/S1473-3099(20)30287-5
• Wu J, Huang Y, Tu C, et al. Household Transmission of SARS-CoV-2, Zhuhai, China, 2020. Clin Infect Dis. 2020 May 11. PubMed: https://pubmed.gov/32392331. Full-text: https://doi.org/10.1093/cid/ciaa557

Higiene ambiental y desinfección

• Cleaning and disinfection of environmental surfaces in the context of COVID-19, WHO 16 May 2020
• Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020 Mar;104(3):246-251. PubMed: https://pubmed.gov/32035997. Full-text: https://doi.org/10.1016/j.jhin.2020.01.022
• Disinfection of environments in healthcare and non-healthcare settings potentially contaminated with SARS-CoV-2. ECDC, March 2020

Vacuna contra la gripe estacional y para COVID-19 (aún no disponible)

• Arokiaraj MC. Correlation of Influenza Vaccination and the COVID-19 Severity (April 10, 2020). Full-text at SSRN: https://ssrn.com/abstract=3572814 or http://dx.doi.org/10.2139/ssrn.3572814
• Mendelson M. Could enhanced influenza and pneumococcal vaccination programs help limit the potential damage from SARS-CoV-2 to fragile health systems of southern hemisphere countries this winter? Int J Infect Dis. 2020 May;94:32-33. PubMed: https://pubmed.gov/32194236. Full-text: https://doi.org/10.1016/j.ijid.2020.03.030
• Singer BD. COVID-19 and the next influenza season. Science Advances 29 May 2020. Full-text: https://doi.org/10.1126/sciadv.abd0086

Prevención a nivel institucional

Hospitales y otros entornos de atención sanitaria

• Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-513. PubMed: https://pubmed.gov/32007143. Full-text: https://doi.org/10.1016/S0140-6736(20)30211-7
• Infection prevention and control andpreparedness for COVID-19 in healthcare settings. ECDC Second update – 31 March 2020
• US CDC Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings (Update May 18, 2020)
• Hoe Gan W, Wah Lim J, Koh D. Preventing intra-hospital infection and transmission of COVID-19 in healthcare workers. Saf Health Work. 2020 Mar 24. PubMed: https://pubmed.gov/32292622. Full-text: https://doi.org/10.1016/j.shaw.2020.03.001
• Ghinai I, McPherson TD, Hunter JC, et al. First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA. 2020 Apr 4;395(10230):1137-1144. PubMed: https://pubmed.gov/32178768. Full-text: https://doi.org/10.1016/S0140-6736(20)30607-3

Instalaciones de enfermería

• Gandhi M, Yokoe DS, Havlir DV. Asymptomatic Transmission, the Achilles’ Heel of Current Strategies to Control Covid-19. N Engl J Med. 2020 May 28;382(22):2158-2160. PubMed: https://pubmed.gov/32329972. Full-text: https://doi.org/10.1056/NEJMe2009758

Instituciones de cuidados a largo plazo

• Yen MY, Schwartz J, King CC, Lee CM, Hsueh PR; Society of Taiwan Prevention and Control. Recommendations for protecting against and mitigating the COVID-19 pandemic in long-term care facilities. J Microbiol Immunol Infect. 2020 Apr 10;53(3):447-53. PubMed: https://pubmed.gov/32303480. Full-text: https://doi.org/10.1016/j.jmii.2020.04.003
• Lai CC, Wang JH, Ko WC, et al. COVID-19 in long-term care facilities: An upcoming threat that cannot be ignored. J Microbiol Immunol Infect. 2020 Apr 13;53(3):444-6. PubMed: https://pubmed.gov/32303483. Full-text: https://doi.org/10.1016/j.jmii.2020.04.008

Lugares de trabajo

• Prevention and Mitigation of COVID-19 at Work ACTION CHECKLIST, International Labor Organization 16 April 2020
• Guidance on Preparing Workplaces for COVID-19, US CDC and OSHA 3990-03 2020.

Escuelas

• UK Department of Education Guidance Actions for schools during the coronavirus outbreak Updated 3 June 2020
• Cao Q, Chen YC, Chen CL, Chiu CH. SARS-CoV-2 infection in children: Transmission dynamics and clinical characteristics. J Formos Med Assoc. 2020 Mar;119(3):670-673. PubMed: https://pubmed.gov/32139299. Full-text: https://doi.org/10.1016/j.jfma.2020.02.009
• Lee B, Raszka WV Jr. COVID-19 Transmission and Children: The Child is Not to Blame. 2020 May 26:e2020004879. PubMed: https://pubmed.gov/32457212. Full-text: https://doi.org/10.1542/peds.2020-004879
• Ludvigsson JF. Children are unlikely to be the main drivers of the COVID-19 pandemic – a systematic review. Acta Paediatr. 2020 May 19. PubMed: https://pubmed.gov/32430964. Full-text: https://doi.org/10.1111/apa.15371

Prisiones

• Yang H, Thompson JR. Fighting covid-19 outbreaks in prisons. 2020 Apr 2;369:m1362. PubMed: https://pubmed.gov/32241756. Full-text: https://doi.org/10.1136/bmj.m1362
• Burki T. Prisons are “in no way equipped” to deal with COVID-19. 2020 May 2;395(10234):1411-1412. PubMed: https://pubmed.gov/32359457. Full-text: https://doi.org/10.1016/S0140-6736(20)30984-3
• Barnert E, Ahalt C, Williams B. Prisons: Amplifiers of the COVID-19 Pandemic Hiding in Plain Sight. Am J Public Health. 2020 May 14:e1-e3. PubMed: https://pubmed.gov/32407126. Full-text: https://doi.org/10.2105/AJPH.2020.305713

Refugios para personas sin hogar

• Tsai J, Wilson M. COVID-19: a potential public health problem for homeless populations. Lancet Public Health. 2020 Apr;5(4):e186-e187. PubMed: https://pubmed.gov/32171054. Full-text: https://doi.org/10.1016/S2468-2667(20)30053-0
• Wood LJ, Davies AP, Khan Z. COVID-19 precautions: easier said than done when patients are homeless. Med J Aust. 2020 May;212(8):384-384.e1. PubMed: https://pubmed.gov/32266965. Full-text: https://doi.org/10.5694/mja2.50571
• Barbieri A. CoViD-19 in Italy: homeless population needs protection. Recenti Prog Med. 2020 May;111(5):295-296. PubMed: https://pubmed.gov/32448878. Full-text: https://doi.org/10.1701/3366.33409