There is currently an explosion of sustained person-to-person community spread of COVID-19 in several countries, including South Korea, Italy, Iran, Japan, Taiwan, Thailand, and Singapore.

The strategy of containing the disease at the borders may no longer be enough. The strategy would shift from a containment strategy to that of mitigation.

Community mitigation guidelines

1. Non-pharmaceutical interventions include personal practices, covering coughs and washing hands, community and environmental measures like surface cleaning.
2. Community measures include distancing, or limiting contact in face-to-face settings, closing schools, telework or teleschool for children, and modifying, postponing, or canceling mass gatherings.
3. In healthcare settings, triaging patients, conducting patient visits via telemedicine, and delaying elective surgeries.
4. The CDC urged healthcare, education, and business sectors, to start preparing because when the virus hits the community, it hits quite rapidly.
5. Commercial labs need to pitch in for testing.
6. The case definition of COVID-19 is still travel-associated. It may change based on information in other countries.
7. We are not sure if community spread of COVID-19 will be mild or severe, but it is better to be overprepared than underprepared.
8. The testing criteria may change to testing only symptomatic cases and admitting cases only with breathlessness.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA