How should humans respond to an infectious pandemic if vaccines and drugs ultimately fail?

!--webeditor: page title" -- May 5, 2020 / -- In many countries around the world, the epidemic curve of COVID-19 has leveled off, but not with new antiviral drugs or vaccines.
non-drug interventions, such as isolation, social isolation, hand washing, and masks and other protective equipment used by health care workers, are saving us.
hope that a vaccine will be developed by 2021.
but what should we do in the meantime? What's more, what if there's no vaccine? The world is spending most of its research money on finding vaccines and effective drugs.
such efforts are essential, but simultaneous research on how to target and improve non-drug interventions is the only effective approach to date.
debate over basic issues, such as whether the public should wear masks, whether we should be 1m, 2m or 4m apart, and whether we should wash our hands with soap or hand lotion.
we need answers now.
image source: What about non-drug intervention studies? In all health studies, about 40% of clinical trials focus on non-drug interventions.
, however, receive much less attention than drug development and testing.
millions of dollars were made available to research groups around the world during the COVID-19 pandemic to develop vaccines and test possible drug treatments.
hundreds of drug and vaccine clinical trials are under way, but we can only find a small number of non-drug intervention trials, and there are no trials on how to improve drug dependence.
when we hold our breath and wait for the vaccine... We all hope that the global effort to develop a vaccine or drug treatment for COVID-19 will be successful.
but many experts, including Ian Frazer, who developed Australia's HPV vaccine, say it won't be easy or quick.
if there is no effective vaccine or drug, we will need a plan B that uses only non-drug interventions.
that's why we need high-quality research to find out what works and how to do it as effectively as possible.
non-drug intervention not direct? You might think that washing your hands, wearing a mask, and socializing are all simple things that don't need to be studied.
fact, non-drug interventions are often very complex.
research needs to understand not only the "positive elements" of intervention (e.g., hand washing), but also how much is needed, how to help people start and continue to wash their hands, and how to communicate this information to people.
and implementation of effective non-drug interventions is very different from the development of vaccines or drugs, but it can be just as complex.
example, there is an event called "Masks4All" that encourages everyone to wear a mask.
but what kind of mask is useful, what material should be used to do it? Who should wear a mask -- a sick person, a sick person, or everyone else? When and where? There is little consensus on these details.
it sounds easy to wash your hands.
but for how long? Twice a day, 10 times, or at a specific trigger time? What is the best way to teach people to wash their hands properly? If people don't have perfect hand washing techniques, will hand lotions be better than soap and water? Is wearing a mask and doing hand hygiene more effective than both? These are just things we don't know about non-drug intervention.
The current research is insufficient And we recently reviewed all randomized controlled trials that were designed to make physical interventions to stop the spread of respiratory viruses, including combinations such as masks, hand hygiene, eye protection, social alienation, isolation, and any of these interventions."
we found a messy and variable set of trials, many of which were low-quality or small sample sizes, with no randomized trials for certain types of interventions.
non-drug options studied include built environments such as heating, ventilation, air conditioning cycles and surfaces (for example, SARS-CoV-2 viruses "die" on copper surfaces much faster than other hard surfaces).
are some of the things we're doing ineffective? possible.
problem is that we don't know what works.
we urgently need to know this so that we don't waste time, energy and resources on useless things.
when we need to achieve rapid behavior change on a large scale, inconsistent and conflicting information can only create confusion and make it more difficult to achieve behavior change.
picture source: What about the next pandemic? If a successful COVID-19 vaccine is developed, we are now out of danger.
, but what happens when the next pandemic or pandemic comes? Vaccines are virus-specific, so the next time a new virus threatens us, we'll be in the same situation again.
, however, what we know now about non-drug interventions can be used to protect us from other viruses, and we need to wait again for another new vaccine or drug.
we have recently had the opportunity to study non-drug interventions for respiratory viruses, particularly during the Severe Acute Respiratory Syndrome (SARS) pandemic in 2003 and the H1N1 influenza pandemic in 2009.
, the opportunity for rigorous research has been largely wasted, and we now find ourselves desperately searching for answers.
's a study of Plan B? In preparation for the future and Plan B, if the vaccine has not yet appeared, we need randomized trials of non-drug interventions to prevent the spread of respiratory viruses.
current pandemic provides us with a unique opportunity to conduct trials quickly to answer many unknown questions about this range of non-drug interventions.
to focus all our money, efforts and resources on vaccine and drug research could be a devastating and costly mistake in health care and the economy.
will be felt not only in this pandemic, but also in future pandemics.
() References: 1. Plan B for coronavirus: Research on vaccine and drug options is urgently needed !--/ewebeditor: page--!--ewebeditor:page?""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""350 doi: https://doi.org/10.1136/bmj.h1323 (Published 27 March 2015) 3 Physical interventions to interrupt or reduce the spread of. The viruses. Part 1 - Face masks, eye protection and person distancing: system review and meta-analysis!--/ewebeditor:page--