From the Centers for Disease Control and Prevention:
Interim
Operational Considerations for Implementing the Shielding Approach to
Prevent COVID-19 Infections in Humanitarian Settings
Updated July 26, 2020
This document presents considerations from the perspective of the U.S. Centers for Disease Control & Prevention (CDC) for implementing the shielding approach in humanitarian settings as outlined in guidance documents focused on camps, displaced populations and low-resource settings.1,2 This approach has never been documented and has raised questions and concerns among humanitarian partners who support response activities in these settings. The purpose of this document is to highlight potential implementation challenges of the shielding approach from CDC’s perspective and guide thinking around implementation in the absence of empirical data. Considerations are based on current evidence known about the transmission and severity of coronavirus disease 2019 (COVID-19) and may need to be revised as more information becomes available. Please check the CDC website periodically for updates.What is the Shielding Approach1?
The shielding approach aims to reduce the number of severe COVID-19
cases by limiting contact between individuals at higher risk of
developing severe disease (“high-risk”) and the general population
(“low-risk”). High-risk individuals would be temporarily relocated to
safe or “green zones” established at the household, neighborhood,
camp/sector or community level depending on the context and setting.1,2 They would have minimal contact with family members and other low-risk residents.
Current evidence indicates that older adults and people of any age
who have serious underlying medical conditions are at higher risk for
severe illness from COVID-19.3 In most humanitarian settings, older population groups make up a small percentage of the total population.4,5 For
this reason, the shielding approach suggests physically separating
high-risk individuals from the general population to prioritize the use
of the limited available resources and avoid implementing long-term
containment measures among the general population.
In theory, shielding may serve its objective to protect high-risk
populations from disease and death. However, implementation of the
approach necessitates strict adherence1,6,7,
to protocol. Inadvertent introduction of the virus into a green zone
may result in rapid transmission among the most vulnerable populations
the approach is trying to protect.
A summary of the shielding approach described by Favas is shown in Table 1. See Guidance
for the prevention of COVID-19 infections among high-risk individuals
in low-resource, displaced and camp and camp-like settings 1,2 for full details.
Table 1: Summary of the Shielding Approach1
Household (HH) Level:
A specific room/area designated for high-risk individuals who are physically isolated from other HH members.
Low-risk HH members should not enter the green zone. If entry is necessary, it should be done only by healthy individuals after washing hands and using face coverings. Interactions should be at a safe distance (approx. 2 meters). Minimum movement of high-risk individuals outside the green zone. Low-risk HH members continue to follow social distancing and hygiene practices outside the house.
Neighborhood Level:
A designated shelter/group of shelters (max 5-10 households), within a small camp or area where high-risk members are grouped together. Neighbors “swap” households to accommodate high-risk individuals.
Same as above
Camp/Sector Level:
A group of shelters such as schools, community buildings within a camp/sector (max 50 high-risk individuals per single green zone) where high-risk individuals are physically isolated together.
One entry point is used for exchange of food, supplies, etc. A meeting area is used for residents and visitors to interact while practicing physical distancing (2 meters). No movement into or outside the green zone.
Operational Considerations....
I hope this alleviates any fears or anxieties.
