COVID-19: Readiness criteria and indicators for easing restrictive public health measures

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About restrictive public health measures

Restrictive public health measures aim to control the spread of COVID-19 by reducing the number of exposures to the virus. These measures include:

Deciding to instate, maintain, ease or re-instate restrictive measures

These indicators were developed with a data driven approach to support public health professionals and government decision makers in considering when to ease or re-instate public health measures, taken into consideration that thresholds and application of these indicators may vary based on local epidemiology and level of restrictive measures already in place.

Further, adjustments to restrictive public health measures must be considered in the context of risk associated with variants of concern, and the effect of increasing vaccine coverage.

In general, decisions regarding not easing, easing, and instating or re-instating of public health measures should take into account the following factors considered collectively within each category.

No easing

No easing if restrictive public health measures are already in place when:

  • transmission is uncontrolled
  • variants of concern are becoming increasingly prevalent
  • there is insufficient health care capacity to respond to surges
  • there is limited public health capacity to test, trace and monitor those in isolation

Consider easing

Consider easing if restrictive public health measures are already in place when:

  • transmission is controlled
  • there is sufficient testing and contact tracing capacity
  • there is low incidence allowing for testing and tracing to cope with:
    • outbreaks
    • surges in cases
  • there is high vaccine coverage in populations that are at higher risk and in higher-risk settings
  • there is a phased plan in place that starts slowly with:
    • easing up on restrictions in the least risky venues
    • at least 3 weeks between phases to allow detection of resurgence

Instate or re-instate

Instate or re-instate if restrictive public health measures are not already in place when:

  • modelling-based forecasts suggest:
    • resurgence
    • case incidence overall is increasing (and Rt rising)
    • adherence to public health measures is declining
  • evidence exists of community spread of variants of concern with potential negative impacts on:
    • transmissibility
    • ability of diagnostics tests to detect cases
    • the effectiveness of therapeutics or vaccines

Indicators for easing public health measures

1. COVID-19 transmission is controlled to a manageable level

2. There is sufficient public health capacity to test, trace, isolate and quarantine a high proportion of cases and contacts

3. Sufficient health care capacity exists (including substantial clinical care capacity) to respond to surges

4. Risk reduction measures are in place for high-risk populations and settings

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