Coronavirus: the differences between horizontal and vertical isolation

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Isolation measures during the pandemic of the new coronavirus have divided the opinion of scientists
Isolation measures during the pandemic of the new coronavirus have divided the opinion of scientists. Credit: Pixabay

Since the new coronavirus hit the world, showing its high spreading power – one person can infect up to three others, according to experts – health organizations, doctors and government officials have been debating isolation practices to stem the pandemic’s progress.

THE World Health Organization (WHO) and a large part of the medical profession defends the practice of horizontal isolation, which aims to reduce the circulation of people to the maximum.

Some groups of scientists, however, have advocated the method of vertical isolation, in which only people who are part of the group at risk of the disease should be isolated. This measure won two supporters last week, President Jair Bolsonaro and Donald Trump, in the United States.

But what are the differences between these two types of isolation and the impact on society during a pandemic?

HORIZONTAL INSULATION

According to the president of the Brazilian Society of Infectologists in Espírito Santo, Alexandre Rodrigues, horizontal isolation restricts the circulation of the largest number of people, closing shops and schools, for example. The goal is to keep the population indoors to reduce contact and transmission of the virus.
Date: 03/20/2020 - ES - Cariacica - Commerce on Avenida Expedito Garcia in Campo Grande - Editoria: Cidades - Foto: Vitor Jubini - GZ
Commerce on Avenida Expedito Garcia, in Campo Grande, was closed after state decree. Credit: Vitor Jubini
The measure, however, is criticized for its economic impact, since with the isolation of people, they cannot go out to work and most activities are paralyzed.

Alexandre Rodrigues

President of the Brazilian Society of Infectious Diseases in Espírito Santo

“In terms of economics, horizontal isolation has a greater impact. But from the point of view of public health, it is what has brought the most results to countries in containing coronavirus cases, since most of them are not able to quickly diagnose and isolate people who have the virus “

VERTICAL INSULATION

Vertical isolation, which was initially adopted in the United Kingdom, advocates separating only people who are more at risk of progressing to serious cases or deaths. This is the case of the elderly or people with pre-existing diseases. In addition to those who have already been infected by the virus.

Alexandre Rodrigues

President of the Brazilian Society of Infectious Diseases in Espírito Santo

“It is an isolated isolation, which removes from circulation only those most exposed to the effects of the disease or who have already contracted it”

This method of isolation, according to Rodrigues, has less economic impact, as it keeps activities running. However, it can have a disastrous effect on hospitals. In the United Kingdom, when the government saw an increase in the number of infected people and a possible collapse of the health system, the government opted to close schools and suspend other activities.
Workers wearing protective clothing spray disinfectant as a precaution against coronavirus in a bus garage in Seoul, South Korea
In South Korea, rapid diagnostic measures and monitoring of infected people have been adopted to contain the spread of the virus. Credit: AHN YOUNG-JOON / AP
Despite being practiced in specific situations and countries, such as South Korea, Rodrigues defends vertical isolation only where it is possible to have agility in the diagnosis of the disease to isolate and monitor infected patients. According to him, these factors are essential to control the spread of the virus.

“South Korea is one of the great examples of successful vertical isolation. There, they were able to test very quickly and efficiently who was positive for the virus. As a result, they isolated those specific nuclei and monitored them. As these people were monitored and isolated, the spread of the virus was controlled ”, he recalls.

BRAZILIAN CONTEXT

The measure adopted in South Korea, however, would not be successful in Brazil, according to Rodrigues. For him, in countries like ours, where a rapid diagnosis is not obtained and there is a great population diversity, adopting horizontal isolation is the most effective way to interrupt the virus transmission chain.

Alexandre Rodrigues

President of the Brazilian Society of Infectious Diseases in Espírito Santo

“We have a very different social reality in Brazil, in addition to a population issue as well. We have communities where access to basic hygiene and health is difficult and it would be impossible to monitor the people who live in these places in the same way as in others. We have elderly people living with family members who are not at risk in houses where it is impossible to isolate them. To reduce the transmission of the virus, it is necessary to get everyone out of circulation.

According to the infectologist, not all pandemics lead to total isolation from the population. Measures are taken according to the speed at which the disease spreads and the risk to the population.

At a time of pandemic such as that of the coronavirus, when there is insufficient information on the effects of the disease, he points out that care must be taken when making isolation measures more flexible.

“The virus has already advanced around the world and in Brazil. Practicing vertical isolation can now bring a collapse to the healthcare system. We could see an increase in the number of people infected. With more sick people, more people transmitting the virus to people at risk, and consequently more deaths. In addition to the increase in people who, even if they did not die, could have a severe disease ”, he concluded.





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