Guidance on Community Social Distancing During COVID-19 Outbreak (2)

by Africa Centre for Disease Control and Prevention (Africa CDC)

Recommendations

Member States, at all levels of government, should implement prominent public messaging about individual social distancing, specifically by:

1. Member States, at all levels of government, should begin risk communication now with key opinion and faith leaders and the general public about the future possibility of community social distancing. Messaging must be clear, consistent, and culturally respectful. Information must be provided about why such measures are important and must be provided far in advance of their application to give people time to prepare psychologically and practically.
2. Acceptance of these measures can be improved by emphasizing personal/social responsibility and that social distancing is a means of protecting oneself.
3. Public acceptance of social distancing measures will be facilitated by advertising them with an anticipated end-date,  but it should also be made clear that this could be extended if there is another wave of transmission.
4. As much as possible, community social distancing should be implemented with community consent and by encouraging social responsibility through trusted authorities and channels. As a last resort, governments should review their laws at national and sub-national levels to ensure that they have the authority to implement community social distancing.
5. Governments and public health agencies should identify trusted channels and actors to explain community social distancing measures and to listen to concerns and obstacles to community social distancing.
6. Risk communication should consider different audiences (e.g. by including minority languages).

Implementing Social Distancing

1. Community social distancing should be implemented immediately after populations have been sensitized and with considerations for the social and political situation, as well as epidemic phase.
2. The signal to implement community social distancing is indicated when any cases or deaths are detected outside of known chains of transmission.
3.  Member States, at all levels of government, should monitor compliance in healthcare facilities and congregate settings, such as prisons and nursing facilities, with individual social distancing and infection prevention and control standards.
4. After it has been instituted, community social distancing should be maintained for a sustained period and reviewed carefully before it is withdrawn.
5. Community social distancing should only be used in the most limited geographic unit necessary to achieve the desired impact.
6. Member States should ensure that any legal enforcement of community social distancing, isolation, and quarantine is conducted with full respect for human rights and dignity.
7. Several layers of social distancing should be instituted simultaneously, rather than one by one.
8. Community social distancing should also include:
   • Working with faith leaders to adapt religious services to support social distancing, e.g. worshiping outdoors, maintaining a minimum distance of one metre between worshippers and avoiding the sharing of utensils or consumables.
   • In routine gathering places, such as bus stations and markets, people maintaining individual social distancing precautions, e.g. one metre distance from other people, non-contact greetings.
   • Employers working with their staf to increase physical distance between employees, including changing shift patterns and staggering work schedules, allowing work-from-home, moving work activities outdoors, and limiting work-related gatherings.
   • Employers providing paid sick leave, support for parents to provide childcare, and incentivizing workers to stay at home if they have any respiratory symptoms.
   • Prominent public messaging encouraging people aged 60 or older and people with chronic lung or heart disease to strictly limit their time in public and restrict travels.
   • Prominent public messaging instructing people with fever, cough, shortness of breath, or other respiratory symptoms to:
     • Immediately isolate themselves in their home and contact relevant public health agencies.
     • Only seek medical care if they have severe symptoms, such as dificult breathing.
     • Follow effective infection prevention in the household and receive support from government and/or community to do so.

Supporting Organizations and Individuals to Practice Social Distancing

1. All levels of government and non-government entities should ensure widespread availability of hand hygiene materials at the entrance of every building and in every bathroom facility, such as soap and water and alcohol-based hand rub.
2. Public transportation  should be kept open to facilitate access to food, medical services and other social support.
3. Physical force should not be used to restrict movement of people outside their homes or outside the geographic unit that is implementing community social distancing.
4. Government agencies should consider all possible mechanisms to provide food, financial support, medicines, religious support, and social support to all individuals adversely impacted by community social distancing, with attention to vulnerable groups.
5. Authorities should proactively address the potential stigma associated with quarantine by promoting a sense of solidarity in the population: “everyone is at risk”, and “we are all in this together”.