Department of Health Policy and Management, University of Maryland School of Public Health, College Park, MD, United States.
Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, United States.
Front Public Health. 2021 Nov 5;9:747894. doi: 10.3389/fpubh.2021.747894. eCollection 2021.
Eighteen months into the COVID-19 pandemic, and as the world struggles with global vaccine equity, emerging variants, and the reality that eradication is years away at soonest, we add to notion of "layered defenses" proposing a conceptual model for better understanding the differential applicability and effectiveness of precautions against SARS-CoV-2 transmission. The prevailing adaptation of Reason's Swiss cheese model conceives of all defensive layers as equally protective, when in reality some are more effective than others. Adapting the hierarchy of controls framework from occupational safety provides a better framework for understanding the relative benefit of different hazard control strategies to minimize the spread of SARS-CoV-2.
在 COVID-19 大流行的 18 个月后，随着全球努力实现疫苗公平、出现新变种以及最早也要在数年内才能实现根除的现实，我们提出了一个概念模型，以更好地理解针对 SARS-CoV-2 传播的预防措施的不同适用性和效果，从而增加了“分层防御”的概念。目前对 Reason 瑞士奶酪模型的改编设想所有防御层都具有同等的保护作用，但实际上有些比其他的更有效。从职业安全中采用控制层次结构框架为理解不同危险控制策略的相对益处提供了一个更好的框架，以最大程度地减少 SARS-CoV-2 的传播。
