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Prevention is multi-layered, and we need all its layers to be effective


Case rates in Devon, and nationally, are rising, with England having one of the highest rates of coronavirus in Western Europe. 

Steve Brown, Devon’s Director of Public Health, argues that we need step up the prevention measures to avoid any re-introduction of restrictions as we head towards winter.

He said:

“The vaccination programme is going well, with booster jabs progressing among our older and eligible population and vaccinations now available for 12-15 year olds via schools and vaccination centres.

“But with rising case numbers in Devon, and nationally, we need to double-down on our efforts now to stop cases increasing.

“The vaccination, while extremely effective, can not be used in isolation as a measure to combat coronavirus.

“Rising case rates now, as we head towards winter, indicate a changing level of risk.  The more cases there are in the community, the more risk there is to us personally of catching and spreading it to our families and friends.

“Even though it’s not mandatory to do so, we all need to think about wearing face coverings in crowded and indoor places when mixing with others and as required when on public transport.  Remember, others benefit from you wearing your face covering, so it needs all of us to do the right thing by each other and remember the importance of face coverings.

“When mixing with others try to socialise outdoors, perhaps to enjoy an autumnal walk.  If indoors, remember the importance of ventilation. Keeping a little distance from each other is still an effective way to reduce risk to ourselves and others.

“Wash your hands regularly when out and about   Many shops still have hand sanitiser at the door – use them on entry and exit.

“Use lateral flow device tests to regularly test yourself twice a week if not showing symptoms, and self-isolate and take a PCR test the moment you develop COVID symptoms.

“Effective prevention is multi-layered.  The individual components on their own are not as effective as using all of the prevention measures at the same time.

“To prevent cases rising further, we need to take up all these measures again, alongside the vaccination roll out.”

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Steve Brown, Director of Public Health Devon

Vaccines alone will not stop COVID spreading – the Swiss cheese model

The BBC has previously published an animated infographic explaining the ‘Swiss Cheese’ model of COVID-19 measures, and why we need to keep layering multiple measures. It describes a principle whereby multiple prevention measures – face coverings, testing, washing hands, social distancing, as well as vaccination – are all required for prevention to be most effective.

You can see it here

The Swiss Cheese model was first created by Ian M Mackay, a virologist at the University of Queensland, Australia. His infographic has been translated into more than two dozen languages. It’s based on a concept originated by James T Reason, a cognitive psychologist, now a professor emeritus at the University of Manchester, UK. It is used in scientific circles when discussing mitigating risk.


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