Thread by @rvenkayya

THREAD

Swiss cheese is great for explaining how to slow a virus, as @MackayIM's fantastic graphic shows.

There's a history. Dr. Carter Mecher first applied Swiss cheese to pandemics in 2006 at the White House. I told the story @statnews in April. 1/

statnews.com/2020/04/24/swi…

Carter came across James Reason's work in human failures and complex systems when he worked on patient safety at the Dept of Veterans Affairs.

Swiss cheese was a good way to explain the power of early coordinated NPIs in a pandemic, which was called "community mitigation." 2/

Community mitigation came out of @DrRHatchett's work to understand the impact of combined NPIs. In 2006 Richard commissioned NIH-funded MIDAS modelers (3 groups) to model NPIs at different points in time. 3/

@PNASNews @betzhallo @neil_ferguson @ilongini

pnas.org/content/105/12…

Community mitigation was a major focus of the US Government's pandemic planning in 2006-7. The community mitigation strategy was published in 2007 along with the now-famous "flattening the curve" graphic. stacks.cdc.gov/view/cdc/11425 4/

@CDCgov

Community mitigation was just one part of a comprehensive pandemic influenza strategy and implementation plan issued in 2006 with over 300 actions for departments & agencies across the US Government. cdc.gov/flu/pandemic-r… 5/

It's great to see the Swiss cheese model come to life through @MackayIM's illustration. It's opening people's eyes and helping them understand the power of combined imperfect interventions to slow the spread of a pandemic, just as it did 14 years ago. 6/

nytimes.com/2020/12/05/hea…