Difference between revisions of "Team:NYU Abu Dhabi/Human Practices"

(Prototype team page)
 
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{{NYU_Abu_Dhabi}}
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<html>
 
<html>
  
<div class="column full_size judges-will-not-evaluate">
 
<h3>★  ALERT! </h3>
 
<p>This page is used by the judges to evaluate your team for the <a href="https://2018.igem.org/Judging/Medals">medal criterion</a> or <a href="https://2018.igem.org/Judging/Awards"> award listed below</a>. </p>
 
<p> Delete this box in order to be evaluated for this medal criterion and/or award. See more information at <a href="https://2018.igem.org/Judging/Pages_for_Awards"> Instructions for Pages for awards</a>.</p>
 
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 +
<!------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------->
 +
<!--- THIS IS WHERE THE HTML BEGINS --->
 +
<!------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------->
  
 +
<head>
  
<div class="column full_size">
+
<!-- This tells the browser that your page is responsive -->
 +
<meta name="viewport" content="width=device-width, initial-scale=1">
  
<h1>Human Practices</h1>
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</head>
<p>
+
At iGEM we believe societal considerations should be upfront and integrated throughout the design and execution of synthetic biology projects. “Human Practices” refers to iGEM teams’ efforts to actively consider how the world affects their work and the work affects the world. Through your Human Practices activities, your team should demonstrate how you have thought carefully and creatively about whether your project is responsible and good for the world. We invite you to explore issues relating (but not limited) to the ethics, safety, security, and sustainability of your project, and to show how this exploration feeds back into your project purpose, design and execution.
+
</p>
+
  
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 +
    display: table;
 +
    clear: both;
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 +
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 +
h6 {
 +
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 +
color: #0BB4C1;
 +
  font-size: 30px;
 +
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 +
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 +
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 +
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button:focus {outline:0;}
  
<p>For more information, please see the <a href="https://2018.igem.org/Human_Practices">Human Practices Hub</a>. There you will find:</p>
+
html, body {
+
  height: 100%;
<ul>
+
  margin: 0;
<li> an <a href="https://2018.igem.org/Human_Practices/Introduction">introduction</a> to Human Practices at iGEM </li>
+
}
<li>tips on <a href="https://2018.igem.org/Human_Practices/How_to_Succeed">how to succeed</a> including explanations of judging criteria and advice about how to conduct and document your Human Practices work</li>
+
.content {
<li>descriptions of <a href="https://2018.igem.org/Human_Practices/Examples">exemplary work</a> to inspire you</li>
+
  min-height: 100%;
<li>links to helpful <a href="https://2018.igem.org/Human_Practices/Resources">resources</a></li>
+
}
<li>And more! </li>
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</ul>
+
  padding: 20px;
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text-align: center;
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margin-top: 25px;
  
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}
  
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}
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</style>
  
 +
<div class="bg"></div>
  
<p>On this page, your team should document all of your Human Practices work and activities. You should write about the Human Practices topics you considered in your project, document any activities you conducted to explore these topics (such as engaging with experts and stakeholders), describe why you took a particular approach (including referencing any work you built upon), and explain if and how you integrated takeaways from your Human Practices work back into your project purpose, design and/or execution. </p>
+
<body>
+
<div class="content">
<p>If your team has gone above and beyond in work related to safety, then you should document this work on your Safety wiki page and provide a description and link on this page. If your team has developed education and public engagement efforts that go beyond a focus on your particular project, and for which would like to nominate your team for the Best Education and Public Engagement Special Prize, you should document this work on your Education and Education wiki page and provide a description and link here. </p>
+
    <div class="content-inside">
</div>
+
<h6><b>Expert Counsel</b></h6>
+
<!-- <hr style="width:25%"> -->
<div class="clear"></div>
+
  
+
<div id='adnan'>
<div class="column full_size">
+
  <img src="https://static.igem.org/mediawiki/2018/0/03/T--NYU_Abu_Dhabi--Expert_Counsel--adnan2.png" alt="Photo_with_Dr_Adnan" border="0" style="width:230px;height:230px; float: left; margin-top:25px;border-radius: 100%; border: 0%;margin-left:50px; margin-right:25px">
<div class="highlight decoration_background">
+
  <h2> <br> <font size="5.5"> Dr. Adnan Alatoom </font></h2>
<p>The iGEM judges will review this page to assess whether you have met the Silver and/or Gold medal requirements based on the Integrated Human Practices criteria listed below. If you nominate your team for the <a href="https://2018.igem.org/Judging/Awards">Best Integrated Human Practices Special Prize</a> by filling out the corresponding field in the <a href="https://2018.igem.org/Judging/Judging_Form">judging form</a>, the judges will also review this page to consider your team for that prize.  
+
  <h2> <i> <font size="3"> Staff Physician and Head of the Pathology & Laboratory Medicine Institute <br>
</p>
+
Cleveland Clinic Abu Dhabi </font></i> </h2>
 +
  <h4> &ldquo;Currently, the fastest clinical tools for pathogen detection take over 6 hours and cost 140$ per test.&rdquo; </h4>
 +
    <h2> Clinical laboratories are at the center of the health providers&rsquo; analysis of food pathogens. Currently, the fastest tools they possess are PCR-based and take over 6 hours with per-sample price of over 100$. Less financially supported hospitals and healthcare providers might have to depend on machines that take several days. The more rapid the result is, the faster the response the clinical laboratory can provide to physicians and others. Bacterial pathogens of note in the region of Abu Dhabi are Campylobacter and Shigella. Devices used in the laboratory are provided for free by the manufacturers and they are recharged for the biological buffer and reagents. </h2>
 
</div>
 
</div>
 +
<div id='carol'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/6/69/T--NYU_Abu_Dhabi--carol2.png" alt="carol" border="0" style="width:230px;height:230px; float: left; margin-top:60px;border-radius: 100%; border: 0%; margin-left:50px;margin-right:25px">
 +
  <h2> <br> <br> <br><font size="5.5"> Dr. Carol Brandt </font></h2>
 +
  <h2> <i> <font size="3"> Associate Vice Chancellor, Head of Global Education and Outreach, Vice Provost <br>
 +
NYU Abu Dhabi </font></i> </h2>
 +
  <h4> &ldquo;This device can create a global network of increasing food safety and contribute significantly to global health.&rdquo; </h4>
 +
    <h2> The device could be a first step in creating an integrated network across the world, providing low-income communities not only with much higher food safety, but coupled with educational programs, providing them also with the skills they need to take it even further. Reaching out to local members of the community can make the device a household name and increase trust, not just in the device, but also in the NGOs working on the field. To this end, collaboration with already developed on-the-ground NGOs is a great window into integrating the device into the communities. Therefore, with centers around the world working on feedback and education of the device, it can make an even bigger contribution to global health. </h2>
 +
</div>
 +
<div id='akpaka'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/9/9f/T--NYU_Abu_Dhabi--Patrick.png" alt="Patrick" border="0" style="width:230px;height:230px; float: left; margin-top:70px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br> <font size="5.5"> Dr. Patrick E. Akpaka </font></h2>
 +
  <h2> <i> <font size="3"> Professor of Medical Microbiology <br>
 +
University of the West Indies, St. Augustine </font> </i> </h2>
 +
  <h4> &ldquo;Conventional tests take 48 hours and cost 30-50$, being limited by series of tests needed after which the results are still not definitive.&ldquo; </h4>
 +
    <h2> Dr. Akpaka informed us about the impact Salmonella and pathogenic E. Coli have on the communities on Trinidad, encasing our project as one of global impact. Current highest-class toxin identifiers take 30 minutes with the devices being expensive and not usable in the field. The conventional tests are much cheaper but take several days, thereby restricting diagnosis by physicians and laboratories. It is finding a balance between cheap, fast, and reliable that has led our project through development. In Dr. Akpaka&rsquo;s own words: &ldquo;such a device would enable the doctor to give a more accurate diagnosis.&rdquo; In the end, point-of-care diagnostics are limited by their price and their sensitivity, both issues solved by our simple design and amplifying technique. </h2>
 +
</div>
 +
<div id='khalid'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/e/ee/T--NYU_Abu_Dhabi--khalid2.png" alt="khalid" border="0" style="width:230px;height:230px; float: left; margin-top:75px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br> <br> <br> <font size="5.5"> Dr. Khalid Malik </font> </h2>
 +
  <h2> <i> <font size="3"> Consultant Physician
 +
NYU Abu Dhabi Health and Wellness </font> </i> </h2>
 +
  <h4> &ldquo;Currently, we have to wait 48-72 hours for targeted laboratory results of the patient&rsquo;s blood and stool sample.&rdquo; </h4>
 +
    <h2> Dr. Khalid has stressed the important potential the device can contribute by making the diagnosis of food infections much faster, providing nearly immediate results compared to current solutions. This attribute provides the physician with more time and higher flexibility when trying to diagnose. The device can also make sure the patients themselves check their food as well as themselves for possible infections before having to consult a physician. Such opportunity becomes even more important, even life-saving, in communities with lower access to health professionals. </h2>
 
</div>
 
</div>
  
<div class="clear extra_space"></div>
+
<div id='food_agency'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/thumb/e/e2/T--NYU_Abu_Dhabi--food_safety2.png/1200px-T--NYU_Abu_Dhabi--food_safety2.png" alt="food_safety" border="0" style="width:230px;height:230px; float: left; margin-top:40px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br><font size="5.5"> Abu Dhabi Food Safety Agency </font> </h2>
  
 +
  <h4> &ldquo;With a much faster response than 3 days, the device makes rapid and urgent response possible for the food inspector.&rdquo; </h4>
 +
    <h2> As food products are being imported into the UAE, they are being kept at airports and ports of entry until they are screened for bacterial pathogens which can takes more than 3 days. With this device, products can enter the market faster, and with food, the chance of it going to waste is severely decreased. It also makes it possible for routine inspections in grocery stores and restaurants to end in immediate response by the food inspector so that when the results are positive, the business can be closed for the public&rsquo;s safety. The Agency has expressed full support of the project and suggests that accreditation of the device is possible for use in government regulation. </h2>
 +
</div>
  
 +
<div id='niyati'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/a/a8/T--NYU_Abu_Dhabi--parekh2.png" alt="Perekh_Niyati_center" border="0" style="width:230px;height:230px; float: left; margin-top:70px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br> <font size="5.5"> Dr. Niyati Parekh </font> </h2>
 +
  <h2> <i> <font size="3"> Director and Associate Professor of Public Health Nutrition
 +
<br>
 +
NYU College of Global Public Health
 +
</font> </i> </h2>
 +
  <h4> &ldquo;Lots of children&rsquo;s lives were lost yearly due to contacting water contaminated with food-related pathogens.&rdquo; </h4>
 +
    <h2> From her devotion in community outreach and involvement in projects related to global health back in India, Dr. Parekh stressed the paucity of potable, uncontaminated water in underdeveloped communities. Enormous number of young people, especially children under 5, suffer or die from dehydration due to consuming unclean water. To make an impact, Dr. Parekh highlighted the importance of instilling the mindset of valuing the safety of food and water through educational programs. She commented on how marketing strategies, such as the four Ps of marketing (product/place/price/promotion), can be utilized to aid cultivating the habit and promoting health and wellness in these communities.  </h2>
 +
</div>
  
<div class="column full_size">
+
<div id='diana'>
+
  <br> <br>
<h3>Silver Medal Criterion #3</h3>
+
  <img src="https://static.igem.org/mediawiki/2018/5/5c/T--NYU_Abu_Dhabi--diana2.png" alt="Silver_Diana_Center2" border="0" style="width:230px;height:230px; float: left; margin-top:70px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
<p>Convince the judges you have thought carefully and creatively about whether your work is responsible and good for the world. Document how you have investigated these issues and engaged with your relevant communities, why you chose this approach, and what you have learned. Please note that surveys will not fulfill this criteria unless you follow scientifically valid methods. </p>
+
  <h2> <br> <br> <br> <br> <font size="5.5"> Dr. Diana Silver </font> </h2>
 +
  <h2> <i> <font size="3"> Associate Professor of Public Health Policy and Management
 +
<br>
 +
NYU College of Global Public Health
 +
</font> </i> </h2>
 +
  <h4> &ldquo;This device could contribute to the health of immuno-compromised individuals in the US, and to communities in low-income countries&rdquo; </h4>
 +
    <h2> A challenge to implement this device in low-income countries would be the cost, drawing from a similar discussion on insect repellent bed nets (ITNs). The take-up could also be faced with other barriers in trying to make the device more affordable. For the US, the USDA (Department of Agriculture) can provide possible frameworks in ensuring food regulation through such a device.  </h2>
 +
</div>
  
 +
<div id='sanela'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/4/43/T--NYU_Abu_Dhabi--sanela2.png" alt="sanela" border="0" style="width:230px;height:230px; float: left; margin-top:70px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br> <br> <font size="5.5"> Dr. Sanela Teskeredzic </font> </h2>
 +
  <h2> <i> <font size="3"> Specialist and Head of Clinical Microbiology Laboratory
 +
<br>
 +
Hospital &ldquo;Travnik&rdquo;
 +
</font> </i> </h2>
 +
  <h4> &ldquo;The high cost of DNA amplification devices limits the majority of hospitals and laboratories in providing the fastest and most accurate result possible.&rdquo; </h4>
 +
    <h2> With the concept of the device as presented, it could significantly contribute to the work of most microbiological (clinical or sanitary) laboratories in the world. As we already use incubators, the eventual heating of the device for a faster result is not a problem. Using DNA rather than growing colonies not only increases the faithfulness of the result but decreases the time, effort, and danger of the traditional way of checking for these bacteria. </h2>
 +
</div>
 +
<div id='osmani'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/8/8c/T--NYU_Abu_Dhabi--osmani2.png" alt="Mr_sci_dr_Zudi_Osmani" border="0" style="width:230px;height:230px; float: left; margin-top:60px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br> <br>  <font size="5.5"> MSc Zudi Osmani </font> </h2>
 +
  <h2> <i> <font size="3"> Head of the Department for Hygiene and Health Ecology
 +
<br>
 +
Institute for Public Health, SBK
 +
</font> </i> </h2>
 +
  <h4> &ldquo;This device will allow inspectors to act immediately to contain food-related dangers, and not have to depend on several days old laboratory results. In that time, the food would have already been eaten.&rdquo; </h4>
 +
    <h2> Accreditation will be the cornerstone of the fidelity of using such a device. The low cost of having such an accurate and fast way of detecting these pathogens is revolutionary for many areas of food inspection. Presently, devices that rely on similar DNA amplification methods are too expensive, and bulky, to significantly contribute to the improvement of food safety and sanitation in large parts of the world. </h2>
 +
</div>
  
<h3>Gold Medal Criterion #1</h3>
+
<div id='who'>
<p>Expand on your silver medal activity by demonstrating how you have integrated the investigated issues into the purpose, design and/or execution of your project. Document how your project has changed based upon your human practices work.
+
  <br> <br>
</p>
+
  <img src="https://static.igem.org/mediawiki/2018/9/96/T--NYU_Abu_Dhabi--who.png" alt="who" border="0" style="width:230px;height:230px; float: left; margin-top:60px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br> <br> <font size="5.5"> World Health Organization, Office in Bosnia and Herzegovina </font> </h2>
 +
  <h4> &ldquo;Food safety is an important component of any public health policy or measures to prevent diseases. Any region of the world can be affected where no or weak measure of food safety is implemented.&rdquo; </h4>
 +
    <h2> The WHO stressed the recent outbreaks of Listeria in Hungary, and stressed the benefit our device would provide to Food Authorities and Public Health Institutions. The project directly touches upon the WHO principles as pointed out on their main web page. Prior to the use of the device for setting a standard in Food Health globally, authoritative licensing is required. </h2>
 
</div>
 
</div>
  
 +
<div id='public_health'>
 +
  <br> <br>
 +
  <img src="https://static.igem.org/mediawiki/2018/c/c7/T--NYU_Abu_Dhabi--zavod.jpeg" alt="zavod" border="0" style="width:230px;height:230px; float: left; margin-top:60px;border-radius: 100%; border: 0%; margin-left:50px; margin-right:25px">
 +
  <h2> <br> <br> <br> <br> <font size="5.5"> Institute for Public Health, Central Bosnia </font> </h2>
 +
  <h4> &ldquo;The faster the result, the faster we can act. In intervening circumstances, such as in educational institutions, being able to prevent harm is vital.&rdquo; </h4>
 +
    <h2> The device would make life much easier for the food inspection patrol. Immediate action can be taken, on-the-ground, without waiting for several days to receive the result. This kind of action is needed in certain intervening circumstances, such as in educational institutions, and in massive public gatherings, where the scale of impact of an infection is severe. </h2>
 +
</div>
 +
<br><br><br><br><br>
 +
</div>
  
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<h3>Sponsors:</h3>
 +
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Expert Counsel
Photo_with_Dr_Adnan


Dr. Adnan Alatoom

Staff Physician and Head of the Pathology & Laboratory Medicine Institute
Cleveland Clinic Abu Dhabi

“Currently, the fastest clinical tools for pathogen detection take over 6 hours and cost 140$ per test.”

Clinical laboratories are at the center of the health providers’ analysis of food pathogens. Currently, the fastest tools they possess are PCR-based and take over 6 hours with per-sample price of over 100$. Less financially supported hospitals and healthcare providers might have to depend on machines that take several days. The more rapid the result is, the faster the response the clinical laboratory can provide to physicians and others. Bacterial pathogens of note in the region of Abu Dhabi are Campylobacter and Shigella. Devices used in the laboratory are provided for free by the manufacturers and they are recharged for the biological buffer and reagents.



carol




Dr. Carol Brandt

Associate Vice Chancellor, Head of Global Education and Outreach, Vice Provost
NYU Abu Dhabi

“This device can create a global network of increasing food safety and contribute significantly to global health.”

The device could be a first step in creating an integrated network across the world, providing low-income communities not only with much higher food safety, but coupled with educational programs, providing them also with the skills they need to take it even further. Reaching out to local members of the community can make the device a household name and increase trust, not just in the device, but also in the NGOs working on the field. To this end, collaboration with already developed on-the-ground NGOs is a great window into integrating the device into the communities. Therefore, with centers around the world working on feedback and education of the device, it can make an even bigger contribution to global health.



Patrick




Dr. Patrick E. Akpaka

Professor of Medical Microbiology
University of the West Indies, St. Augustine

“Conventional tests take 48 hours and cost 30-50$, being limited by series of tests needed after which the results are still not definitive.“

Dr. Akpaka informed us about the impact Salmonella and pathogenic E. Coli have on the communities on Trinidad, encasing our project as one of global impact. Current highest-class toxin identifiers take 30 minutes with the devices being expensive and not usable in the field. The conventional tests are much cheaper but take several days, thereby restricting diagnosis by physicians and laboratories. It is finding a balance between cheap, fast, and reliable that has led our project through development. In Dr. Akpaka’s own words: “such a device would enable the doctor to give a more accurate diagnosis.” In the end, point-of-care diagnostics are limited by their price and their sensitivity, both issues solved by our simple design and amplifying technique.



khalid






Dr. Khalid Malik

Consultant Physician NYU Abu Dhabi Health and Wellness

“Currently, we have to wait 48-72 hours for targeted laboratory results of the patient’s blood and stool sample.”

Dr. Khalid has stressed the important potential the device can contribute by making the diagnosis of food infections much faster, providing nearly immediate results compared to current solutions. This attribute provides the physician with more time and higher flexibility when trying to diagnose. The device can also make sure the patients themselves check their food as well as themselves for possible infections before having to consult a physician. Such opportunity becomes even more important, even life-saving, in communities with lower access to health professionals.



food_safety




Abu Dhabi Food Safety Agency

“With a much faster response than 3 days, the device makes rapid and urgent response possible for the food inspector.”

As food products are being imported into the UAE, they are being kept at airports and ports of entry until they are screened for bacterial pathogens which can takes more than 3 days. With this device, products can enter the market faster, and with food, the chance of it going to waste is severely decreased. It also makes it possible for routine inspections in grocery stores and restaurants to end in immediate response by the food inspector so that when the results are positive, the business can be closed for the public’s safety. The Agency has expressed full support of the project and suggests that accreditation of the device is possible for use in government regulation.



Perekh_Niyati_center




Dr. Niyati Parekh

Director and Associate Professor of Public Health Nutrition
NYU College of Global Public Health

“Lots of children’s lives were lost yearly due to contacting water contaminated with food-related pathogens.”

From her devotion in community outreach and involvement in projects related to global health back in India, Dr. Parekh stressed the paucity of potable, uncontaminated water in underdeveloped communities. Enormous number of young people, especially children under 5, suffer or die from dehydration due to consuming unclean water. To make an impact, Dr. Parekh highlighted the importance of instilling the mindset of valuing the safety of food and water through educational programs. She commented on how marketing strategies, such as the four Ps of marketing (product/place/price/promotion), can be utilized to aid cultivating the habit and promoting health and wellness in these communities.



Silver_Diana_Center2





Dr. Diana Silver

Associate Professor of Public Health Policy and Management
NYU College of Global Public Health

“This device could contribute to the health of immuno-compromised individuals in the US, and to communities in low-income countries”

A challenge to implement this device in low-income countries would be the cost, drawing from a similar discussion on insect repellent bed nets (ITNs). The take-up could also be faced with other barriers in trying to make the device more affordable. For the US, the USDA (Department of Agriculture) can provide possible frameworks in ensuring food regulation through such a device.



sanela





Dr. Sanela Teskeredzic

Specialist and Head of Clinical Microbiology Laboratory
Hospital “Travnik”

“The high cost of DNA amplification devices limits the majority of hospitals and laboratories in providing the fastest and most accurate result possible.”

With the concept of the device as presented, it could significantly contribute to the work of most microbiological (clinical or sanitary) laboratories in the world. As we already use incubators, the eventual heating of the device for a faster result is not a problem. Using DNA rather than growing colonies not only increases the faithfulness of the result but decreases the time, effort, and danger of the traditional way of checking for these bacteria.



Mr_sci_dr_Zudi_Osmani





MSc Zudi Osmani

Head of the Department for Hygiene and Health Ecology
Institute for Public Health, SBK

“This device will allow inspectors to act immediately to contain food-related dangers, and not have to depend on several days old laboratory results. In that time, the food would have already been eaten.”

Accreditation will be the cornerstone of the fidelity of using such a device. The low cost of having such an accurate and fast way of detecting these pathogens is revolutionary for many areas of food inspection. Presently, devices that rely on similar DNA amplification methods are too expensive, and bulky, to significantly contribute to the improvement of food safety and sanitation in large parts of the world.



who





World Health Organization, Office in Bosnia and Herzegovina

“Food safety is an important component of any public health policy or measures to prevent diseases. Any region of the world can be affected where no or weak measure of food safety is implemented.”

The WHO stressed the recent outbreaks of Listeria in Hungary, and stressed the benefit our device would provide to Food Authorities and Public Health Institutions. The project directly touches upon the WHO principles as pointed out on their main web page. Prior to the use of the device for setting a standard in Food Health globally, authoritative licensing is required.



zavod





Institute for Public Health, Central Bosnia

“The faster the result, the faster we can act. In intervening circumstances, such as in educational institutions, being able to prevent harm is vital.”

The device would make life much easier for the food inspection patrol. Immediate action can be taken, on-the-ground, without waiting for several days to receive the result. This kind of action is needed in certain intervening circumstances, such as in educational institutions, and in massive public gatherings, where the scale of impact of an infection is severe.






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