COVID-19 FAQ #25: How can the “Swiss cheese” model help myeloma patients stay safe?

In this episode, Dr. Brian G.M. Durie shares how the "Swiss Cheese" model, a model used in healthcare to analyze risk, can help illustrate how myeloma patients can stay safe during the pandemic.


Talk to your doctor about how you can best remain safe. A multilayered approach including mask wearing, physical distancing, and handwashing, helps reduce your risk of infection. 

If you have a question that you’d like to suggest for a future episode of Ask Dr. Durie, please submit it to [email protected]. 

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Videos in the COVID-19 Series


This week’s “Ask Dr. Durie” comes from an inquisitive patient who has read about a model called the “Swiss cheese” model for combating COVID-19 infections.   

And so, this is actually an interesting model, which was developed many years ago in the UK, actually related to protections against nuclear exposure, and the idea is that if you have different layers of protection, none are perfect. And so, this can be envisaged as slices of Swiss cheese. And so, for those of you, hopefully, are familiar with swiss cheese. It is notorious for having all of those different size holes in the cheese. And so, if you cut slices, you’re going to have some big holes, some little holes. But, if you stack these slices of Swiss cheese up, like dominos and then try to shoot particles through the different slices of cheese, the particles are not going to be able to get beyond the first slice through the third, and fourth, and fifth slice, because the holes are not lined up. Some of the holes are big, but they might line up with very few, or no holes in the next slice. 

And so, this is a very good model or imagery for thinking about; how do we combat COVID-19? How do we protect ourselves? And all the things that we do are not perfect. They do have some holes in them.   

So, masks, they work well they probably reduce transmission by over fifty percent, most likely in careful use. Then, there can be distancing, which is protective. Handwashing and other sanitizing things are very, very good. And, avoiding crowds, particularly indoors, very good, but that’s still not a perfect thing if you just do that. Then, of course, we're moving forward towards what look to be quite effective vaccines and increasing, we have some therapies that can work against this COVID-19 virus. 

And so, we do have all of these different slices, all of these different layers. Each of which come together to give us really, really, good protection. And I think that we just need to become more careful and committed to using these multiple strategies to really get us through these winter months, this time of crisis, and move forward into the coming months.   

I think that despite the availability of excellent vaccine approaches, we are going to be faced with continuing to wear masks and relying on the vaccine through until the summer of next year, most likely. But, with these approaches, we can be doing a better job. We can be doing a good job.   

So, the BOTTOM LINE is: Please talk to your doctor about the different things that you can do to stay safe. And, working together, we will get through this together in as safe a way as possible. 



Image of Dr. Brian G.M. DurieDr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.


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