Immuno-Inclusivity in Opera

Part 2: Artist Experiences, Practices, and Barriers

2.5 Prevention principles

Part 2: Artist Experiences, Practices, and Barriers: contents
  1. 2.1 Early pandemic practices
  2. 2.2 Removal of protections
  3. 2.3 Artists’ experiences
  4. 2.4 The path forward
  5. 2.5 Prevention principles

In reviewing immuno-inclusivity practices, a recurring theme is that collective and systemic solutions are often more effective at addressing shared problems than individual actions. In workplace health & safety, this is illustrated by a framework called the Prevention Triangle.

Infographic of a light orange pyramid with three tiers, labelled the Prevention Triangle. The bottom widest layer is most effective, and the top smallest layer is least effective. The foundational level, Level 1, is labelled Prevent or Eliminate: Protect everyone, get rid of the hazard. Examples: scent-free, test/stay home, digital/remote, informed substitution. The middle layer, Level 2, is labelled Prevent at Source: Prevent the source of harm from reaching people. Examples: respirator masks as source control, air and surface cleaning. The upper smallest layer, Level 3, is labelled Limit Harm: Reduce harm, only protect individuals. Examples: hand washing, respirator masks as PPE. Text at the bottom notes, If the triangle is upside down, it falls over. Based in part on the work of Dorothy Wigmore.
Figure 9. The Prevention Triangle. Illustration by the Immuno-Inclusivity in Opera Collective, based in part on the work of Dorothy Wigmore.Footnote 125

This approach prioritizes preventing hazards rather than simply controlling them, and stopping hazards at the source where possible. It also highlights that no single solution works for everything.

The Prevention Triangle operates on three levels. At the foundation, Level 1 protects everyone by removing hazards or avoiding the introduction of new ones (e.g., testing for illnesses/staying home when sick, remote and digital work, scent-free environments, and substituting products). Level 2 applies when the hazard can’t be removed, but it can be prevented from reaching most people (e.g., through collective solutions and engineering controls such as ventilation and air filtration, cleaning and disinfecting surfaces, and policies to wear respirator masks as source control). At Level 3, the focus shifts to limiting harm to individuals (e.g., hand washing, wearing respirator masks as personal protection, and other individual behaviours).

When hazards may exist but are not fully understood, experts emphasize following the precautionary principle: a foundational framework of health and environmental decision-making that can be summed up as “better safe than sorry.”Footnote 126

Immuno-inclusivity requires a layered approach—multiple steps, options, and solutions to provide the most effective protection. One way of illustrating this is the “Swiss Cheese” metaphor.

The Swiss Cheese Airborne Illness Defence Graphic - recognizing that no single intervention is perfect at preventing spread. An illustration shows many layers of swiss cheese. Germs enter through the cheese holes on the left, and are caught by subsequent layers until no germs reach the human figure on the right. Mice, labelled the 'Misinformation Mouse', nibble more holes. Each cheese layer is labelled with a different responsibility. Personal responsibilities include: wear a fitted, N95-or-better respirator; get vaccinated and boosted; stay home if sick; practice hand hygiene; limit risky indoor time; increase distance, socialize outdoors. Leadership and collective responsibilities include: fast, sensitive testing (act on results); increase fresh air, filter air, measure CO2; require fitted, N95-or-better respirators; real-time data on cases, variants, hospitalizations, and deaths; funding to improve vaccines and education; science-informed leadership and education; empathic, factual, culturally responsible communication. Text at the bottom reads: Every intervention (slice/layer) has imperfections (holes). Holes vary in size, number, and position based on pathogen burden, implementation, and compliance. Multiple layers improve success. In this graphic, layer order is not relevant. lan Mackay & Katherine E. Arden, virologydownunder.com - based on the work of James T. Reason, 1990. Version 5.3, update: 17 Oct 2022. With minor modifications by the Immuno-Inclusivity in Opera Collective.
Figure 10. The Swiss Cheese Airborne Illness Defence Graphic. Ian Mackay & Katherine E. Arden, 2022. CC BY 4.0. With minor modifications by the Immuno-Inclusivity in Opera Collective.Footnote 127

By closing policy gaps, using the right tools, and building on proven models, the performing arts sector has the opportunity to move forward and improve accessibility, sustainability, and wellbeing for everyone.

Footnotes (3)
  1. “Prevention Principles,” Wigmorising, accessed July 15, 2026, https://www.wigmorising.ca/prevention-principles/; “Health and Safety Prevention and Controls,” Occupational Health Clinics for Ontario Workers Inc., accessed July 15, 2026, https://www.ohcow.on.ca/posts/health-safety-prevention-controls/. Back to text
  2. “Precautionary Principle: The Wingspread Statement,” Collaborative for Health & Environment, accessed July 4, 2026, https://www.healthandenvironment.org/resources/resource-library/eh-history/precautionary-principle-the-wingspread-statement; Canadian Aerosol Transmission Coalition, Proposals to Strengthen, 2–3. Back to text
  3. Ian M. Mackay, The Swiss Cheese Respiratory Virus Defence v.5.3 (Figshare, 2020, accessed July 15, 2026), https://doi.org/10.6084/m9.figshare.13082618.v26; “The Swiss Cheese Graphic That Went Viral,” Virology Down Under, accessed September 10, 2026, https://virologydownunder.com/the-swiss-cheese-infographic-that-went-viral/. Back to text
Part 2: Artist Experiences, Practices, and Barriers: contents
  1. 2.1 Early pandemic practices
  2. 2.2 Removal of protections
  3. 2.3 Artists’ experiences
  4. 2.4 The path forward
  5. 2.5 Prevention principles