LESSONS TO BE LEARNT FROM COVID-19

-Dr Poonam Nayak

 

COVID-19 needs no introduction. From December 2019, when it was merely a pneumonia of unknown cause in the Wuhan of China, it is now a disease that has reached epic proportions with nearly 951,754 cases globally (as of 2nd April 2020).

With the rapid spread of the novel coronavirus to nearly all the countries of the world, we are grappling with a disease at pandemic proportions. This leads us to ask a pertinent question, what lessons can be learnt this time around? Were the steps taken by China too harsh or a success story? What did South Korea get wrong? Is India prepared to handle COVID-19?

In February 2020, a report was published by WHO, a joint mission report with experts from 25 countries and headed by Dr. Bruce Aylward of WHO and Dr. Wannian Liang of the Peoples Republic of China [2]. It published records of the outbreak in Wuhan and measures that could be taken to prevent the spread. What was interesting was that the measures taken by China were not only found to be effective but also was found to have helped the world gain more time to combat the new disease.

 

Although in the process of containing the spread there was a major invasion of privacy which raised more than a few eyebrows, the basic strategy implemented by the Chinese government was precise. The main objective when dealing with a virus, especially anairborne virus is speed. Contact tracing and self-quarantine have to be implemented in order to prevent the rapid spread. Prevention of gatherings of large groups is a necessary step in the intervention.

Another very important measure is the surveillance of the disease. While having a specialized team for surveillance is important, it is extremely beneficial if the general population itself can serve as a surveillance team. For example, while there is major panic and anxiety surrounding the Covid-19 virus, not many people know that the main symptoms of the disease are fever and dry cough, or that it is first a URTI. It is of utmost importance that every general practitioner has a succinct idea of the emergency response to be carried out in the event of a positive case identification and the levels of hierarchy in the management of the disease. China set up various fever clinics” to diagnose more cases at a grassroots level, something that proved extremely beneficial in ultimately finding more contact sources and helping to curb spread. Meticulous contact tracing and quarantine of known close contacts must be done.

The reason for the rapid containment of the cases in China is also attributed to the fact that on recognition of the epidemic, the government made testing of the virus and urgent care services free of cost, something that the west is still grappling with [3]. The number of cases identified will significantly increase when the population at risk are allowed to test for free with no incurred costs related to the testing (especially true for the uninsured and lower class).

Readiness to handle an outbreak is the key to controlling the spread. Countries must have a multidisciplinary surveillance team to respond and contain the new cases. India with and outdated epidemic diseases act of 1987 [4], [5] The current act was made in 1987 to combat the plague epidemic of Mumbai but has not since been changed. It still provides for sea travel and doesnt for air travel and travel restrictions to be placed in an event of a pandemic. There is a desperate need to revamp the act in accordance with the WHO guidelines.

Lastly, Behavioral modification of the general population can be a key to controlling the disease. The general population needs to not only be informed of the current situation and symptoms, but care must be taken to painstakingly inform the population of the various steps they can take to prevent acquiring the disease. [6] Simple actions like correct method to wash hands, self quarantine on showcasing the symptoms, keeping a distance from those who are sick can go a long way in checking the spread of the disease.

In conclusion, if the coronavirus has taught the world anything it is this: Panic can only get you so far, the best way to deal with the disease is to get to the bottom of the disease, and methodically work your way up, and quarantines and behavioral modification of the population can contain even the most vapid of diseases.

References:

2. Lauren E. Wisk and Whitney P. Witt. Predictors of Delayed or Forgone Needed Health Care for Families With Children. Pediatrics December 2012, 130 (6) 1027-1037. Available from: https://doi.org/10.1542/peds.2012-0668.
3. Patro BK, Tripathy JP, Kashyap R. Epidemic diseases act 1897, India: Whether sufficient to address the current challenges?. J Mahatma Gandhi Inst Med Sci [serial online] 2013;18:109-11. Available from: http://www.jmgims.co.in/article.asp?issn=0971-9903;year=2013;volume=18;issue=2;spage=109;epage=111;aulast=Patro#ref4
4. PS, Rakesh The Epidemic Diseases Act of 1897: public health relevance in the current scenario. Indian Journal of Medical Ethics, [S.l.], v. 1, n. 3 (NS), p. 156, nov. 2016. ISSN 0975-5691. Available at: https://ijme.in/articles/the-epidemic-diseases-act-of-1897-public-health-relevance-in-the-current-scenario/?galley=html
5. Susan Michie. Behavioural science must be at the heart of the public health response to covid-19. Available from: https://blogs.bmj.com/bmj/2020/02/28/behavioural-science-must-be-at-the-heart-of-the-public-health-response-to-covid-19/

 

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