Today the 9th day of lockdown, being at home with minimal work, I thought of penning down a few lines on the ongoing COVID 19 pandemic. There are various respiratory viruses that infect the humans all through the year. Its high during the winter months. Seasonal variations do have an impact on them, though evidence says COVID 19 does not thrive in hot & humid climates.
To fight a battle against viruses we need to devise effective public health measures, before that we need to have a proper understanding of Infectivity, Pathologenicity & Virulence of an organism – (COVID 19 Virus).
Infectivity: rate at which the virus spreads from one host to another.
Pathogenecity: ability of the virus to cause disease in the host.
Virulence: refers to the severity of disease caused in the host.
Infectivity in case of COVID 19 is denoted as RO (WHO guidelines). R0 for COVID 19 is 2.0 to 2.5, meaning infected individual can transmit to 2 to 2 ½ others on an average.
This virus does not have high Pathogenecity as evidenced by more number of symptomatic & mildly symptomatic causes.
The Virulence rates are very low as referred to as CFR (Case fatality rates) globally. For COVID 19 it is -2.3% CFR, comparatively EBOLA was 50%, small pox – 30% & SARS was 9.4%.Therefore COVID 19 has moderate infectivity & Pathogenecity & is of low virulence while to fight a battle against any VIRUSES one need to know the nature of the enemy. To succeed a battle we must have an insight into the germ’s biology & behaviour.
There is no need to panic in a case of COVID 19 as 80% of the infected (asymptomatic, mildly symptomatic) hardly need any medical treatment, 20% need medical advice, out of which 5% may need hospitalisation in emergency situations.
We should not get panic stricken as COVID 19 in question is a “self limiting” viral illness in vast majority (as influenza/ flu).To combat against COVID 19 or any of the respiratory viruses in future we should adopt the following targeted public health measures as mentioned below:
We should concentrate on segments / hotspots of population likelihood of carrying the infection & acting as reservoirs. A segment of population with foreign travel & their close contacts need to be segregated, isolated, tested & treated.
Lockdown alone is not the perfect answer for these viruses, though it has an impact in slowing down the spread. As clinicians we should be aware that India has one of the youngest populations in an aging world. The median age being just 28. This is how this age group has a demographic protection against COVID 19 (Herd Immunity), which in comparison has high virulence in the elderly. For a long term arsenal in the battle against their viruses we should follow:
1.Hand Hygiene: Various studies have proven that hand washing at least 3-5 time a day usually would act as a preventive tool.
2.Cough etiquette – needs to be thoroughly followed.
3.Government should enact legislation to ensure that all public restaurants, canteens & toilets should have tap water & soap & tissue papers.
4.Investment in public infrastructure to decongest cities & prevent overcrowding.
5.Mass congregations & rallies to be disallowed or banned.
6.Social distancing etiquette has to be put in place in future, as it’s being practised in Japan. They are good at social distancing & keep physical distancing from strangers.
7.Avoidance of handshakes : whenever possible while greeting people / guests should be done by namaste or bowing instead of shaking hands.
8.Wearing masks: We all should adopt the policy that most of the people working outdoors or in workplaces should wear surgical masks. A mask can prevent from exhaling infectious droplets. But perhaps more importantly, it can signal other people to keep their distance
The above measures will have a far reaching impact on improving health & preventing as all against these viral diseases in future. India must recapitulate, learn & imbibe valuable lessons from public health battles fought & won in the past by Donald Henderson & John Snow both are the best examples of targeted public health approaches.
By: Dr. Sreejoy Patnaik, Chairman: Shanti Memorial Super Speciality Hospital Cuttack | ODISHA
The views are of the author and not that of Prameyanews.