Editor,
As the fear of the unknown unfolds before our eyes, we are stilled by the daily rise in numbers of Covid19 fatalities. The breeze that once seemed more of a nuisance is now spreading its ambience for we are long gone from the hustle and bustle of the rush hour. Silence descends upon our city as social distancing becomes the norm. What of man in the days to come? Yonatan Brad, assistant professor of Immunology and Infectious disease at Harvard said that, “social distancing is really the key thing we can do right now”. Social distancing comprises three factors: First and foremost, #Stay at home. Although we would agree that majority of the people quickly embraced this tool as a mean of stopping the spread of infection, yet there are always those believe they are above the law and in this case above the infection itself, despite the fact that the RO index of this virus is higher than MERS and EBOLA. The RO index for COVID-19 is 2.8 which means that the virus is more contagious that EBOLA and MERS.
It therefore baffles me that many such imbeciles have passes that have been dutifully given them in good faith, yet the misuse of the passes is incomprehensible. Are they not able to understand that the norms of social distancing command us to stay at home and not go for joy rides or visiting long lost relatives? But an idle mind, after all is the devils workshop! “There are no cases yet!” is their justification. However, let me inform that for testing this virus, a throat or nose swab is required, and only cases with fever and history of travel are being tested. That leaves the rest of those, who hid their travel history or who simply chose to buy over the counter drugs as asymptomatic potential carriers.
Secondly, maintaining a distance of at least 3 feet or one metre, if at all we have to go out is compulsory. Going out may seem more like a privilege to many. But in these situations, it’s a risk of exposing oneself and one’s family members. We are advised that we go out only when necessary. The third point is to avoid unnecessary contact and maintain hand and face hygiene. Coming from a culture that is defined by smearing betel remnants or lipstick on someone’s cheek, avoiding contact must seem outrageous. However, much to my surprise this is something, we as a society have remarkably managed to overcome.
Social distancing has proven to be an effective tool in most pandemics that have occurred in the past. In terms of this pandemic, according to many sources, India is still at the stage of local transmission whereby there is a locally acquired case or cases clustered in a single household or nearby houses. In countries where there is community transmission, containment of the disease is becoming very difficult as sources can no longer be identified. Let us together strive as a society, by doing the least that we can by staying home and adopting strict social distancing.
With social distancing, we can flatten the infection curve and build herd immunity. Due to the sudden burst of cases, social distancing is the only tool left to contain the spread because time has passed for widespread testing and contact tracing which normally would have been the initial steps to be taken. If we waste this time, it will be a further tragedy.
Social distancing should be continued until the infection curve bends drastically to a point where it seems safe to resume social activities. Transmission of the virus happens due to contact with the patient, by droplets, aerosols and formites since the virus can remain active and infectious for hours and on different surfaces for days. The spectrum of the disease varies from mild (81%), severe (14%) presenting with difficulty in breathing or infection of more than 50% of the lung and critical (5%). The death rate is 3.4%. However, this may vary from country to country.
Today social distancing should become more of a choice rather than a law imposed upon us. Van Kerkhove says, “We know they are incredibly difficult, but countries that don’t implement these measures may face an endless cycle.” Hence there is no alternative to social distancing in order to combat Covid19.
Yours etc.,
Dr Ininaki Naomi Lyngdoh
Via email
Lockdown lessons
Editor,
Covid-19 outbreak has massive implications for the lives and livelihoods of people around the world. The disease has killed thousands and thousands more are infected every day. The entire productive human activity has come to a screeching halt as nations have been under lockdown. What began as a mysterious pneumonia-like illness in Wuhan, China late last year has morphed into a global health crisis that has threatened health systems and economies alike.
The impact of the disease on people and their lives varies from country to country. In India, the outbreak has caused many social problems. Since the emergence of the coronavirus, all attention in hospitals has been focused on covid-19. Consequently, people with other serious diseases and health problems do not get adequate care and attention. People with serious diseases such as cancer, diabetes, TB, HIV, liver diseases, kidney problems, cardiac problems, stroke and the like need close observation and careful attention. But when the attention of medical professionals is focused on covid-19 patients, these critically ill patients are neglected.
These instances show up our faulty healthcare system. It is confronted with enormous problems. Shortage of healthcare workers, poor health infrastructure, paltry health budgets etc., have adversely affected our healthcare system. Shortage of doctors and nurses leads to delay in providing timely and proper treatment. For critically ill patients this is extremely dangerous. In our country, we are unable to follow the WHO norms in the number of medical staff and infrastructure. In India hospital beds to population ratio is 1 : 1, 000. Likewise the ratio of doctors and nurses to population is not according to international norms.
There is a growing apprehension that by the time covid-19 ends, the death toll from other critical ailments could be as high as that of the virus. In the absence of sufficient medical staff and facilities people with other serious diseases won’t get adequate care and treatment. Such a scenario will have enormous ramifications on the health of people and it may lead to human rights and human resource issues.
The outbreak of covid-19 provides us enormous opportunities to learn good lessons. We need to reflect on the failures and weaknesses of our healthcare system and rectify our policy failures that weaken it. An appropriate epidemic policy must be formulated. Further, the will and determination of policy makers are also determinants of an efficient health system.
Yours etc.,
Venu GS
Via e mail