Not in 100 years has the world faced a global health crisis like the COVID-19 pandemic? With more than 31 million (31,798,308) confirmed cases of COVID-19, and 973,653 deaths globally, the pandemic is showing no signs of retreat even after nine months of its first outbreak. Much remains unknown about this insidious virus despite studies in almost every part of the world. The disease which was initially understood to affect the lungs is now known as a multi-system disease affecting the whole human body. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is spread person-to-person through close contact. India now at the global no 2 spot with more than five million cases (5732518) and 91149 deaths. This means India accounts for one in every 8 cases and one in every 11 deaths due to COVID 19. With no effective vaccine or medicine available in the imminent future, we know prevention is our only resort.
Emergency lockdowns were initiated in countries across the globe to slow its spread but its side effects on health, wellbeing, business, and other aspects of daily life are being felt in every region. Therefore we cannot keep going from lockdown to no-lock down in cycles. Coronavirus has been called a “tornado with a long tail” – rising case counts among young people could ultimately spread to vulnerable old people or those with comorbidities and cause an uptick in deaths. People aged 20-49 years are driving the pandemic. The virus is circulating four times more among the under-40 population than in persons age 65 years or more. 87% of COVID-19 deaths in India are among persons of 45 years and above.
Preventing person to person spread is a priority. To reducing the rate of infection or ‘flattening the curve’ COVID-19 prevention relies on pandemic mitigation in community settings. Based on available evidence, optimum distance (1 m or more), use of face masks, eye protection (goggles or face shields) and hand hygiene considerably lowers the transmission of viruses. The use of face masks is highly effective in the reduction of infection, with stronger protection being afforded by N-95 or similar respirators. For the general public evidence shows, disposable surgical masks, or reusable 3 layer cotton ones- are effective too.
It is important to understand that the risk of infection depends upon the distance to the infected individual, exposure time, and the type of face masks and eye protection used. Eye protection has been under consideration but is effective in community settings. High humidity can extend the lifetime of airborne medium-sized virus-laden droplets by 23 times. Scientists have recommended humidity of at least 40% indoors. Ventilation also plays a major role in preventing the spread of the virus. WHO recommends avoiding the three Cs- closed spaces, crowded places, and close-contact settings.
Almost 200 vaccines for COVID-19 are currently in clinical and pre-clinical testing. Once an effective and safe vaccine is finalized, distributing it around the world in a fair manner is going to be a big challenge. WHO plans that in phase 1, the vaccine will be distributed to 20 % of a nation’s population. As per the Serum Institute of India, it will be as long as 3-4 years till everyone is vaccinated.
Nine months since the pandemic hit globally and some countries like South Korea, France, the US, Singapore are seeing a resurgence of cases. Japan is facing a second wave of infections which is larger than the first. Patients are walking into hospitals three months after recovery with complaints of breathlessness, irregular heart conditions, blurred vision etc. India, with the highest number of recovered cases, has to prepare for what lies ahead. We will have a large population with lingering effects. Timely action by KLES Dr.Prabhakar Kore Hospital & MRC, Belagavi Post-COVID Care & Rehabilitation Centre has been started.
With the last One million cases for India taking place in just 12 days, we have to understand that prevention from Coronavirus is our social responsibility. Every citizen has to make it a mission to prevent the spread of corona by taking simple but effective steps. Hand washing, physical distancing, face masks, and eye protection CAN prevent person-to-person transmission of the virus. These personal protection strategies cannot be neglected. Prevention of the spread of coronavirus demands behavioral change from ALL. We should not hesitate to make others practice the same when we observe that they are not. Together we can and we should. Prevention is better than cure!
Prof. Dr. Mubashir Angolkar
Head Dept. of Public Health, Jawaharlal Nehru Medical College
KLE Academy of Higher Education and Research (KAHER), Belgavi