Risk mitigation is now the goal and it can be achieved by focusing on other ‘P’ factors— Prevention, Preparedness, Public health, Political leadership, and most of all, People
By Henrylito D. Tacio
On March 9, Dr. Tedros Adhanom Ghebreyesus, the director-general of World Health Organization (WHO), said in passing during a press conference about coronavirus disease 2019 (Covid-19): “Now that the virus has a foothold in so many countries, the threat of a pandemic has become very real.”
Media, it seemed, failed to notice it. But two days later, the WHO finally declared the viral disease that has spread from China in almost all parts of the world, infecting more than 118,000 and killing more than 4,000 people as a pandemic. “This is the first pandemic caused by coronavirus,” he said at a briefing in Geneva.
At first, the novel coronavirus was just an outbreak in Wuhan, where it started. Then, it became an epidemic when it spread not only in Wuhan but in other parts of China. Now, it is officially a pandemic.
The United States Centers for Disease Control and Prevention (CDC) consider a disease an epidemic when the increase, often sudden, in the number of cases is above what is normally expected in the population in the affected area. Outbreak carries the same definition of epidemic, but is often used for a more limited geographic area.
Pandemic refers, according to CDC, to an epidemic when the disease has spread over several countries or continents, usually affecting a large number of people.
“Pandemic is not a word to use lightly or carelessly,” Dr. Tedros pointed out. “It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.”
Some health experts were surprised with the declaration. For instance, Severe Acute Respiratory Syndrome (SARS), a coronavirus related to Covid-19, which affected 26 countries and resulted in more than 8,000 cases in 2003, did not reach pandemic status.
The last time a pandemic was declared was in 2009 yet when a novel influenza A called H1N1 – called popularly as swine flu – spread quickly from the United States to the world. The CDC estimated “151,700 to 575,400 people around the globe died from infection during the first year the virus circulated.”
Public health crisis
More art than science was how Dr. Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, said in February should a pandemic be declared. “Pandemics mean different things to different people,” he said. “It really is borderline semantics, to be honest with you.”
“This is not just a public health crisis, it is a crisis that will touch every sector – so every sector and every individual must be involved in the fight,” Dr. Tedros said of Covid-19. “I have said from the beginning that countries must take a whole-of-government, whole-of-society approach, built around a comprehensive strategy to prevent infections, saves lives and minimize impact.”
‘Touching’ problem and solution
In medical field, an ounce of prevention is better than a pound of cure. But in this case, there is no known cure yet. The best method against contagion is still prevention. Time and again, the WHO and Department of Health recommend hand washing as one possible solution.
There was this study published in the United States last year about hand hygiene and the global spread of disease through air transportation. It said that “if people wash their hands while at the airport, the spread of a pandemic could be curbed by up to 69 percent.” The same research group previously “found only an estimated 20 percent of people have clean hands while at the airports.”
If hand washing is the solution, then touching must be the problem. “You can clean your hands all day, but as soon as you start touching things again… the germs on your hands increase,” Dr. Connie Steed, president of the U.S. Association for Professionals in Infection Control and Epidemiology, told USA Today.
It’s not only germs, but viruses as well. “Don’t touch MEN,” urged Health Secretary Francisco Duque III in order to control Covid-19 virus from spreading. He said those words when he was interviewed by DZMM. MEN stands for mouth, eyes and nose. “(Touching MEN) could lead to infection because you are introducing a virus,” he explained.
A study published in the American Journal of Infection Control in 2015 showed that people touch their faces more than 20 times on average in an hour. About 44 percent of the time, it involves contact with mouth, eyes or nose.
Almost always, people touch their face without thinking. “Whether it is something intrinsic to our species or a learned behaviour, we continue to repeat it even if we intend to or not,” Dr. Wendy Wood, provost professor of psychology and business at the University of Southern California, told Stat News’ Shafaq Zia.
Wear gloves and glasses
Some experts believe that one of the ways to stop people from touching their face is to make it difficult. “If people are to wear gloves and glasses, they are less likely to touch their face,” Dr. Wood said.
Dr. Richard T. Mata, a DOH consultant for WHO, thinks so, too. “With gloves, you will prevent yourself from touching your face and shaking hands with people,” said the boyish-looking doctor from Davao.
He then gives this illustration: “Imagine in a mall with 1,000 people, including you, there is one who is infected with Covid-19 virus. What are the chances that you will talk to him and he will cough in front of you? Honestly, less than 1 percent. No one wants to cough in public now and of course you won’t talk to strangers.
“Now, what are the chances that you will be able to touch the door at the mall entrance that he touched? Of course, higher! That means to say that wearing gloves is very important, especially if the virus can last a long time on fomites.”
Dr. Mata’s sound advice: “My suggestion is to go above hand washing alone. I suggest a mandatory wearing of gloves for areas where there is an outbreak. Of course, the government can provide free gloves for the people. Spending on prevention is better than cure.”
It is just a suggestion, he said. “If you have the discipline not to touch your face and be able to wash your hands with soap in 20 seconds frequently, then you don’t need to wear gloves. Personally, I have a habit of touching my face due to allergic rhinitis.”
Meanwhile, Dr. Tedros urged the world not to focus on the word “pandemic.” “Let me give you some other words that matter much more, and that are much more actionable. Prevention. Preparedness. Public health. Political leadership. And most of all, people.”