14 February 2021, NIICE Commentary 6789
Dr. Weiam AL-Hunaishi & Dr. Shantesh Kumar Singh
Facing the various strains of Coronavirus family is not a new thing to the world. The world has already suffered from the impact of the Severe Acute Respiratory Syndrome (SARS-CoV) outbreak in 2002, when more than 8000 people suffered and 778 died. Similarly, Middle East Respiratory Syndrome (MERS-CoV) has spread out from Saudi Arabia to 27 countries, including Korea during the period of three months, in 2015, during which the disease has led to approximately 200 clinically confirmed cases and 36 deaths in Korea alone. And now the world is up against Novel Coronavirus (COVID-19), which, according to the World Health Organization (WHO), has reached 102,584,351 clinically confirmed cases and 2,222,647 deaths worldwide, on the 1st of February 2021. With this immense impact of these biological hazards with pandemic potential, prevention started to clearly manifest itself as a key factor in solving the issue.
There is a clear pattern in the public behavior during the timeline of the infectious outbreaks. After the initial discovery of an outbreak, the public expresses an initial negligence and preventive measures deficiency. Moreover, with the presence of asymptomatic cases, rapid spread of the disease starts to occur and suspected cases became more difficult to track. These behaviors typically lead to increase in the initial surge of infections. In the case of COVID-19, this is critical as the virus has more spread-ability compared to the earlier viral outbreaks. Adding to the less perceived threat in primary surge of an outbreak, a primary public and/or later chaos tend to occur due to the lack of knowledge of the disease pathology and roots of transmission.
In hospital setting, similar situation of negligence might also occur, and leads to lack of primary infection control measures. Research states that lack of knowledge of viral infection clinical symptoms, and delay in identifying an outbreak and infected people isolation, were all connected to the delay. This resulted in, an increase in workplace-associated transmission of the infection to patients and health workers. Later on, healthcare workers suffered not only from fear and distress from contracting the virus after the first wave, but also the health workers who developed the disease had to face stigma. In the absence of proper guidelines for the healthcare workers of what to do and how to protect them, they have been led towards potential fear and chaos.
The capacity of countries to respond to COVID-19 has to be linked with both the people and hospitals preparedness. In a developed country such as Singapore, with the surge response capacity, plus the guidelines for doctors and up to date information on how to early diagnose and treat a COVID-19 has been really helpful in mitigating and improving disease prognosis. In the contrary, the status of COVID-19, in developing countries such as Yemen and Africa might not be the same, which indicate the importance of continuous support of one-health approach to ensure health equality, about which the WHO’s Director-General Dr. Tedros Adhanom Ghebreyesus stated in his visions and priorities.
Better public and hospital preparedness, therefore, is a necessity. It is very imperative that, in the hospitals, emphasize should be put on reducing the initial surge and minimise its health impact on hospital occupants and staffs. A systematic review found that proper planning, training and education, and increased capacity are some of the main important factors for better mitigation and response to the outbreak. The CDC guidelines has divided health staffs in three categories according to their exposure to COVID-19 and advised to follow exclusion from work for 14 days for high and some of medium category health staffs. Therefore, it’s really important to empower and educate health staff so that they could be responsive to the biological disaster and to deal with accompanied stress via preparedness trainings. This measure will result in the increased capacity of hospital to maintain patients flow with earlier implementation of preventive measures.
As for the public, increased awareness and surveillance can play an active role to prevent further spread of COVID-19 or any possible future outbreaks. Moreover, normalizing the idea of quarantine and increasing the public capacity to adapt preventive measures, such as social distancing and hand wash, and avoid closed crowded areas are also important in handling the situation in a better way. In addition, empowering the public to adapt and understand measures that prove its effectiveness such as isolation and quarantine would help in fastening the community recovery of the outbreak.
Way Forward
The lesson learned from the past experiences with Coronavirus families indicates the value of prevention, and draw a path to efficiently build public and hospitals preparedness capacities. Preventive measures, such as continuous public sensitivity analysis and increased public self-protection are actions that can be adopted in both developed and developing countries. In addition, trainings that helps healthcare workers becomes more aware of a possible outbreak, in turn help in early diagnosing, isolating and tracking of symptomatic and asymptomatic cases. It will help in proper implementation of needed actions and use of personal protective equipment when it is necessary. Use of technology to avoid crowd in hospitals is another major step towards the mitigation, such as tele-consultation or telemedicine etc. As a result, it will help in improving not only a country’s health condition, but also achieving the global health laws.
