An Unseen Monarch Rules Forcibly

There is a huge amount of panic everywhere around the world with one name that has scared everyone and is currently ruling all the nations. Yes, indeed! The coronavirus has become an urgent topic in many countries right now. This phenomenon originated from ‘a pneumonia of unknown cause was detected in Wuhan’. As per the information given by WHO, China was the first country to report to the WHO country office on 31st December 2019 about this mayhem. On 11th March 2020, WHO declared the outbreak of a novel coronavirus (COVID 19), a pandemic that affected 114 countries and infected close to 120,000 people and caused 4,000 deaths worldwide. As per WHO (as of 7th April 2020), there has been a total of 12,14,466 confirmed cases and 67,767 deaths due to COVID-19 worldwide.

Coronaviruses are a large family of newly discovered viruses that cause illness in animals or humans. In humans, these viruses cause respiratory infections ranging from the common cold to more severe diseases such as MERS and SARS and now COVID-19.

The disease has become pandemic because it has caused illness, also resulting in death in some cases; it has a sustained spread from person to person and have reported worldwide community spread, and is detected with more and more countries being engulfed by the new virus.

In the present scenario, the coronavirus-COVID-19 is affecting 209 countries and territories around the world and 2 international conveyances.

If we look at the statistical analysis of the Ministry of Health and Family Welfare, India on 9th April 2020, we can see that there are 5,095 active cases in India with 472 cured/discharged cases; 166 deaths and a migrated case. The COVID-19 virus mainly spreads through droplets of saliva or discharge from the nose, when an infected person coughs or sneezes. The virus is not airborne. People may also contact COVID-19 by touching a contaminated surface and then touching either nose, eyes or mouth. It is most contagious when people are symptomatic. The virus can survive on surfaces from few hours to few days depending upon the type of surface, temperature, and humidity.

The most common symptoms are fever, tiredness, and dry cough, though; some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. The symptoms are usually mild and the severity gradually increases.

HOW CAN WE PREVENT COVID 19?

Like any game, we have three strategies to fight against it.

DEFENSIVE STRATEGY

Protecting ourselves from the aggressive attack of the virus is what we define as a defensive approach. Here, the virus is more hostile than us.

So, how can we play in a defensive mode?

By following the defined measures, we can stop the Virus from infecting us.

ATTACKING STRATEGY

The approach where we are more proactive than the Virus itself is known as attacking strategy. This is an approach where we are quick in deciding so that loss can be minimized caused by the virus.

The question is how humans can attack a Virus.

The solution is by preparing ourselves at a very fast pace and by taking immediate action.

A series of measures have been taken by both the Central and State Governments to break the chain of transmission. One of these is to isolate all suspect and confirmed cases of COVID-19. However, as the number of cases increases, it would be important to appropriately prepare the health systems and use the existing resources judicially. Available data in India suggests that nearly 70% of cases affected with COVID-19 either exhibit mild or very mild symptoms. Such cases may not require admission to COVID-19 blocks/ dedicated COVID-19 hospitals.

Five action points to follow an attack strategy.

1. Expand-Train-Deploy

Expand the force of frontline warriors like doctors, nurses, paramedical staff. There is a dire need to expand the current medical staff, especially in a country like India, where the population is huge. Looking at the current situation, medical facilities in developed countries are not enough.

The immediate practical solution to increase the workforce is by recruiting interns, students of medical colleges, pharmacy colleges, skill centres, paramedical colleges, so that we have more hands to help.

Train – The work force needs to be trained. The fastest way to train them for the current situation is by conducting webinars by master trainers. Multiple sessions can prepare these students to help existing medical staff.

Deploy – The trained work force should be deployed in every district, especially villages where the medical facility is difficult to reach.

We can also have online consultation in remote areas where immediate medical help is difficult to provide.

As a long-term measure, we should increase medical seats in our existing colleges. All aspirants who would like to pursue a career in the medical field should be allowed to fulfil their dreams.

2. Good tracking system to track suspects and their contacts

As we can see, the huge population is migrating to the rural area, to be with their family. As per the census, 70% of the Indian population belongs to rural areas. They are less educated and even many services and facilities do not reach them. Knowledge of proper sanitization is also not available. People stay in small houses, uses common washrooms; hence, it is more important that we should educate this section of society.

Immediate action should be to create mass awareness to this section of the society.

3. To Ramp up facilities

We should ramp up our facilities in terms of production, procurement, and testing. This can be done by increasing the production and procurement of testing kits. Even private hospitals should be trained to provide these facilities to people.

This will increase to check suspects and will help the isolation of the positive patients at the early stage before they could spread the virus to other people.

4. Identify- Acquire-Equipped

Identify, acquire and equipped medical facilities for isolation, quarantine and treatment of suspects and patients is other important factor. We can immediately acquire medical colleges, paramedical colleges, schools, hotels etc. for isolation and treatment. This way is economical and will save a huge amount of money, then building a hospital. Indian Railways has set one of the best examples. They have converted their coaches into isolation wards.

5. Commitment- Collaboration- Coordination

The highest level of commitment is required by the government. The government is taking stringent steps to handle this situation.

Collaboration and Coordination – This link is equally important. It involves Collaboration between central and state government, between state and state government, between district and headquarters and between a head quarter and blocks/villages. Everyone has to contribute from politicians (MPs, MLAs), Pradhans, Private healthcare providers, Entrepreneurs, Industrialists, Dharma Gurus, NGOs, and other community stakeholders to ignite a mass movement against this virus in India

This level of micro-planning is required to control the virus to prevent it from entering into the villages. The virus has to stop at tier 1 cities. It will become extremely difficult if it reaches villages, rural areas as about 70-80%, health care infrastructure including human resources are confined to tier1/2 cities.

COMBINATION OF BOTH

This is the third strategy and will be the most effective stage to fight against the COVID-19 virus. Our strategy should be a combination of both these approaches. We have to follow both the defensive and attacking approach as per the requirement. As said by Sun Tzu, The Art of War

“Attack is the secret of defense; defense is the planning of an attack.”

Dr. D K Gupta

Guest Author Chairman and Managing Director, Felix Hospital