Coronavirus: Do’s and Dont’s

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Poor access to hygiene information, mass panic and inadequate preparation by health authorities might turn out to be the most dangerous aspects of the global coronavirus outbreak which has infected 89,700 people in 65 countries as of Monday.

China, the epicenter of the disease, has the bulk of cases (80,025) but the virus is now spreading fast in the rest of the world. So far, 3,065 people have died, 2,912 of them in China.

Countries have concentrated effort in limiting infection, including imposing lock downs on whole cities and regions — the Chinese have quarantined 700 million people — but not as much time and resources testing for the virus, training the public and healthcare givers to manage what is essentially a flu, albeit a fatal one in a limited number of cases.

The US, which has banned travelers who have been to China for a certain period, discovered last week that the virus has been spreading undetected in Washington State for more than two weeks.

It now has 88 confirmed cases and two deaths both in a Seattle neighborhood. More rigorous testing is certain to reveal more cases.

Kenya, for the most part, has chosen the sooth-saying path, assuring the public that the country is “clean” of the virus, even though passengers are arriving by the hundreds from China, where the disease originated in Wuhan, a city of 11 million which is devastated by the disease and has been under lockdown for weeks now.

The disease in some cases shows no symptoms for long periods and would not, therefore, show up in temperature tests being used to declare passengers healthy.

Three key important facts about the epidemic may not be getting sufficient airtime as media and political authorities concentrate on reporting infections: COVID-19, the formal name for the disease caused by the coronavirus, is not a death sentence.

It’s not even Ebola which kills about half of those infected. From Chinese and other data, 80 per cent of those infected with the coronavirus develop mild flu-like symptoms and do not necessarily require hospital treatment.

Some 14 per cent have severe symptoms — fever, dry cough and shortness of breath — and only 5 per cent become critically ill, mainly those older than 60 or patients with pre-existing conditions, according to the World Health Organisation (WHO).

The key to preventing infection is hygiene: The virus is transmitted through droplets of mucous or saliva from an infected person.

These droplets cause infection if they find their way into the nose, mouth or eyes. Therefore washing hands with soap and running water (or alcohol-based sanitizer gels), not touching the face, avoiding shaking hands, avoiding close contact with patients are all effective ways of remaining healthy.

Efforts to prevent the spread of the virus should not be to the exclusion of testing, training of doctors, preparing medical equipment and giving the public information on how to stay clean and safely manage those with mild symptoms at home.The Ministry of Health yesterday indicated that it is also planning to rope in the Ministry of Education so that the battle against infection starts from right within the classroom.

In a country like Kenya which has only a few isolation beds and whose healthcare system is largely untested, mass infections, if not handled well, will quickly overwhelm hospitals which could be jammed with patients who require no hospital treatment to the detriment of those who desperately need it.

In countries like Japan where the level of preparedness is higher and where civil discipline is stronger, patients with mild symptoms are being encouraged to stay indoors and take lots of rest and only go to hospital if symptoms continue for two days for the elderly and four days for the rest of the population. With 961 confirmed cases, Japan has had only eight deaths.

The WHO identifies what it calls oxygen therapy and “protective lung ventilation” as some of the most important treatments for patients who fall seriously ill. For countries preparing for an outbreak, ensuring enough supply of oxygen and allied equipment would be critical for all health facilities.

A big risk is the fear-driven response of wasting face masks by healthy people. The consensus is that face masks are important for healthcare workers treating the infected and the infected themselves in controlling germs from flying around.

Secrecy in case management in Kenyan hospitals, lack of transparency in how air travel is being handled, failure to publicly demonstrate the state of preparedness and the apocalyptic images of hazmat-suited healthcare workers and masses of sick people in Chinese hospitals have cultivated that fear and stigma.

Australia is among the countries which have been transparent about the scenarios they have prepared for, right from the assumption that there is widespread infection to the worst-case-scenario where the epidemic persists for at least 10 months and mass vaccination is required.

Similarly in Kenya, laying out the totality of the response plan, explaining clearly the emergency protocols for managing the first patient, handling of contacts, where and how patients will be isolated, which facilities have been prepared for them, what equipment and supplies are available, what disease surveillance mechanisms are in place and what people should do when the virus lands would reduce panic and save lives.