Declaring a Pandemic — what does this mean ?

Its finally happened. Three months after the first case was reported in Wuhan, China,

Its finally happened. Three months after the first case was reported in Wuhan, China, and after a 13 fold increase in cases in just two weeks, the World Health Organisation has designated COVID-19 a pandemic. This disease has resulted in over 121,500 confirmed cases across 114 nations, and 4,300 deaths, over 3,000 of them in China alone.

The WHO has shown alarm at some countries that have shown “alarming levels of inaction” and hope the new designation of pandemic will shock these nations into action. “This is not just a public health crisis, it is a crisis that will touch every sector,” said Dr. Tedros Adhanom Ghebreyesus, WHO director-general, at a media briefing. “So every sector and every individual must be involved in the fights.”

Despite this new update, it is not too late for nations to act, and countries can still impact the course of the outbreak by detecting, testing, treating and isolating patient, with further education to the public and contact tracing of cases.

WHAT IS A PANDEMIC

An epidemic is an increase in the spread of a disease within a community, and can be relatively common. Sometimes a single disease may spread rapidly in a small, unprepared community creating an epidemic. This is happening more often with the prevalence of the anti-vaxx movement, as immunity falters against preventable diseases like measles.

A pandemic on the other hand is the global outbreak of a serious new illness that is “sustainably transmitted throughout the world”. It is not a descriptor that is used lightly, as declaring a pandemic could “cause unreasonable fear, or unjustified acceptance that the fight is over,” if used incorrectly. There has been much discussion whether the declaration of N1N1 “swine flu” as a pandemic caused unnecessary panic, overwhelmed emergency services or caused excessive expenditure on antiviral medication.

Though they were concerned by the spread of the disease and came close by labelling it a “pandemic potential”, the WHO were reluctant to declare it one. Unfortunately, after 2 months of assessing the outbreak, members of the WHO were concerned “both by the alarming levels of spread and severity, and by the alarming levels of inaction.” There is no threshold, number of deaths, number of countries affected.

WHAT DOES THIS MEAN FOR THE COUNTRIES?

According to the World Bank, the annual global cost of a severe pandemic is around $570 billion, or 0.7% of the entire world’s income. This estimation is realised as more people stay at home and more authoritative measures are enforced by governments. At this time, Italy has not put in place nationwide quarantine with further closure of almost all shops and services bar food shops and chemists.

The UK is expected to move from the “containment” phase of the outbreak, aimed at halting the spread of the disease”, to “delay”. This instead accepts the disease cannot be contained, and instead looks to slow its progression. Measures such as “social distancing”, isolation of those showing minor viral symptoms and cancellation of social events. To prepare for the UK epidemic a £30bn package has been prepared to boost the economy during the COVID outbreak.

India has suspended all tourist visas and e-visas until April 15ht as a pandemic is declared. All incoming travellers including Indian nationals will be quarantined for a minimum of 14 days if they have visited China, Italy, Iran, Korea, France, Spain and Germany after 15ht February. Advice has also been given to avoid all non-essential travel abroad.

South Korea has ramped up testing, performing around 4,000 tests per million people between 3rd January and 11th March. In comparison to 1,000 per million in Italy, 400 per million in the UK and only 28 in the UK. This has been due to differences in government responses, the severity of outbreaks in each country and the nature of the healthcare system in each country.

The steady decrease in new coronavirus cases in South Korea has been attributed to this mass testing, improved public communications and the use of new technology to aid diagnosis and management. Interestingly it has been achieved without the drastic quarantine procedures in place in China and Italy.

WHAT SHOULD I DO

Washing your hands has been emphasised by almost all public health agencies and governments. And you should continue to follow this advice. Soap and water is one of the most effective ways to destroy the virus on your hands, and helps prevent its spread.

It is also important to avoid panic, and to not hoard soap, food and toilet roll. Do not trust forwards on WhatsApp or treatment advice suggested, as these can be ineffective or even dangerous. Recently 27 people died from alcohol poisoning after a myth was spread stating strong alcohol could cure coronavirus.

Similarly be wary of false cures being sold online or by un reputable stores. Currently there is no cure for COVID, and supportive treatment is required for those who fall extremely ill.

If you have symptoms of COVID-19, you should self-isolate and notify your local health authorities. Symptoms include fever, cough, sneezing, general lethargy and joint pain, symptoms similar to the flu.

If you have confirmed COVID and have been asked to quarantine yourself, PLEASE STAY INDOORS. There have been instances of infected people continuing to partake in everyday activities, resulting in the spread of the infection, sometimes to vulnerable children and the elderly.

Dr Rajan Choudhary, Product Head, Second Medic Inc, UK

www.secondmedic.com