Methodology

COVID-19 and how we can all stop the spread

There is much to be said about inefficiencies of the response to the novel coronavirus (COVID-19). Active public health surveillance and a swift response—regimented test and trace programs complimented by public health awareness and education campaigns—to ‘a public health emergency of international concern’ as reported by the World Health Organization in January would seem the logical steps to have taken. 

Sadly the bungled sequence of events are symptomatic of health system(s) that were unprepared, had not sufficiently invested in a strong public health workforce and had not anticipated the likelihood of a disease outbreak of this nature, despite lessons from past disease outbreaks in recent times.
 
Therein lies the problem. The fact that previous episodes such as Ebola had been confined to regions like Western and Central Africa and even other coronaviruses such as SARS-COV-1 and MERS had all been viewed as problems in foreign countries unlikely to reach our shores. 

This position has evidently maintained the notion of epidemics and fast spreading viruses as abstract concepts not warranting our concern in the West. It has for the most part been business as usual, until now.
Of course a number of issues, chief among them, the alarming rate of deforestation and encroachment of human settlements on animal habitats has steadily increased the risk of zoonotic disease spillover into human populations. 
 
It really has been a Russian roulette of sorts in terms of what type of virus would—and still can—spillover into humans. Ebola in West Africa emerged from human contact with butchered chimpanzee meat, SARS-COV-1 in South East Asia results from consuming the meat of civet cats likely to have been in contact with bats, MERS resulted from human contact with camels in Saudi Arabia and Hendra virus emerged from human contact with horses that contracted the virus from bats in Brisbane, Australia.
 
History has told us that vigilance is of utmost importance in effectively dealing with disease outbreaks. The second Ebola outbreak in West Africa (2014-2016) was more devastating than the first; a fact signaling that even first-hand experience of such a devastating outbreak did not guarantee long-term vigilance and response preparedness for potential future outbreaks. 
 
Today with COVID-19, the countries heralded as having best responded to this have been Singapore and Taiwan. Both countries experienced the devastating effects of SARS-COV-1 (identified in 2003 in Southern China) and whose respective health systems had sufficiently prepared for the likelihood of another similar catastrophe. 
 
Of course a number of factors influence the relative success over the virus experienced in these countries. A key factor in both nations being the general public’s trust in their governments and the swift and concerted public health responses that were mobilized in the early stages of the pandemic.
 
Unfortunately that horse has now bolted in many countries and efforts are now focused on containing the virus and stifling community transmission. While there has been a lot of hype regarding the many promising candidate vaccines, it is worth remembering that safe and effective vaccines generally take years to develop—even if the process is fast-tracked, as is the case now. 
 
The lengthy process is down to the three phases of vaccine development and the rigorous processes detailing things such as the pharmacokinetics (what the body does to the vaccine), the pharmacodynamics (what the vaccine does to the body) and perhaps most importantly, the short and long-term side-effects.
These all need to be studied meticulously in order to end up with a safe and effective vaccine that could potentially go to the global market and be administered to millions (if not billions) of people. 
 
Long terms side-effects should be at the forefront of our concerns, to use an extreme but appropriate example, the Thalidomide tragedy has been among the biggest lessons in medical history underscoring the vital importance of ensuring safety and effectiveness of medicines.
 
In the absence of a vaccine—therefore in the absence of plausible herd immunity—the perceptions, attitudes and behaviours of the general public are now more important than ever in the fight to contain the spread of this virus. Social and physical distancing, wearing of masks/face-coverings and strict hand-hygiene have all been highly recommended as precautionary health behaviours to be adopted by the public. 
 
It should be noted that these recommendations—additional to the flurry of vaccine research and yo-yoing political opinions—are probably our best shot at stopping this virus in its tracks.
 
Given we exist in the age of misinformation and rife conspiracy theories, it should be acknowledged that the virus has one simple objective, to continue spreading. The Ebola virus was eradicated following a militant test and trace regime in West Africa. 
 
Different test and trace regimes have yielded varied results around the world and the statistics given to public and graphs demonstrating curves being flattened have given false hope and prematurely emboldened the public to ignore social and physical distancing under the impression that the worst is now behind us. 
 
Of course when governments start talking about ‘mystery cases’ and new outbreak clusters, these are all demonstrative of deficiencies in the testing and contact tracing regimes. Bluffing your way out of a pandemic is not an option, the bluff is always short-lived and inevitably truth rears its ugly head, which it always does. 
 
Recently there has been surveillance of sewer systems to help detect any residual virus—this of course is simply ridiculous. Testing greater numbers of people is going to give us a clearer indication of the situation in our communities, not digging around in sh*t.
 
Our current predicament has increasingly turned into a health vs. economics debate with the understandable caveat that everyone is desperate for things to return to normal or some form of ‘new normal’. The pandemic has seen job losses en masse and lockdowns have literally cost livelihoods. 
 
The devastating economic effects of this pandemic are undeniable and governments have put temporary measures into place to help maintain some form of economic stability and social order. These measures however are unsustainable in the long run and therefore the longer it takes to contain this virus the worse the economic impact will be.
 
Returning to the instrumental role of the general public; the grave consequences of prolonged lockdowns can be curtailed by figuratively jumping in with both feet in embracing the precautions necessary to stopping the spread of this virus. 
 
As mentioned before, we cannot rely entirely on the scientific community delivering a safe and effective vaccine in record time and we certainly cannot play political-point-scoring games with this virus. What is needed is vigilance and a collective public effort to contain the spread of this virus. 
 
A virus that cares not about public discourse and political agendas but one whose sole objective is to continue spreading from one human host to the next.

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