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COVID 19: The strange terror and perils of quarantine

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I was in Islamabad last week on a project assignment for three weeks. After a week, I cut short my trip immediately following the World Health Organisation (WHO)'s global warning on the emerging coronavirus epidemic. My trips from Vancouver to and from Islamabad involved stops in Seoul, Bangkok, and Taipei. I am now on self-quarantine at home as advised by the public health authority. I am doing fine and healthy; however, this self-isolation is a responsible behaviour in the context of public health emergencies to prevent, if any, further prospects of infection in the community. As I write, WHO just declared the coronavirus a pandemic. The rapid spread of the virus in so many countries and so fast contributed to the WHO's decision to declare the disease a pandemic. 

Since the outbreak of the coronavirus in December 2019 in Wuhan, the epic center of the epidemic in China, the virus has infected more than 120, 000 people in some 100 countries globally - most of those infected are in China (80,921+), South Korea (7,755+), Iran (9,000+), Italy (12,000+), Japan (1,277+), USA 1,200+), and Canada (120+). The numbers of reported deaths are over 3,500, the vast majority in China, followed by Italy, Iran, and South Korea.  The epidemic, now officially called Covid -19, is increasingly turning deadly. It belongs to the family of viruses that cause common cold, but also more serious respiratory illness. The source of virus infection was traced to a Wuhan seafood market where live animals were sold.

While the number of confirmed new cases in China appears to be slowing down, many suspect a higher global peak within the next few weeks due to spread of confirmed coronavirus cases in many countries across continents - for example, Australia - 128,  Singapore - 178, Malaysia - 149, India - 60, Thailand - 59, Taiwan - 47, Kuwait -72, France - 1,784, Spain 2031, Germany - 1,908, United Kingdom - 373, Netherlands -503,  Switzerland - 613, Sweden - 500, Norway - 598 and many more countries. It is picking up speed in Europe and the United States at an alarming rate like a "strange terror."  As of 11 March, 19 states in the US have confirmed cases of coronavirus, and is growing by hours as testing widens.

The virus can infect both animals and people and can cause a range of respiratory illness - from common cold to lung injuries and pneumonia. It is very contagious and can spread very easily from persons to person, particularly in confined spaces such as hospitals, aeroplanes, homes, shopping malls, schools, mosque/church etc. The pathogen can travel through air as a tiny respiratory droplets when a sick person talks, breathes, coughs or sneezes. Typically, the symptoms can take between 5 to 7 or maximum 14 days, and include fever, cough, and shortness of breath. Often milder cases may resemble the flu or bad cold. In such situations, a person may pass on the virus even before developing symptoms.

The Wuhan data reveal that males are marginally more likely to be affected by the virus (at 2.8 per cent fatality rate) than females (1.7 per cent). The data further reveal survival rates across age groups - for example, fatality rate for affected persons under 9 year is 0 per cent; those under 50 years is 0.4 per cent; and people 50+ year are more vulnerable with fatality rate as high as 14.8  per cent for 80 years or older. The survival rate is lower among older people with other pre-existing health conditions.

How can you protect from being affected? Medical advices include three important steps: first, washing hands thoroughly with soap frequently or use hand sanitiser, and avoid  touching your face and eyes; second, covering face with a tissue or your elbow when coughing or sneezing; and third, staying home if you are sick, and stay at least 6-feet away from others to avoid any potential transmission. The use of face masks is discouraged as many medical experts doubt their effectiveness. Instead, practising good hygiene at home and work should be more helpful for personal protection. In many countries, new measures include nationwide ban on mass gathering, and sports events, including advising people to avoid greetings like kissing or shaking hands.

Apart from the health, Covid-19 has brought havoc globally with dire economic and social consequences. In China where the virus first emerged, entire cities have turned ghost towns as millions of people are under quarantine; the government also temporarily shut down factories and closed schools indefinitely. An estimated one-tenth of the people in China are confined to their homes. With the spread of the virus, other countries also took extraordinary measures. Italy is in complete locked down. In the US, partial locked down has already started in New York and Washington States.  All schools are closed in Italy, South Korea, and Japan. In addition, people associated with the illness are facing stigma everywhere, more so in Europe as a result of fear of the deadly virus.

The economic pain from the epidemic is already overwhelming. Needless to say that China has been badly hit by the outbreak. With much of the Chinese economy stalled, the impacts are already felt globally, even for emergency medical kits and supplies.  The global financial markets, stocks, commodities, airlines, banking and other sectorsare sinking every day. Many countries are struggling to handle the rising number of cases because of lack of resources and infrastructures. The IMF (International Monetary Fund) recently announced $50 billion in aid available for low-income and emerging markets to fight the serious threats from the epidemic.

Right now, the outbreak seems to have entered a new phase dictated by local or community transmission. Many countries such as South Korea, Japan, Singapore, Australia, Malaysia,  Vietnam, Italy, Germany, France, UK and the US have confirmed local transmission. This community spread is perhaps inevitable now, and will likely prove a much bigger challenge to contain. China, which responded to the epidemic with resources and infrastructure, will weather it, and indications are that the situations are slowly getting under control.

The US, after calling it a "hoax" by President Trump, eventually approved an $8.0 billion dollar budget - more as a political response to the crisis - without adequate preparedness at the local and state-level and the needed infrastructure. In contrast, Canada with a small number of infected cases is closely monitoring this emerging and rapidly evolving situation. The post-travel social isolation at home, supported by a strong public health care system, is expected to keep tab on the spread of the coronavirus epidemic in the country.

How does and when the Covid-19 outbreak end? According to WHO, it is a "false hope" that coronavirus will disappear in the summer like flu. Medical experts are of the opinion that failures to contain the virus by governments in many countries mean that it may be here to stay. There is also possibility that the virus keeps regularly infecting human like common cold. Under this scenario, it is prudent that we learn to adapt to this strange terror in our everyday life as another health hazard through improved preparedness, education, access to medical help, personal protection and better care, particularly for the most vulnerable groups. Long-term quarantine and shutting down of schools, factories and entire cities will likely do more harm in terms of social-psychological and health impacts in the future. Therefore, once the current uncertain situation is better understood by experts such as virologists, immunologists and epidemiologists, we should take an adaptive approach to managing this newly-found illness.

Mohammad Zaman, PhD is an international development specialist and lives in Vancouver, B.C., Canada.



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