Understandably, those who are not infected or have no loved ones who have been infected with the infection caused by Coronavirus, they have become increasingly restless staying four weeks or more inside homes and could not make sense of the continued closure or semi-closure of the public places and businesses, and are buttressing the re-opening campaigns.
It does not make sense to them because they have not witnessed yet on them or in their loved ones what catastrophic damage this disease would cause – to their body, to their mental status, to their relation with society and to the delicate balance in the family.
There have been re-openings of several public places and businesses in several cities and states.
Those re-openings are artificial and utterly at odds with the science and public health. A natural re-opening would bewhen the infection rate has significantly come down, the death rate has gone down, there are no new cases for several weeks and the hospital and health care providers are well equipped to manage the next surge in the infection rate.
Ask anyone who have had a loved been ill, hospitalized, been in the ICU or in a ventilator, or have passed away at the hands of this dreadful parasite, and they would empathetically tell you: do not deliberately lure people to the ‘battlegrounds’ of public places where there are mines everywhere.
At this moment, the odds of a healthy person getting infected when he is out in the public place is much higher now than it was a month ago. Why? Because both the asymptomatic persons and the persons with mild symptoms are out in the public.
Asymptomatic persons are those who do not show symptoms although they are infected with the virus. They either do not know they are infected or are ignoring the value of not infecting others.
The closer a healthy person is with the infected person and longer he is closer, the greater are his chances of getting infected. The droplets coming out of the infected persons when they sneeze, cough, or talk contain virus that land within 2 meters. If a healthy person who is within the radius of 2 meters from the infected person for sufficiently longer period, his probability of getting infected is multiple fold.
Once the viruses get into a person, the chances of him getting infected depend on two critical components. A, the dose of the virus and b, his immunity’s ability to ward off the viruses. Akin to the dosage of a drug to cause an impact on the disease in our body, the dosage of the virus determines the infection and sickness.
If the dosage of a drug is low there is no effect on the body, and if it is high there is over-reaction. If the dosage of the virus is low, it is not able to cause infection, but if it is high, the severity of the disease is much high.
How low is low dosage of virus? We do not know what the dosage of the virus to cause the corona infection. But to cause the influenza infection, a similar microorganism, at least 3000 virions of influenza (viruses) are needed. For instant, inhaling only 500 virions would not cause the infection and inhaling 10,000 particles would cause the infection and symptoms. More the dosage of the virus, the severe the disease.
Closer an uninfected person is to the infected person, and longer he is closer the greater his chances are getting infected. Wearing masks tremendously reduces the chances of getting the viruses on to a person or in reducing the dosage of the virus getting inside body.
Wearing masks, keeping at least 2 meters distance, and not touching nose and mouth before washing hands thoroughly with soap and water keep the virus away and tremendously decrease the chances of getting infected.
The criteria for re-opening should be this. There need to be sustained decrease in the infection rate and there should be no new infection or negligibly new infection for at least two weeks. There need to be new death for same period. Testing ought to be easily and readily available for anyone who is suspected or who want to get tested. The hospital staffs, doctors and nurses are confident that they have enough personal protection equipment. The health care delivery system is ready to handle new surge in the infection.
The immature and untimely re-opening adds to the recipe of the second wave. What is the second wave? It is the surge of the new cases and once the curve have bent slightly or significantly. The infection rate reaches as high as or higher than the previous wave.
If there is impatience in re-opening without meeting the aforementioned criteria, then stringent measures need to be applied with the re-opening. This will, at the very least, reduce the risk for anyone getting infected.
These measures include: any suspected person –asymptomatic person, and those with mild symptoms — should not get out in the public, everyone need to cover their nose and mouth healthy or infected; if regular masks are unavailable then any cotton clothes could be used to cover. Each person needs to keep at least 2 meters of physical distance to any stranger whose infection status is unknown.
Dismissing the Corona infection as mild to most people would be detrimentally remiss, such would be dismissing it just as a like-flu-virus. It is neither mild nor it is just like flu! It causes detrimentally harmful effect on human body. Attacking primarily the respiratory tract and the lungs, it spares no organs or systems. Kidney, heart, brain and liver, all are impacted.
The rush to re-open will have adverse public health consequence that the authority and the public would realize after seeing them happen.
(Dr. Sapkota is the chairperson of Health Committee of Non-Resident Nepali Association. He is also is the vice-president of Public Health STAR Scholars Network. He lives in Lawrenceville, Georgia, the United States)
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