The coronavirus pandemic is getting worse day by day. Over 530,000 cases of COVID-19 have been reported globally, out of which only a little over 123,000 persons have recovered, and more than 24,000 have been reported as deceased.
In India, over 640 cases have been reported, out of which only forty-five are recovered but sixteen were reported dead. Bihar state has over 300 suspected cases, but the number of positive cases is six with one death.
The Bihar government-invokes “Bihar Epidemic Diseases COVID-19 Regulation” based on British-era law the “Epidemic Diseases Act, 1897” utilizing the provision made under section 2, 3 and 4 of this law. Under this act provisions are made to seal the area barring entry and exit of population from the contaminated area. The district magistrate and chief medical officers are empowered to impose measures for controlling COVID-19 such as home quarantine, institutional quarantine and/or isolation besides actions necessary to control this pandemic. The purpose of implementation of the act is to prevent coronavirus infection and spread of COVID-19 in public. This will also help in managing overwhelming health care facilities in this crisis in both private and public sector.
People who have been exposed to the new strain of coronavirus (COVID-19) are at the risk of acquiring COVID-19. Especially those who has been returning to Bihar from infection prone area are at greater risk not for themselves but for other residents. People will act as a “vector” to transmit the virus and worsen the situation. Experts and government are emphasizing the need of social distancing and quarantine to stop the spread of this contagious disease. The primary route of transmission between people is respiratory droplets containing the inoculum from an infected person to another in close proximity. It can also spread due to close contact between individuals such as shaking hands and touching of the face etc. Frequently touched surfaces such as doors, windows, knobs, handles, walls, tabletops, beds, furniture, etc. can become contaminated, and pose a serious infection risk to those exposed.
This virus seems to be spreading easily and sustainably in the community mainly due to travelling or coming in close contact with infected individuals. The spread of COVID-19 can be minimized by adapting some precautions and lifestyle changes. Social distancing, self-quarantine and isolation are some useful practices that are helpful in stopping or minimizing the risk of community spread due to this virus.
Social distancing is an activity in which the physical space between person to person is deliberately increased in order to control the infection dissemination and thus preventing illness. Not participating in social gatherings, group assemblies and other events where people conglomerate are an integral part of social distancing. Working from home, restricting outdoor activities; closing schools, other governmental and non-governmental institutions; cancelling or postponing travel plans; rescheduling conferences, meetings, sports events, communicating electronically with family, friends or coworkers if possible; maintaining distance from other individuals and staying at home are some suggested good social distancing practices. On the other hand, self-quarantine is a mechanism by which if an individual recently exposed to COVID-19 can prevent further disperse of this epidemic.
Health experts advise to self-quarantine for at least 14-days if one has been potentially exposed to COVID-19. Nearly all infected persons will show symptoms within the 14-day period. Commonly it is being witnessed that the infected individual will start showing the symptoms from mild to severe. This is an important step to screen for potentially infected individuals in order to isolate them to prevent spread and to give them the proper treatment. It is highly encouraged to practice self-quarantine, especially if you have recently travelled through a COVID-19 impacted zone, or have come in contact with infected household members, intimate partners, caregivers, or have participated in events where known or potentially infected individuals have participated. This process involves increasing personal hygiene such as washing hands frequently, avoiding touching of the face, not sharing towels and other utensils, not having visitors, staying at least 6 feet away from other people in the household and enhancing environmental hygiene of frequently touched surfaces and maintaining the Heating Ventilation and Air-conditioning System (HVAC). Once the self-quarantine period has ended, you may return to your normal routine upon the advice of a medical professional.
When an individual has been confirmed to be infected with COVID-19, the person must be isolated to prevent further spreading of the infection. Isolation refers to a condition under which an infected patient is separated from other non-infected persons. This isolation can take place at home, at the hospital or at another care giving facility. The care giver must use special personal protective equipment (PPE) to avoid infection.
History shows that taking the above actions slow down the progression and limit the risk of such a pandemic. These steps may not be easy to implement, but certainly help communities and individuals to break the infection chain in order to control it. When a graph is plotted between social distancing and self-quarantining, the spreading of infection flattens (commonly termed as “flattening the curve”). and better organized medical intervention can be introduced. These processes also help in preventing and managing fear and anxiety about COVID-19 in public. The public can be encouraged in order to minimize the R0 factor (it is a factor which refers to the average number of new infections caused by each infected person), a term that is commonly used by Public health professionals to closely monitor the situation.
The World Health Organization (WHO) recommends maintaining a safe and healthy work environment to minimize the impact due to coronavirus. WHO strategizes the following objectives to mitigate the risk of COVID-19:
Interrupt human-to-human transmission including reducing secondary infections among close contacts and health care workers, preventing transmission amplification events, and preventing further international spread; identify, isolate and care for patients early, including providing optimized care for infected patients; identify and reduce transmission from the animal source; address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics; therapeutics and vaccines; communicate critical risk and event information to all communities and counter misinformation; minimize social and economic impact through multisectoral partnerships.
This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of the cases, identification and follow up of the contacts, infection prevention and control in health care settings, implementation of health measures for travelers, awareness-raising in the population and risk communication. As a precaution maintain your indoor environment and air quality to minimizing the risk of environmental transmission of coronavirus.
It is highly encouraged to follow the recommendations and other information as provided by the local, state, federal governments besides the experts from medical and epidemiology field. Social distancing, self-quarantining, isolating, are good practices, but still the virus needs to be eliminated from the chain of infected persons to decrease COVID-19. While the options of clinical manifestations are being explored, it is highly advisable to prevent the exposure of the virus by maintaining social distancing, self-quarantine, isolation as well as the environmental hygiene (indoor air/environment quality) of the occupiable space.
Dr. Rajiv Sahay, FIAS, CIAQP
Environmental Diagnostic Laboratory at Pure Air Control Services, Inc.
4911-C Creekside Drive, Clearwater, FL 33760 USA