Post Mortem

covid-19: How to avoid panic and neglect

By Nagaland Post | Publish Date: 2/21/2020 11:01:42 AM IST

 Global health emergencies are adding to the increasingly intense and severe natural and human-induced disasters. Coronavirus disease (COVID 2019) is one of the current horrifying outbreaks that has claimed 1,669 lives with laboratory-confirmed cases of 51,857 (as on February 16, 2020) already. COVID 2019 has a lower fatality rate than SARS – currently, it’s hanging around 2% (SARS was around 10%). But, it transmits rapidly and there is sustained human-to-human transmission. Even as we were evaluating our learnings from SARS, H1N1 Swine flu and Ebola, COVID 2019 exposed lack of our readiness to withstand such outbreaks. As we know, it has already been muddling the world and we are panting to deal with it.

Why have such outbreaks been going beyond our control? An effective response to such pandemic depends on the preparedness measures taken before such outbreaks. Let us have a look at how prepared the world is to deal with the current coronavirus attack. 

As per the Global Health Security (GHS) Index 2019, the global overall average score is 40.2 (out of a possible 100). The Index shows that collectively, international preparedness for epidemics and pandemics remains very week. India stands at 57 (out of 195 countries), slightly below China (51).

The world is grimly ill-prepared while encountering the current outbreak with a low level of preparedness on the six building blocks of health system. The haphazard response and service delivery to COVID 2019 in China failed to contain it and led to its spread over a wider area, affecting all 34 regions of the country, and countries outside China. 

COVID 2019 is a novel form of coronavirus and is putting additional pressure on the already overstretched health system in China and affecting service delivery globally for people with other illness. For instance, there are 60,000 general health practitioners, roughly one practitioner serving 23,000 persons in China, which coupled with a scarcity of personal protective equipment (PPE) and essential medicines. WHO has warned about shortage of PPE. Why can’t we have a contingency of PPE that could help us respond quickly and save precious lives? 

The health information and alert system need to be more efficient and faster to track and report emerging and re-emerging health concerns. By the time COVID 2019 was reported, it had already spread wide affecting a large number of people. Even today, there are countries without systems in place to detect coronavirus cases. Modern technology of air travel and just-in-time supply chain is several times faster to transport such virus than it gets detected and reported. We must put more effort to equip labs and develop systems to detect, map and alert quick enough to contain such diseases at their origin. 

As seen during SARS or any other outbreaks, global actors rush to fund response to such diseases once it impacts large area and it is forgotten once it is under control. This is inefficient, costly and keeps ourselves vulnerable to future outbreaks. World Bank Group President Dr Kim Yong described this as “a cycle of panic and neglect.”  According to WHO, COVID 2019 Preparedness and Response Plan for the period February to April 2020 requires USD 675 million. While dealing with such outbreaks costing us a lot, it has a negative impact on the global economy too. Multinational companies that produce their products in Chinese factories or sale their products to Chinese consumers are hit already. The tourism industry is hard hit. The stock market has responded negatively – the Shanghai Composite Index fell by 8% on February 3 (biggest fall in four years). Amid the coronavirus attack, global economic growth forecast by experts shows it might dip by 0.2% to 0.3% in 2020. This could bring the global economic growth down to an annual rate of 2.3%, the slowest pace since the 2008 global financial crisis. 

Community-level mitigation and engagement is inextricable to prepare communities for such outbreaks. Very less is being done to communicate the risk, aware people and educate them on good health behaviour, especially in the hard-to-reach communities. Hospital staffs need to be trained on how to communicate and reassure the people. Mental health and psychosocial support must address the well-being of population and counteract fear, stigmatisation and misconception with appropriate information. These outbreaks often lead to flooding of misinformation and rumours – those need to be tracked and managed urgently. 

The unprecedented rate of urbanisation, climate change, etc, provide perfect breeding ground and conducive environment for spreading of outbreaks like COVID 2019 at a fast pace. Further, there are children (seems to be escaping current outbreak, so far), women, differently-abled, poor, hard-to-reach communities, etc, who are especially vulnerable and might be disproportionately burdened to such outbreaks. The preparedness must consider the most vulnerable groups of people. 

Preparedness is everybody’s business, most importantly of the government and leadership. The government and world leaders need to put more effort to brace preparedness for future health emergencies. There should be conducive national health policies addressing the need for essential medicines and pharmaceuticals, putting a robust health system in place, more research and development, etc. It demands engagement from not only health professionals, but also wider stakeholders, including community. The humanitarian agencies too should and have been playing an important role in tackling such outbreaks. 

Experts have already warned that these coronaviruses are indications of things to come. What if more deadly outbreaks grip the world tomorrow? We can’t face the challenge without having a proper strategy and adequate preparedness. The world needs to accelerate efforts for global pandemic preparedness. At the national level, countries, especially those with weak health systems, need to invest more on their health systems to contribute to effective preparedness. This will help us prepare ourselves to save lives and millions of dollars in response. Let’s not forget our collective experience from the previous and current pandemics – let’s continue our effort to prepare ourselves for future health emergencies.

Sheikh Khairul Rahaman & Anirban 



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