As India preps to make Janta Curfew a success today, it is time we realised that COVID-19 is spreading through our human networks and that a single person’s behaviour can cause ripple effect across the globe transmission. The onus, therefore, is upon us to check its spread, writes Dr Tamorish Kole

Myth: Coronavirus will disappear when summer sets in India.

Fact: From the evidence so far, the new coronavirus can be transmitted in all areas, including areas with hot and humid weather.

Myth: Taking a hot bath can prevent coronavirus disease.

Fact: Our normal body temperature is 97.5 degree F. Taking hot bath will only raise our body temperature. Additionally, extreme hot water is harmful for us.

Myth: Pets at home can spread coronavirus.

Fact: To date, there is no evidence that pets such dogs or cats can be infected with COVID-19. However, it is prudent to wash hands before and after handling them.

Myth: Eating Chicken or other meats can cause COVID-19.

Fact: There is no such evidence. However, eat well cooked meat and avoid raw meat.

Myth: Wear a mask when you step out.

Fact: There is no need to wear a mask for healthy people. If you have fever, cold and cough wear a three-layer surgical mask to protect others from getting infected. Seek medical attention as well. N95 mask is only required for healthcare professionals.

The novel coronavirus outbreak (2019-nCoV, now called SARS-CoV-2) causing the COVID-19 viral disease that has swept into 156 countries, which affected 191,127 people (as on March 18, 2020) and killed more than 7807 people is now officially a pandemic, as declared by the World Health Organisation (WHO).

It is for the first time that the WHO has called an outbreak a pandemic since the H1N1 “swine flu” in 2009. The 1918 Spanish flu epidemic was the deadliest flu season that we know of, infecting about one-third of the world’s population.

Coronaviruses are a large group of viruses that are known to infect both humans and animals, and in humans causes respiratory illness that range from common colds to much more serious infections. The most well-known case of a coronavirus epidemic was Severe Acute Respiratory Syndrome (SARS), which, after first being detected in southern China in 2002, went on to affect 26 countries and resulted in more than 8,000 cases and 774 deaths.

The COVID-19 disease appears to have originated from a Wuhan seafood market where wild animals, including marmots, birds, rabbits, bats and snakes, are traded illegally. Coronaviruses are known to jump from animals to humans, so it is thought that the first people infected with the disease — a group primarily made up of stall holders from the seafood market — contracted it from contact with animals.

If we compare COVID-19 with two other coronavirus outbreaks in the recent past, we will see that it is less lethal. With a mortality rate currently estimated at around 2 percent (a range of 0.7 to 3), it is less deadly to those who become affected than SARS or MERS. According to early WHO estimates, the average reproductive rate (r0) of coronavirus ranged between 1.4 and 2.5. That means, on an average, each confirmed case of coronavirus would infect between 1.4 and 2.5 other people. It is, therefore, more contagious than some of the deadliest airborne viruses.

India is one of the first countries in the world to prepare for an outbreak of COVID-19 outbreak. According to Health ministry, India began screening people at airports from 17 January onwards, six days after Chinese state media reported the first known death from an illness caused by the virus and a good two weeks before the WHO declared it a global health emergency.

As on date, India has over 200 confirmed COVID-19 cases and is on Stage 2, which means we have only local transmission from positive cases. The Indian Council of Medical Research (ICMR) believes that we may eventually slip into Stage 3, where the disease spreads in the community and large areas are affected. ICMR also says that we have approximately 30 days window period to halt this transmission and that’s where our focus as a country should be on.

Till now, India has taken following stringent measures to address the problem:

• Mandatory checks at airport and quarantine as required.
• Blanket Visa ban until at least April 15, 2020.
• Invoked Disaster Management Act to centralise the response and preparedness.
• Invoked Epidemic Act for the same purpose.
• Created isolation facilities across the country using Armed Forces and Paramilitary Forces facilities.
• Carried Rescue Missions from China, Iran and Italy to bring back Indians who are at risk of COVID-19 exposure.

Indian Healthcare Sector along with Central and State Government is fully prepared to deal with the outbreak. However, we need to keep in mind that every country in the world is facing some challenges despite their socio-economic status as the virus is spreading very rapidly.

In today’s world, naturally fear is always the first wave of every epidemic. But, we must realise that we have had pandemics before, and we have responded to them before. It is very important to know what each one of us can do to fight against COVID-19.

WHO advises seven simple steps for every one of us to stay safe and prevent the virus from spreading to other people. These are:

STEP 1: Wash your hands frequently, regularly and thoroughly with an alcohol-based hand rub (use a hand sanitiser that contains at least 60% alcohol, for at least 20 seconds) or wash them with soap and water (for at least 40-60 seconds). Wash your hands after coughing or sneezing, when caring for the sick, before, during and after you prepare food, before eating, after toilet use, when hands are visibly dirty and after handling animals or animal waste. We use our hands to touch objects and surfaces that may be contaminated. Without realising it, we then touch our faces, transferring viruses to our eyes, nose and mouth where they can infect us. Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands, including the virus that causes COVID-19.

STEP 2: Avoid touching your eyes, nose and mouth to avoid transmission of virus. Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth and can then enter your body and make you sick.

STEP 3: Cover your mouth and nose when you sneeze or cough with the bend of your elbow or with a tissue. Also make sure that you, and the people around you, follow good respiratory hygiene. Dispose of the used tissue immediately into a closed bin and wash your hands. When someone coughs or sneezes, they spray small liquid droplets from their nose or mouth which may contain virus. By covering your cough or sneeze, you avoid spreading viruses and other germs to other people. By using the bend of your elbow or a tissue and not your hands to cover your cough or sneeze, you avoid transferring contaminated droplets to your hands. This prevents you from contaminating a person or a surface through touching them with your hands.

STEP 4: Avoid crowded places and close contact with anyone that has fever or cough, and international travel history in recent past. This is more important for people over 60 years of age or with underlying health condition such as high blood pressure, diabetes, heart and lung diseases or cancer. Maintain at least 1 metre (3 feet) of distance between yourself and anyone who has a fever or cough. COVID-19 spreads mainly by respiratory droplets that come out of the mouth or nose when a person who has the disease coughs. By avoiding crowded places, you keep yourself distant from people who may be infected with COVID-19 or any other respiratory disease. This is called Social Distancing and is proven a very effective strategy for containment.

STEP 5: Stay at home if you feel unwell, even with a slight fever and cough. By staying home and not going to work or other places, you will recover faster and will avoid transmitting diseases to other people. This is called Home Isolation and is very effective for rationing of healthcare resources to sicker individuals.

STEP 6: If you have a fever, cough and difficulty breathing, seek medical care early. If you can, call your hospital or health centre first so that they can tell you where you should go. In India the helpline number set up by Ministry of Health and Family Welfare is: +91 11 23978046. This will help to make sure you get the right advice, are directed to the right health facility, and will prevent you from infecting others.

STEP 7: Get information from trusted sources. Stay informed about the latest information from about COVID-19 from trusted sources. Make sure your information comes from reliable sources — Ministry of Health and Family Welfare, Government of India website, the WHO website, or local health authorities. Everyone should know the symptoms — for most people, it starts with a fever and a dry cough. Local and national authorities will have the most up-to-date information on whether COVID-19 is spreading in your area. They are best placed to advise on what people in your area should be doing to protect themselves.

In addition, we also need to understand that so far 80% of people affected by COVID-19 have mild symptoms and recovered from the disease in two weeks. Most coronavirus illness are also generally mild for children and young adults. Treatment is similar to other coronavirus outbreak protocols with some drugs (Under trial) are now being tried in very sick patients. We do not have an effective vaccine as yet and therefore seek proper medical attention in time and avoid self-medications.

It is time we realise that COVID-19 is spreading through our human networks — through our countries, our towns, our workplaces and our families. In this spread, a single person’s behaviour can cause ripple effect across the globe. Let us be responsible and fight the coronavirus outbreak together.

The author is President, Asian Society for Emergency Medicine (ASEM)