Coronavirus Disease (COVID-19) PANDEMIC: Evolving Perspective, Growth of Cases and Response

Watching the coronavirus (COVID-19) spread is a little like watching a hurricane approach, anticipating that the storm loses strength and changes course, but staying calm and preparing for impact at the same time.  Changing the language of COVID-19 to a “global pandemic” does not change the characteristics of the virus or the invaluable advice given by public health officials.  It highlights the importance of countries taking intense actions to protect their citizens and reduce the impact of the disease.  Like in many things, good preparedness and response will make the difference.

It was on 31^st December 2019 when the Chinese authorities first alerted the World Health Organization (WHO) about a cluster of 44 cases of SARS like illnesses in Wuhan, Hubei Province, China.  These cases were later confirmed to be a new virus of the coronavirus family which has been named “SARS-CoV-2” and identifiable as “coronavirus disease 2019” or simply COVID-19.  On 11th March 2020, being seventy days after the first reporting, WHO declared a global pandemic of COVID-19; a diagnosis several public health experts felt was here already. Meanwhile, the world’s largest economy, the United States of America, leads the biggest charge on social distancing to reduce the spread of the virus. President Trump announced last Wednesday that all travels to the United States from Europe (except for the United Kingdom) will be banned for 30 days effective, today, 13^th March 2020.

So what caused this official shift to pandemic status?  Let’s look at some new developments since last week up to the day before WHO declared a global pandemic: 

1. Cases outside of Mainland China have more than tripled with the count reaching 45,566 and deaths of 1,464 (versus 12,173 cases and 185 deaths reported outside Mainland China as of 3 March 2020).
2. The World-O-Meter shows global cases surpass 126,000 across 124 countries on 6 continents and total deaths of 4,633.
3. New cases were found in 45 more countries including in the Caribbean, Latin America and Europe.
4. United States’ cases went from about 60 to an increase of over 500 within a week which is now over 1,700 cases.
5. Several cases in the United States are from Europe and not from the disease’s origin, China.
6. Italy has seen a rapid increase in cases from 1,100 to 7,300 within a week and is dominating the mortality rate outside of Mainland China.  (The current total cases stand at 15,113 with 1, 016 death).
7.  Iran’s growth in cases reached over 6,500 from about 590 last week with total deaths of 194 which continues to increase significantly.
8.  South Korea cases have almost doubled growing from over 3,700 to 7,300 within a week.

Cluster Movement

Since the start of COVID-19, its movement has proven to spread largely in clusters.  Person to person contact or independently touching contaminated surfaces in a crowded area are bound to increase the infection rate. Some clusters have been associated with:  

1. Several cruise ships. The Diamond Princess in the pacific ocean registered 696 COVID-19 cases with 7 deaths, Luxor “A-Sara” Nile in Egypt registered 45 cases, and the Grand Princess docked in Oakland California had 21 people test positive.
2. Nursing and retirement homes such as the Life Care Centre in Kirkland, Washington linked to 19 deaths.
3. US Biotech Conference in Boston, USA which is linked to a cluster of 77 cases.
4. Religious gatherings in South Korea, Singapore and Hong Kong. (The Grace Assembly of God Church in Tanglin and Bukit Batok Singapore emerged to have 23 cases among other religious groups.)
5. Business and hotel venues such as the Grand Hyatt and Yong Thai Hang medical shop in Singapore linked to a cluster of 19 cases.
6. Markets such as the Hunan Seafood Market in Wuhan City, China linked to several outbreaks. 
7. Dinner functions and family gatherings such as the SAFRA Jurong (Singapore) dinner function which lead to over 30 cases from one affected person attending the event.

Early Actions in the Caribbean

Coronavirus cases in the Caribbean are currently very low but a major spread to the region is equally capable of escalating.  Ten Caribbean countries including 5 members of the Caribbean Community (CARICOM) reported 20 cases of COVID-19.  Guyana reported yesterday its first case and first death of a middle-aged woman with uncertainty of persons she interacted with since the illness.   The highest case count reported per country is 5 in the Dominican Republic. Most of the Caribbean countries are virus free.  Early and intense actions by local governments and social distancing by citizens are worthwhile to keep the virus away!   

Social Distancing, the Interim Vaccine for COVID-19

To be able to slow down the spread of COVID-19, everyone has to be more socially responsible. Research shows that public health officials traditionally recommend social distancing to slow down or stop a highly contagious disease. It does not mean no more activities with healthy friends and family. It simply means to avoid large crowds and gatherings, enhance good hygiene measures, not going to school and work or socializing when sick. It’s a sacrificial method used to save lives and make communities a lot safer. This new behavior will become the “interim vaccine” to buy time for the development of effective health treatments and a vaccine. Social distancing involves:

1. Cancelling major events. Already, the NBA has suspended games since the pandemic announcement and Jamaica is canceling issued permits and will no longer issue new permits for large events.
2. Self-isolation to include home schooling, working and worshipping from home and avoiding large gatherings.
3. Cancellation of non-essential travels to affected countries and going into crowds and on public transportations.
4. No socializing when sick.  Stay at home. Seek medical help.
5. Increasing hygiene measures. Wash/sanitize hands, cover mouth when sneeze or cough and disinfect surfaces used often.
6. Changing into cleaner clothes immediately after a day from work or school. 
7. Avoid handshakes, hugs and kisses.
8. Wearing a mask if you absolutely must enter a crowded area. 

Should you wear a mask?  There is no scientific evidence found to show that wearing a mask will protect you from coronavirus. However, the fact that an infected person can go undetected by showing no symptoms of COVID-19 may especially be important in a healthy person making a decision to wear a mask in large crowds.  Chances of respiratory droplets penetrating your mask and entering your body through the mouth and nose would be unlikely. 
 
Mask wearing is largely found in Asian countries but shunned in western countries.  Several experts in Hong Kong who studied viruses like the 2003 SARS and the bird flu which followed encourage mask wearing.  As a matter of fact, Hong Kongers may widely think you’re crazy if you don’t wear a mask in public with this new virus!  Perhaps mask wearing should not be dismissed in large gatherings without a better alternative for protection.  Masks essentially could be used while traveling to infected countries, commuting on public transport and walking through crowded airports and other venues.  Should mask wearing be incorporated in social distancing?  This is a non-political question for individual discretion and reasoning with public health experts.    
 
The main effort here is to control the pandemic with unified commitment while public health professionals buy time to develop effective treatments and a vaccine.  Without mitigating measures, there will be more sick people and greater impact on economies. 
 
Information provided herewith is to draw awareness to the COVID-19 pandemic. More ways to take precaution can be found in my last article titled, “The Development of COVID-19 Outside of Mainland China and the Threat of a Pandemic.”  Research shows that viruses like this one can either run its course, be contained, treated or a vaccine developed.  Stay calm, stay healthy!