COVID-19, social distancing and our population

Ghana has been fighting the Coronavirus disease 2019 (COVID-19) since March 12, 2020. It is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The virus and its characteristics are still under research, but already it has spread to many parts of the world, from Wuhan, the capital of China’s Hubei province, where it was first identified.

Since then social distancing and ‘stay home’ directives have been applied in countries globally.

The Editor of the Junior Graphic, DOREEN HAMMOND, spoke with the Executive Director of the National Population Council (NPC), Dr Leticia Adelaide Appiah, to find out more about the virus, social distancing measures and the population.

Question (Q): What makes the virus so dangerous?

Answer (A): COVID-19 is dangerous because it is a novel virus that causes a respiratory disease, easily spreads, makes people very sick and in some cases leads to deaths.

It is spreading fast because humans are not yet immune and, therefore, have no specific protection against it. When a community becomes immune to an infectious disease, the spread or infections stops, for example, measles, polio, rubella, etc.

Building immunity happens in two ways. First, many people, about 50 to 70 per cent, contract the disease and build an immune response. Second is vaccination against the disease to achieve immunity.

Because the virus is novel, neither has been achieved yet. Combined with the ease of transmission, even by asymptomatic patients, COVID-19 is a dangerous virus. There are no medications yet.

That poses a great challenge for healthcare personnel, who, like everyone else, are not immune and so can also be infected in their line of duty. This presents a situation where sick health personnel will be unable to provide health care, because they have also become patients.

This can contribute to high mortality, because of reduced healthcare workers, not forgetting the devastating consequences to their families and loved ones.

Q: Why does it spread so fast?

A: As it is said, the virus moves when we move. The virus needs us to move, hug, shake hands, touch contaminated surfaces and touch our mouth, nose or eyes with our infected hands to survive and spread.

COVID-19 spreads fast because it does that through droplets (sneezing, coughing, speaking loudly), handshakes and hugs among people. The more people are crowded together and moving about, the more the virus spreads to the next person, as they inhale or touch surfaces infected with the virus.

Again, about a quarter of infected people are not aware they are infected, in those who develop symptoms, the virus has an incubation period of  two to 14 days, making it very easy to transmit fast before the infection is detected.

Q: Why has it spread so fast in Europe and North America and so far does not seem to be spreading so widely in Africa?

A: The virus is spreading so fast in Europe and North America because of the ease of travel from anywhere to everywhere across and within Europe and North America. Remember, the infection can be asymptomatic. Within 24 hours you could be in three or four different countries spreading the infection if one has it.

For the long haul distances, confinement for long periods, the use of washrooms by so many people without proper hygienic practices, especially of toilet handles, could spread the infection on board.

Thirdly, high volumes of air traffic in many European and North American countries and cities, coupled with the fact that we are not immune, accounts for the fast spread in those regions.

Q: Why do countries impose lockdown on citizens?

A: Lockdown is a containment measure to curb the spread, reduce workload on health facilities and staff and, ultimately, reduce associated mortality.

Authorities lock down because schools, bars, restaurants, churches, shopping malls, playgrounds, stadia are more crowded than homes.

Therefore, the home is the best place for self-quarantining and social distancing, as the best protocol needed at this point, until a vaccine or medications are developed.

Lockdowns are supposed to keep us away from crowded places and not be in close proximity with one another. This is an important way of slowing the spread. Slowing the spread is as important as stopping the infection, because it makes it easy for the sick to access health care quickly, without burdening the healthcare system.

One major COVID-19 prevention measure being encouraged and even enforced in many countries is social distancing. It is an act of self-isolation to prevent and control the spread of person to person infection.

The objective is to reduce the probability of contact between persons carrying the infection and others who are not infected, so as to minimise transmission, morbidity and ultimately mortality. Self-quarantining, whether you have the symptoms or not, staying at home and avoiding any non-essential interaction, is key to helping contain and ultimately stop the disease.

The enforcement of social distancing and lockdown is an attempt to reduce infection and limit the number of persons who contract this disease. This is important because there is a level of capacity that our existing hospitals and healthcare staff can manage. That is why social distancing and COVID-19 preventive measures are essential in reducing the numbers.

Q: People may obey the lockdown, but live in congested households. How careful can members of a household be when so many people live in single rooms?

A: The essence of lockdown is to make it easy to practise social distancing and self-isolation to reduce spread and break transmission. In congested rooms, it may be impossible to adhere to the ‘at least a metre distancing’ among the people and so we need to find other ways of breaking transmission.

This can be done by making sure that one keeps his or her droplets to him/herself by coughing or sneezing into a tissue or your elbow and disposing of contaminated tissues properly through burning, etc.

One can also use the mask when there are older people living around. Under no circumstance, should masks be shared, because it will be a sure and easier way of spreading the virus.

Regular handwashing with soap under running water or from a Veronica bucket, the use of hand sanitisers, frequent cleaning of door handles, especially public toilet handles, are all forms of social distancing from the virus to break transmission.

Q: Can spitting contribute to the spread of the virus?

A: Yes, of course spitting produces more saliva than speaking, so yes, spitting can spread it.

Q : Why have some countries banned the use of chloroquine in treating COVID-19?

A: Yes, chloroquine was used to treat malaria till the parasites developed resistance and Artemisinin-based combination therapy was recommended by the World Health Organisation (WHO) for the treatment of malaria. No conclusive study has been carried out to prove the efficacy of chloroquine in treating COVID-19.

The dosage, the frequency of administration and the duration of use are important in order not to create more severe complications in our quest to quickly find a cure. Vaccines and medicines are mainly given to healthy young adults in communities; so it is important that they not only work but are also safe in order not to compromise the health and economy of nations.

Since infected individuals may be asymptomatic and testing everyone would not be feasible, assuming everyone to be potentially infected and observing the personal hygiene measures universally may be the best way to break the chain of infections.  In any case, positive cases are isolated; this is an enhanced social distancing.

We need to protect our immune system through regular exercise, healthy diet, intake of Vitamin C and Zinc, while smoking, stress and excess alcohol intake are discouraged.

With an annual net increase of between 700,000 and 800,000 in population and a dependency ratio of 76, according to our 2010 Population and Housing Census (PHC), achieving a decent accommodation, water and sanitation for all will be difficult, if family planning is not repositioned as a health, economic, development and poverty reduction intervention as in all developed countries.

Family Planning is necessary, mindful of the fact that undiscovered viruses exists, which may require a lockdown in future. Family Planning will make it easier to practise optimal social distancing in case of future epidemics.