Health April 21, 2020
Mitigating the global impact of Covid-19 

By Sarah Cartledge - World Healthcare Journal

British Prime Minister Boris Johnson is currently recovering from Covid-19 at his country home Chequers outside London. He was the first global leader to be hospitalised in intensive care when his condition deteriorated following 10 days of self-isolation. He attributed his recovery after 48 hours that were ‘touch and go’ to the dedication of the National Health Service and two nurses in particular, one from New Zealand and the other from Portugal.

As world leaders wished him well, the British public learned two lessons. The first, that social distancing is vital at this stage in the global pandemic – clearly the PM had not been following his own advice. Secondly, that Covid-19 is a serious health crisis. All those who had been flouting the lockdown rules suddenly took heed and went back inside.

An exit strategy?  

Now, as the UK enters an extended period of lockdown it is looking to its European neighbours for guidance on exit. The Labour party is pushing for a formal exit strategy to be put in place, but it makes sense to see how Europe fares in the next few weeks. Spain, which has a death toll of more than 20,000, has just allowed factory and construction workers to return to work while Italy has also lifted its isolation a little as a reaction to the threatened social unrest after months of enforced confinement.

Austria has reopened some shops, with the use of face masks mandatory for shoppers and travellers on public transport. Norway has allowed its citizens to travel to their country homes, and the Czech Republic now permits people to travel abroad but they must enter a two week quarantine period on their return.

Meanwhile, Denmark has reopened its schools, despite the anxiety of many parents who feel their children may become guinea pigs for the strategy. Teachers are concerned they may catch the virus from children, who are thought to be more carriers than victims of coronavirus, while parents are worried that the illness may be brought home to vulnerable relatives.

Yet in Iceland, where they have carried out extensive testing, it has been discovered that a huge percentage of the population has already been exposed unwittingly to Covid-19 and, as a result, are potentially immune. A study by Icelandic scientists in the New England Journal of Medicine reveals 0.8 per cent of the population is infected with several strains and clades of the virus, supporting the concern that silent carriers spread the disease that has entered Iceland from different countries. So we have a lot to learn about this pandemic but more importantly, a lot to learn about living with it.

But given the current resurgence of cases in Singapore and Japan which lifted restrictions earlier than other countries, we also know that emerging too fast from lockdown can cause a new spike in cases.

Global co-operation 

If there is one overarching observation to come out of this strange time, it is that we are a single people in search of a solution to a life-threatening disease. It is not about pointing the finger – President Trump’s reference to the Chinese virus and his accusations of incompetence against the WHO seem ill-timed to say the least. Rather, we should all look at the lessons learned and aim to create a strategy to deal with similar outbreaks in the future.

The Chinese are sending planes with medical supplies to governments around the world including Ireland. Cuban doctors have travelled to Spain to help the beleaguered health system cope while Turkey, which now has a higher incidence total than Iran, has also contributed to the efforts of other countries, in particular sending much needed PPE to the UK. We need to work together to stop this pandemic from getting out of control.

The greatest concern at the moment is the spread across Africa, India and South America. In many developing countries health systems are in their infancy and their qualified professionals choose to work abroad. Other challenges abound – lack of infrastructure, lack of running water to wash hands, overcrowded homes where generations live together, and vast distances served by a handful of healthcare workers in difficult conditions.

In the Amazon, a teenage Yanomami boy has died, thought to be the victim of Covid-19 brought in by illegal loggers in this remote tribal area. The villagers are demanding the removal of the loggers but the Brazilian government has been slow to act on the threat of coronavirus and the Amazon remains at risk.

Other nations are under threat too. Pakistan’s Prime Minister Imran Khan has spoken of the issues surrounding lockdown where millions need to work to eat and provide for their families. He is currently allowing prayers in mosques for the holy month of Ramadan. In India, the overnight lockdown created huge armies of workers returning on foot to their villages sometimes hundreds of miles away, risking starvation in the meantime.

Each government has to balance the challenges it faces with the risk of never coming out of successive lockdowns. And how will we get back to normal? Will we ever be able to travel again? Europe is rightly concerned by the spread of Covid-19 in Africa, so close to its borders and it has pledged 15bn euros in aid to help African governments deal with the issue. “If we don’t solve the problem in Africa, we will not be able to solve the problem in Europe. Africa is of particular concern to us,” says Josep Borrel, the EU Minister for Foreign Affairs.

Some pundits have suggested an international council to put regulations in place that all countries will have to follow should another outbreak occur. But this requires communication and co-operation, along with a consolidation of the learning so far. We may well be three years away from understanding the trajectory of Covid-19, but we have to do all we can while we are in the epicentre to mitigate its impact.

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