Abstract
The scourge of COVID-19 continues its surge all over the world, engulfing as many as 213 countries in all continents. The total count of confirmed cases of Coronavirus infection has crossed 18.8 million taking a death toll over 0.7 million (5 August 2020). Having devasted Europe, mainly Spain, Italy, France and Germany, the pandemic travelled to the United States of America which is the most affected country with COVID-19 pandemic. The leading countries most affected are United States of America, Brazil, India, Russia and South Africa. The virus has affected 3.9 million people, claiming over 143,239 lives. Brazil has reported over 2.8 million cases with 96,326 deaths. The number of infected people has crossed 2.0 million mark with over 40,000 deaths in India. The new epicentre of the pandemic is South America where Brazil, Peru, Chile and Mexico are the most affected countries. The global trends suggest that the pandemic has reached African continent, with South Africa being the most affected country.
Most countries in the world have been under lockdown by restricting movement of people to prevent transmission of the disease. Use of face mask, social distancing and handwashing are promoted. People are confined in their homes, international flights are grounded all over, trains and public transport have halted, shopping malls and markets are closed, industries and business have come to a halt. Many persons have lost their jobs. Economy of most countries is devasted and the global average GDP is expected to go down by –2.4 per cent. In a country like India, lockdown resulted in migration of several million people from the metro cities and industrial towns to their native places in the eastern region of the country with insurmountable human sufferings and miseries. The migrants have posed a serious threat of spreading infection into the countryside in various states in India, which was essentially confined to urban areas.
Health systems are overstretched and finding it difficult to cope with the COVID-19 pandemic, with many health workers in-dispensed due to coronavirus infection. The systems have been overawed with the patients in the hospitals, leaving patients of other illness unattended causing excess mortality due to cardiovascular diseases, diabetes, chronic kidney disease, COPD and tuberculosis. The pandemic has changed the lifestyles and behaviours and business practices. Work from home is the new norm of working and use of digital technology is the new mode of interaction and meetings.
The key questions being asked are: Have we reached the peak? When the pandemic will finally stop? Epidemiological/mathematical models have by and large failed to answer theses seemingly easy questions. But it was difficult to predict as Coronavirus 2 was a new virus, little or no understanding of its natural history, no established treatment yet and so also availability of a vaccine. New theories of aerosol transmission are now making rounds.
Only the time-tested public health measures can help prevent spread of the virus: containing the source of infection, blocking the channels of transmission and protecting susceptible population. The key public health interventions include isolation of the test positive cases/clinically manifest patients, and quarantine of contacts. Social distancing is crucial for the prevention of spread of the virus. Awareness among people for practicing social distancing, use of face mask and handwashing will play an important role in containing the transmission of the virus. Creating herd immunity is another option to stop the pandemic, which could be achieved by either allowing virus to infect about 60 per cent population, or by immunising population with an effective vaccine. The first option would mean letting 60 million people die, hence, unacceptable. The second option is the vaccine against the new coronavirus, but it will take another 10–18 months to develop an effective vaccine specific to this virus. There is a fierce competition among countries and pharmaceutical companies to develop an effective vaccine. Several human clinical trials are at various stages of vaccine development.
Until then, the only options left are self-protection and safety, community awareness and implementation of public health measures.
The current issue of Journal of Health Management has attempted to bring out clinical, genetic, epidemiologic, public health, social and economic aspects of the global pandemic of COVID-19.