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Abstract

The COVID-19 pandemic is exponentially growing. It is the defining global health crisis of our time and the greatest challenge since World War Two. Countries are racing to slow the spread of the virus by testing and treating patients, carrying out contact tracing, limiting travel, quarantining citizens, and cancelling large gatherings such as sporting events, concerts, and schools. The pandemic is moving like a wave. Some countries have effectively contained the pandemic, while others have been slow and the consequences of delay in responding to the challenge are obvious. Every day, people are losing jobs and income, with no way of knowing when normality will return. Nations need to act immediately to prepare, respond, and recover. Nations must focus on the procurement and supply of essential health products, strengthening crisis management and response, and addressing critical social and economic impacts. Researchers are working tirelessly to discover new life-saving medical innovations. The strategy is to develop diagnostic tools to quickly and effectively detect the disease in the first place, alleviating symptoms so that people who have disease experience milder symptoms, and lowering the overall mortality rate. One of the most promising leads on a COVID-19 vaccine is mRNA-1273. This vaccine, is being developed with extreme urgency, skipping straight into human trials before it was even tested in animals. The aftermath is likely to be something we have never witnessed. A new social order will emerge, a new structure of the society, a paradigm shift in human relationships and above all a new economic adjustment.
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Introduction
The COVID-19 or severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) pandemic is affecting 209 countries around the world
and two international conveyances affecting everyday life, disrupting
modern society on a scale that most living people have never witnessed.
The virus is highly transmissible spreading exponentially all over the
globe. People infected with SARS-CoV-2 might be spreading virus
without recognizing, or prior to recognizing, symptoms.COVID-19
is transmitted quite efciently. The average infected person spreads
the disease to two or three others — an exponential rate of increase.
There is also strong evidence that it can be transmitted by people who
are just mildly ill or even presymptomatic”.1 The virus is detectable
in aerosols for up to three hours, up to four hours on copper, up to
24 hours on cardboard and up to two to three days on plastic and
stainless steel. SARS-CoV-2 disproportionately affects older people
with underlying conditions. The insufcient testing or of a delay
between the onset of virus and its manifestation makes the exact
numbers of infected cases opaque. In EU/EEA countries, 30% of
diagnosed SARS-CoV-2 cases were hospitalised and 4% had severe
illness. Hospitalisation rates were higher for those aged 60years and
above. The older people are much more vulnerable to SARS-CoV-2.
Clinical presentations of SARS-CoV-2 range from no symptoms
to severe pneumonia; severe disease can lead to death. The basic
reproductive number (R0) of 2019-nCoV is estimated to be 1.4–3.9.
The R0 of SARS-CoV-1 in the absence of interventions was 2.3–3.7.
The SARS-CoV-2 may have jumped from bats to human. SARS-
CoV-2 is primarily transmitted from symptomatic people to others
who are in close contact through respiratory droplets, by direct
contact with infected persons, or by contact with contaminated objects
and surfaces. Shedding of the SARS-CoV-2 virus is highest in upper
respiratory tract early in the course of the disease. People may be
more contagious around the time of symptom onset as compared to
later on in the disease.
The incubation period for SARS-CoV-2, is on average 5-6days,
however can be up to 14days. Transmission from a pre-symptomatic
case can occur before symptom onset.
This Pandemic has broken health-care systems and adversely
affected economies. Health facilities and empty spaces are
overcrowded. This is a human tragedy that affects hundreds of
thousands of people. Nations are facing an enormous challenge to
contain widespread community transmission. SARS-CoV-2 has a
case fatality risk around 1%; this rate would make it many times more
severe than typical seasonal inuenza, putting it somewhere between
the 1957 inuenza pandemic (0.6%) and the 1918 inuenza pandemic
(2%).2
Some countries like China, South Korea, Singapore and Hong
Kong have effectively managed the pandemic. There is a lot to learn
from their successes. However, countries like the USA and India have
not done enough to prevent and control the community spread. The
USA has not responded promptly to the pandemic. The initial response
of the USA has been inadequate. It could have accurately tracked the
spread of the virus; hospitals could have executed their pandemic
plans, girding themselves by allocating treatment rooms, ordering
extra supplies, tagging in personnel, or assigning specic facilities
to deal with SARS-CoV-2 cases. Hospitals exceeded the maximum
handling capacity. There was obvious shortage of basic protective
equipment. There is shortage of hospital beds and the ventilators. The
result is, America was not prepared to manage COVID Pandemic.
The USA has maximum ventilators per 34 per 1000 population
and decided not to lock down; South Korea has minimum ventilators
J Cardiol Curr Res. 2020;13(2):4144. 41
©2020 Tabish. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and build upon your work non-commercially.
COVID-19 Pandemic: the crisis and the longer-term
perspectives
Volume 13 Issue 2 - 2020
S. A. Tabish
Department of Hospital & Health Administration, Sher-i-
Kashmir Institute of Medical Sciences, India
Correspondence: Dr. S. A. Tabish, Department of Hospital
& Health Administration, Sher-i-Kashmir Institute of Medical
Sciences, Srinagar, India, Email
Received: April 08, 2020 | Published: April 22, 2020
Abstract
The COVID-19 pandemic is exponentially growing. It is the dening global health
crisis of our time and the greatest challenge since World War Two. Countries are racing
to slow the spread of the virus by testing and treating patients, carrying out contact
tracing, limiting travel, quarantining citizens, and cancelling large gatherings such as
sporting events, concerts, and schools. The pandemic is moving like a wave. Some
countries have effectively contained the pandemic, while others have been slow and the
consequences of delay in responding to the challenge are obvious. Every day, people are
losing jobs and income, with no way of knowing when normality will return. Nations
need to act immediately to prepare, respond, and recover. Nations must focus on the
procurement and supply of essential health products, strengthening crisis management
and response, and addressing critical social and economic impacts. Researchers are
working tirelessly to discover new life-saving medical innovations. The strategy is to
develop diagnostic tools to quickly and effectively detect the disease in the rst place,
alleviating symptoms so that people who have disease experience milder symptoms, and
lowering the overall mortality rate. One of the most promising leads on a COVID-19
vaccine is mRNA-1273. This vaccine, is being developed with extreme urgency, skipping
straight into human trials before it was even tested in animals. The aftermath is likely to be
something we have never witnessed. A new social order will emerge, a new structure of the
society, a paradigm shift in human relationships and above all a new economic adjustment.
Keywords: coronavirus, pandemic, COVID-19, infectious diseases, social distancing,
vaccine, contact tracing, testing
Journal of Cardiology & Current Research
Review Article Open Access
COVID-19 Pandemic: the crisis and the longer-term perspectives 42
Copyright:
©2020 Tabish
Citation: Tabish SA. COVID-19 Pandemic: the crisis and the longer-term perspectives. J Cardiol Curr Res. 2020;13(2):4144.
DOI: 10.15406/jccr.2020.13.00472
(10/1000) but decided to lock down and strict testing and quarantine.
Italy too has minimum ventilators but did not quarantine strictly. It is
argued that it has mishandled the COVID-19 crisis to a substantially
worse degree. It may end up with the worst outbreak in the
industrialized world. Italy and Spain have been struggling to cope
with little success. Health infrastructure, essential medical supplies
and human resource being overstretched, rationing care to patients
who are most likely to survive, while letting others die, is being
practiced. America has fewer hospital beds per capita than Italy. ICU
beds will fall short to accommodate those who need it most.
A recent study3–5 suggests that “80% of those infected either are
asymptomatic or have mild symptoms, a nding that implies that
demand for advanced medical services might apply to only 20% of
the total infected. Of patients infected with Covid-19, about 15%
have severe illness and 5% have critical illness”. Overall mortality
ranges from 0.25% to as high as 3.0%.3-5 “Case fatality rates are much
higher for vulnerable populations, such as persons over the age of 80
years (>14%) and those with coexisting conditions (10% for those
with cardiovascular disease and 7% for those with diabetes)”.3 SARS-
CoV-2 is substantially deadlier than seasonal inuenza, which has
mortality of roughly 0.1%.4
According to a study “even if social-distancing measures can
reduce infection rates by 95 percent, 960,000 Americans will still
need intensive care. There are only about 180,000 ventilators in
the U.S. and, only enough respiratory therapists and critical-care
staff to safely look after 100,000 ventilated patients”.5 The risk of
severe disease associated with SARS-CoV-2 for people in the EU/
EEA and the UK is currently considered moderate for the general
population and very high for older adults and individuals with chronic
underlying conditions. Focus should be on protecting the most
vulnerable population groups from severe illness and fatal outcome
by reducing transmission in the general population and enabling the
reinforcement of healthcare systems.6 To contain the further spread of
virus and to mitigate the impact, some workable actions are required
that include slow the demand for ICU beds; safeguard risk groups;
protect healthcare workers; and minimise the export of cases to other
healthcare facilities and the community.
Critical care needs can be required for up to 15% of hospitalised
patients with SARS-CoV-2. Health professionals need proper training
on PPE use. Patients with mild clinical presentation, particularly
those who are not in a recognised risk group for developing severe
disease, can be managed at home with instructions to follow up if
symptoms deteriorate. “Patients presenting with respiratory distress
with increased need for oxygenation require management in hospital.
Patients in critical condition need specialised care, on average for
more than two weeks”.6 What the USA needs is social distancing,
large scale testing, aggressive contact tracing, PPE, it may halt the
wave of spread of pandemic.
Concerns & constraints
According to an analysis, “the government of India is showing
how not to handle a pandemic. The lockdown puts responsibility for
containing the outbreak on citizens, instead of instituting a robust
ofcial support system. It is to the greater disadvantage of the most
vulnerable in society. The government is offering little in the way
of a safety net. Governments in Britain, Spain, and Germany have
offered stimulus plans of up to 20 percent of GDP, India’s amounts to
less than 1 percent of its GDP. It provides no help for day laborers or
other workers in similar unorganized sectors. It contains no measures
for migrant workers. For the poor, work has dried up entirely, and
so those migrant workers who could seek to beat the lockdown
by heading home in huge numbers”. Proper planning ought to have
been done before ordering lockdown of 1.37billion people. Safety
measures (social security) for poor, disadvantaged and weaker sections
of society should have been in place prior to lockdown. Hunger can
kill more people. Other diseases that kill millions a year also need
attention. Immunization programme cannot be delayed for a long
time. Food, Shelter, Cash to sustain life is an inescapable necessity.
India has not been testing enough people at just 10.5 per million
residents as compared to South Korea, that has conducted more than
6,000 tests per million residents. That private laboratories are allowed
to charge $60 per test—remember, just $7 a month has been offered
as income support for some residents—means signicant barriers to
conrmation and treatment remain in place. Contact tracing has been
slow. “Measures such as self-quarantines and social distancing are
impractical in a country where much of the population lives in dense
clusters in overcrowded megacities. Whereas the WHO recommends a
ratio of one doctor for every 1,000 patients, India has one government
doctor for every 10,000, according to the 2019 National Health
Prole. A 2016 Reuters report noted that India needed more than
50,000 critical-care specialists, but has just 8,350. India’s health-care
system is in no position to cope with an avalanche of patients with a
contagious respiratory infection in the manner that China and Italy
have been doing”.7
Aggressively testing, isolating conrmed cases, and performing
contact tracing is absolutely essential if India wants to prevent further
spread of SARS-CoV-2 in the community.
Another priority area is the most vulnerable population groups
from severe illness and fatal outcome by reducing transmission in
the general population and enabling the reinforcement of healthcare
systems. To mitigate the impact of the pandemic some important
measures need to be taken: social distancing should be implemented
meticulously and with active community engagement, can contribute
to decreasing the spread of SARS-CoV-2 in the community. Layered
application of social distancing measures like closure of, workplaces
and educational institutions; restrictions in movement and social
gatherings) can play a signicant role in reducing community
transmission if strictly adhered to.
Critical care needs can be required for up to 15% of hospitalised
patients with COVID-19. Long-term care facilities should implement
infection prevention and control measures. Patients in critical condition
need specialised care, on average for more than two weeks. Capacity
for nCoV laboratory testing at high levels is essential. Shortages in
testing capacity need to be anticipated and addressed, taking the needs
for testing of other critical diseases into account.
To prevent the scarcity of medical resources, supplies like personal
protective equipment or high-ltration N-95 masks for health care
workers have to be arranged on a top priority basis. “Interventions like
testing, PPE, ICU beds, ventilators, therapeutics, and vaccines should
go rst to front-line health care workers and others who care for ill
patients and who keep critical infrastructure operating, particularly
workers who face a high risk of infection and whose training makes
them difcult to replace. These workers should be given priority
not because they are somehow more worthy, but because of their
instrumental value: they are essential to pandemic response”.8 If
physicians and nurses are incapacitated, all patients will suffer greater
mortality and years of life lost.
COVID-19 Pandemic: the crisis and the longer-term perspectives 43
Copyright:
©2020 Tabish
Citation: Tabish SA. COVID-19 Pandemic: the crisis and the longer-term perspectives. J Cardiol Curr Res. 2020;13(2):4144.
DOI: 10.15406/jccr.2020.13.00472
Is rationing justied?
Rationing of care is currently being debated to make it justiable
to give priority to maximizing the number of patients that survive
treatment with a reasonable life expectancy and to regard maximizing
improvements in length of life as a subordinate aim. “Operationalizing
the value of maximizing benets means that people who are sick but
could recover if treated are given priority over those who are unlikely
to recover even if treated and those who are likely to recover without
treatment. Because young, severely ill patients will often comprise
many of those who are sick but could recover with treatment, this
operationalization also has the effect of giving priority to those who
are worst off in the sense of being at risk of dying young and not
having a full life”.9
Governments must protect health professionals in a fragile health
system. Without them nothing signicant can be achieved so for heath
of the nations is concerned.
Socio-economic impact
It is argued that most countries are not able to achieve the same
rapid control that China managed. “A global slowdown would
affect small and mid-size companies more acutely. Less developed
economies would suffer more than advanced economies. Given the
relatively quick economic restart in China, many companies are
focused on temporary stabilization measures rather than moving
supply chains out of China moving supply chains out of China.
COVID-19 is also serving as an accelerant for companies to make
strategic, longer-term changes to supply chains—changes that had
often already been under consideration”.6 Poor, and particularly
the migrant workers are worst-hit. In India, they are struggling for
food, shelter and money. Many who left metro cities are stranded
at borders and this is emerging as a humanitarian crisis. Lockdown
without planning ads to the miseries that is otherwise avoidable. A
perfect strategy to deal with the pandemic is possible. According to
the analysis by the UN Department of Economic and Social Affairs
(DESA), the global economy could shrink by up to 1 per cent in 2020
due to the corona virus pandemic Fitch Ratings on 3 April, 2020 has
slashed India’s growth forecast for the current scal to a 30-year
low of 2 per cent, from 5.1 per cent projected earlier, as economic
recession gripped global economy following the lockdown.
The psychology of pandemics
The potential of the pathogen to spread is represented by R0
pronounced as “R naught” and referred to as the Reproductive number.
It is dened as the number of people who will get the infection from
one infected person in a susceptible population not protected by
vaccination or intervention. R0 of more than one leads to an epidemic
when R0 equal to one the disease is alive and stable while R0 of less
than one leads to the decline of disease and control of infection. R0
is calculated from the Force of infection and the infectious period of
the pathogen. All our efforts today (lockdown, social distances, hand
washing, masks, etc) are interventions to alter R0 of the SARS-C0V-2
so that epidemic curve attens or declines. SARS-CoV-2 infection
has RO of around 2.0-2.5, meaning one COVID-19 patient can infect
a maximum of 2 to 3 persons. The reasons why somebody becomes a
Super-spreader are many and ill-understood. It may be related to his
or her viral load, her social activities while infected or other unknown
factors.
It is becoming obvious in certain countries that after the pandemic,
people who recover from COVID-19 infection might be shunned or
stigmatized. Health-care workers will take time to heal. People who
went through long bouts of quarantine will carry the scars of their
experience. Communities are nding new ways of coming together,
even as they must stay apart. A new social order may emerge after the
pandemic is over. The Covid-19 pandemic has attened the world like
never before. The pendulum has swung away from nuclear arsenal to
life saving equipment’s. Attitudes to health may also change for the
better. History may have to be re-written.
Diseases have destabilized cities and societies many times over.
The socio-economic aspects have to be addressed. Whether through
accumulating herd immunity or the long-awaited arrival of a vaccine,
the virus will nd spreading explosively more and more difcult. To
contain such a pathogen, nations must develop a test and use it to
identify infected people, isolate them, and trace those they have had
contact with. That is what South Korea, Singapore, and Hong Kong
did to tremendous effect.
Scientists can develop antiviral drugs. Hospitals can stockpile the
necessary supplies. Testing kits can be widely distributed to catch the
return of virus as quickly as possible.
Research
Presently no denite treatment for SARS-CoV-2 is available. A
few drugs like chloroquine and hydroxychloroquine are being used
(in India) but they are not evidence-based. Similarly scientists are
pinning hope on PrEP and PEP (Pre- and Postexposure Prophylaxis)
to reduce infections. Drug discovery is of paramount importance for
the researchers. Trials of drugs to prevent SARS-CoV-2 infection
have started in health care workers in the USA, Spain and some other
countries.
Blood from infected and recovered SARS-CoV-2 patients
(Convalescent sera) is being explored as a possible means to ght this
human python. Possibility should be explored and it needs to full
several conditions and has been tried in the past for several infections.10
Recent modelling of the basic reproductive number (R0) from Italy
estimate R0 between 2.76 and 3.25. Researchers from Lombardy who
analysed the early phase of the outbreak in their region reported a
reduction in R0 shortly after the introduction of mitigation measures.
A recent review of 12 modelling studies reports the mean R0 at 3.28,
with a median of 2.79. R0 is proportional to the contact rate and will
vary according to the local situation. Further research is needed to
get a more accurate estimate of R0 in the various outbreak settings.11
Nations need to build a system that can develop safe, effective
vaccines and antivirals, get them approved, and deliver billions
of doses within a few months after the discovery of a fast-moving
pathogen.
Surge capacity plans must be up-to-date in health facilities and
launched in expectation of the high demand for care of patients with
moderate or severe respiratory distress. Designating and establishing
treatment facilities for sub-intensive and intensive care needs is a
necessity.
“Cohorting may help conserve PPE and reduce the risk of
transmission. The minimum requirements for units designated for
the management of conrmed SARS-CoV-2 patients include staff
adequately trained in infection prevention and control and safe
diagnostic evaluation and management of SARS-CoV-2 patients,
the availability of appropriate PPE, adequate laboratory support,
and appropriate cleaning and waste management procedures.”6 An
estimated 10–15% of mild cases progress to severe, and 15–20% of
COVID-19 Pandemic: the crisis and the longer-term perspectives 44
Copyright:
©2020 Tabish
Citation: Tabish SA. COVID-19 Pandemic: the crisis and the longer-term perspectives. J Cardiol Curr Res. 2020;13(2):4144.
DOI: 10.15406/jccr.2020.13.00472
severe cases become critical according to data from China. Home care
could also be considered for symptomatic patients no longer requiring
hospitalisation, or in a case of informed refusal of hospitalisation.12,13
The recommended diagnostic test for SARS-CoV-2 infection is
by viral RNA detection with nucleic acid amplication tests (NAAT),
such as RT-PCR. In areas with widespread community transmission
of SARS-CoV-2 and when laboratory resources are limited, detection
by RT-PCR of a single discriminatory target is considered sufcient.
Conrmatory testing should be performed only for specimens if the
rst result is technically not interpretable.
Laboratory staff should get proper training in laboratory diagnosis
of SARS-CoV-2. Point-of-care testing (POCT) represents a set of
technologies that can lead to the rapid detection of infectious diseases
and inuence the way patients are treated for suspected infections.
Conclusion
The SARS-CoV-2 pandemic has the potential to create
devastating social, economic and political crises that will leave
deep scars. It will require all of society to limit the spread of
SARS-CoV-2 and to cushion the potentially devastating impact it
may have on vulnerable people and economies. A global response
now is an investment in our future. Widespread testing is the most
important diagnostic tool to for prevention and control of virus in the
community. Inexpensive test kits that offer quick results will be key
to curbing the outbreak.
Action plan should include: provide food, shelter and some cash to
poor labourers, migrant workers, daily wagers. Requisition all private
spaces, community halls, vacant school buildings, stadia, private
Hospitals and Nursing Homes etc for isolation and/or housing migrant
workers Mobile health teams should be deployed to those areas
while health facilities are non-existent or weak. Public Distribution
System has to be made effective and responsive. Reassure people
a stable environment. Train basic health workers in SARS-CoV-2
(in areas where testing facilities are not available) so that they can
report concerned authorities, a case as and when they notice it for
proper treatment. Manufacture Rapid Testing tools, Ventilators and
PPE at a large scale. We need to save lives now while also improving
the way we respond to outbreaks in general in future. It needs a
methodological and human response. Moreover, special attention
must be paid to people living in conict zones. The aftermath of this
once-in-a-century pandemic is likely to change the global order. Life
will not be same after the pandemic is over. Changes in perceptions,
beliefs, values, and human understanding will make an altogether new
world. New roles and responsibilities in changing world will emerge.
Acknowledgment
None.
Conicts of interest
There were no conicts of interest during the study.
Funding source
None.
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... That is, effective treatment for the virus is not available [8]. Currently, there is no available vaccine against SARS-CoV-2 [13]; no definite treatment for SARS-CoV-2 is available [14]. The complete clinical classification of the virus is not yet fully understood [15] but enhanced surveillance and further investigation are ongoing [16]. ...
... In fact, it is already having negative impacts on almost every sector in the society. Some of these negative impacts on the society have been reported [1,14,17,[22][23][24]. Thus, concerted efforts with quick and active responses from major stakeholders in the world in fighting the virus become important. ...
... Currently, no scientifically, medically or clinically approved vaccine or drug has been discovered for its permanent treatment [12]; no definite treatment for SARS-CoV-2 at the moment [14], no clinical treatments or prevention strategies are available for any human coronavirus [30]. Though, trials of drugs to prevent SARS-CoV-2 infection have started in some countries in the world such as USA, Spain, etc. [14]. ...
Article
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Abstract The outbreak of COVID-19 pandemic in the world especially in African continent and Nigeria in particular has created negative effects on humanity. Continuous holding on to some misconceptions about the reality of the virus among people may create further problems for humankind. However, very few studies particularly in Nigeria have actually considered the implications of these misconceptions about the disease in relation to its daily increases; coupled with the fact that many people still hold on to some of these misconceptions in the country. Therefore, this study examined the implications of some common misconceptions among people about COVID-19 pandemic in relation to its daily increases in Nigeria. This study has documented some of the most common misconceptions about COVID-19 pandemic among few individual persons - both male and female in a neighbourhood area of Ibadan in southwestern Nigeria. These include: “it is white people disease”; “it is an imported disease”; “it is the disease of the wealthy people”; “incessant heat in Nigerian environment will destroy the disease (i.e. hot weather)”; “poor people cannot contract it”; “maintaining physical distancing practice is unnecessary”; “taking local herbs will destroy it”; “taking hot drinks (local gins) will destroy it”; “wearing of face masks is not necessary”; etc. both in rural and urban areas. Daily increase in the cases and fatalities of the virus in the country has been suggested in this study to be as a result of tenaciously holding on to these belief-systems among people. Virtually, all sectors in the country such as health, economy, transportation, agriculture, education, security, politics, religion, family, sport, entertainment, etc. have been seriously affected and still being threatened by the virus. Consequently, the negative impacts have been enormous on people’ jobs/works, businesses, family life and social relations thus creating more harms than benefits. Therefore, positive change in people’ health-related behaviours becomes imperative through effective and active public enlightenment and awareness creation with strict compliance to the prescribed preventive measures being put in place by the key stakeholders regarding the virus. This will go a long way in influencing positive health-related behaviours among people, getting rid of some misconceptions about the disease that may trigger larger community transmissions as the efforts to discover new vaccines or drugs for COVID-19 pandemic treatment continue. Keywords COVID-19 pandemic, Virus, Disease, Misconceptions, Effect, Health belief-systems, Nigeria Abbreviations COVID-19: Coronavirus Disease 2019; SARS-CoV2: Severe Acute Respiratory Syndrome Coronavirus 2; SARSCoV: Severe Acute Respiratory Syndrome CoV; MERSCoV: Middle East Respiratory Syndrome CoV; CoVs: Coronaviruses; nCoV: novel Coronavirus; NCDC: Nigeria Centre for Disease Control; WHO: World Health Organisation
... The USA, UK, and India were initially slow that resulted in fast spread. There have also been problems of supply chain (inadequate PPEs, ventilators, oxygen and drugs) and shortage of health facilities like ICUs, beds, etc [5][6][7]. As the virus spreads, even the higher testing capacity has been strained, and state and local governments are hitting their limits and running low on supplies. ...
... Millions of jobs have already been lost, millions of livelihoods are at risk, and an estimated additional 130 million people will be living in extreme poverty if the crisis persists. The unprecedented economic shock generated by the global health emergency has already sharply exposed the global economy's pre-existing weaknesses, severely setting back development progress around the world [5][6][7]. ...
... COVID-19 is a fastevolving pandemic. COVID-19 is emerging as a major public health threat leading to a global crisis that is unprecedented and extraordinary [6,7]. Around the world, more than 1.5 billion children are impacted by school closures. ...
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Stepping into the year 2021 is not without burden of inheritance. During the first half of 2020 SARS-CoV-2 rendered the entire human population speechless, motionless and helpless. It exposed the weak public health systems, fragile disaster management mechanisms, complacency of governments and lack of effective leadership in many countries. Globally, these are the unprecedented times, unimagined and unthought-of. The deadly virus around is forcing people all over the world to make unexpected and drastic shifts in their way of life to keep themselves safe. We are living on the edge. Let us work together to preserve, enrich, and enlighten it. The COVID-19 pandemic highlights the need to protect people from health emergencies, as well as to promote universal health coverage and healthier populations to keep people from needing health services through multisectoral interventions like improving basic hygiene and sanitation. Perhaps life will never return to what it was before. We should make it safer by being better prepared for future pandemics. Vaccine is probably the only hope to contain and prevent SARS-CoV-2 virus. What is crucial for the global community is efficacy, safety, affordability and accessibility of vaccine. Equity is of paramount importance. COVID 19 will stay for decades. It has left scars on all humans. Though we can't undo the damage we should build a strong recovery, we must seize the opportunity for change. Let us rise to the responsibilities of the New World-a world our children and their children inherit-a safer, more resilient and more sustainable.
... Some countries implemented good health data management/epidemiological databases, declared a state of emergency, imposed internal travel restrictions, implemented lockdown policies and followed decentralised communication as shown in Table 2. International travel restrictions [105,106] Improving health facilities [107] Strict quarantine measures [108][109][110] Tracking and testing [47,108,[111][112][113] Built new hospitals for the treatment COVID-19 [110] Building up advisory systems and Creating public awareness [47,114] Stoppage of Non-essential businesses [108,112] Strengthening Government services [115,116] Restriction on mass gathering [108,112,116] School and university closure [108,109,112,116] Curfew [109,112,117] Health data management/ epidemiological data base [47, 108,114] State of emergency [108] Internal travel restriction [112] Lockdown policy [111,112,[117][118][119] Decentralised communication [47] community to be proactive, sharing of responsibility [120,121] Stakeholders and clinical manifestation of COVID-19 [45,122] While others made the community be proactive, coordinated the works with clear role clarity, coordinated different policies, shared responsibilities and implemented effective public health measures. Some connected with their stakeholders by establishing mutual trust and through clinical manifestation to manage COVID-19 [40,45,47,51,56,60,68,[105][106][107][108][109][110][111][112][113][114][115][116][117][120][121][122][123][124][125][126][127][128][129][130][131][132]. ...
... The government should recognise the role of local international non-governmental organisations (INGOs) to the pandemic response and encourage timely provision of medical supplies and hygiene kit to individuals. The government should focus on the provision of social support and care to appropriate communities and vulnerable populations, co-ordination of funding activities and volunteers, R&D in life-saving medical innovations and to Test, Test and Test again the people in order to bring COVID-19 under control [40,45,48,51,56,60,68,69,[123][124][125][126][127][128][129][130][133][134][135][136][137][138][139][140][141][142][143][144][145][146][147][148][149][150][151]. ...
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The coronavirus disease 2019 (COVID-19) pandemic is affecting society’s health, economy, environment and development. COVID-19 has claimed many lives across the globe and severely impacted the livelihood of a considerable section of the world’s population. We are still in the process of finding optimal and effective solutions to control the pandemic and minimise its negative impacts. In the process of developing effective strategies to combat COVID-19, different countries have adapted diverse policies, strategies and activities and yet there are no universal or comprehensive solutions to the problem. In this context, this paper brings out a conceptual model of multistakeholder participation governance as an effective model to fight against COVID-19. Accordingly, the current study conducted a scientific review by examining multi-stakeholder disaster response strategies, particularly in relation to COVID-19. The study then presents a conceptual framework for multistakeholder participation governance as one of the effective models to fight against COVID-19. Subsequently, the article offers strategies for rebuilding the economy and healthcare system through multi-stakeholder participation, and gives policy directions/decisions based on evidence to save lives and protect livelihoods. The current study also provides evidence about multidimensional approaches and multi-diplomatic mechanisms during the COVID-19 crisis, in order to examine dimensions of multi-stakeholder participation in disaster management and to document innovative, collaborative strategic directions across the globe. The current research findings highlight the need for global collaboration by working together to put an end to this pandemic situation through the application of a Multi-Stakeholder Spatial Decision Support System (MS-SDSS).
... İnsanlar bu pandemi krizinde ya sağlığını kaybetmekte ya işini ve kaybetmekte ya da gelirlerini kaybetmektedirler. COVID-19 pandemi krizine karşı olası daha kötü sonuçlar için hazırlık yapılması, alternatif çözüm yollarının üretilmesi, zamanında yanıt verilmesi ve iyileşmenin hızlandırılması için derhal harekete geçilmelidir (Tabish 2020). Ülkeler, interaktif kriz yönetimi ile krizi erken algılama, hazırlık ve tedbir alma aşamalarından oluşan proaktif kriz yönetimi ile birlikte hasar önleme ve iyileştirme aşamalarından oluşan reaktif kriz yönetim uygulamalarını içeren interaktif kriz yönetimi (Tağraf ve Arslan, 2003: 152;Köroğlu, 2018: 21) sayesinde başarılı olabilecektir. ...
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Tüm dünyada yaşanan COVID-19 pandemisi, insanların sağlığını ve sağlık sistemlerini derinden etkilemiştir ve ülkelerin çok ciddi bir krizle karşı karşıya kalmasına neden olmuştur. Bu çalışmada, dünyada ve Türkiye'de salgınla mücadelede en ön saflarda yer alan olağanüstü koşullarda sağlık hizmeti sunmaya çalışan serbest eczacıların, COVID-19 pandemisi ile mücadelesindeki kriz yönetimi uygulamalarının değerlendirilmesi amaçlanmaktadır. Bu bağlamda, Türk Eczacılar Birliği 11. Bölge Diyarbakır Eczacılar Odası'na bağlı serbest eczacılarla yarı yapılandırılmış görüşmeler yapılmıştır. Örneklem seçiminde basit tesadüfi yöntem kullanılmıştır. Yarı yapılandırılmış görüşmelerdeki yer alan sorular literatürdeki çalışmalardan, haberlerden ve kurumların resmi yazılarından oluşturulmuştur. Çalışmanın bulgular bölümünde kamu kurum ve kuruluşları dahil olmak üzere COVID-19 pandemi krizi sırasında alınan destek ve yardımlar, eczane yöneticilerinin aldığı kararlar, eczacıları ve eczane personelini virüsten koruma ve korunma yolları, hasta ve tedarikçilerin ağırlanması, tıbbi ürünlere yönelik artan talebi karşılama yöntemleri, eczacılık uygulamasının kapsamının genişletilmesi ve toplumu bilgilendirme ile ilgili etkinliklere yer verilmiştir. Çalışma sonucunda ülkemizde COVID-19 pandemisine karşı uygulanan faaliyetler değerlendirildiğinde, proaktif kriz yönetiminden ziyade reaktif kriz yönetiminin uygulandığı tespit edilmiştir. Ayrıca, bulgular doğrultusunda, interaktif kriz yönetimi çerçevesinde, gelecekte yaşanabilecek diğer pandemi krizlerinin daha etkin ve verimli yönetilmesine yönelik öneriler geliştirilmiştir.
... The World Health Organization (WHO) announced COVID-19 as a public health emergency and international concern on 30 January 2020 [2]. The COVID-19 pandemic has made a global health problem that has had a big impact on the way people perceive world and everyday lives [3], [4]. ...
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During COVID-19 pandemic, social media has become a basis for information deployment, it has the potential to change people opinion and solve many issues in this situation. Based on Protection Motivation Theory (PMT), threat and coping appraisal were predictors to behavioral responses in pandemics. This study aimed to analyze the impact of social media intervention in adult population during COVID-19 pandemic based on PMT. This review was created using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and data collection from electronic databases such as Pubmed, Mendeley app, Europe PMC, Cochrane Databases, Science Direct, and Wiley Online Library. Inclusion criteria consists of English studies, studies related to the topic and match with required variables. There are five cross-sectional studies involving a total of 2.448 participants that were published in 2020. Among all categories based on included studied, it was shown that cyberchondria, perceived severity and perceived vulnerability are predictors in social media, related to behavioral responses during COVID-19 pandemic. Reducing information overload, related to cyberchondria, via the clear structuring and communication of reliable health information is needed. Hence, educating people on responsible and healthy social media use could help alleviate the observed negative consequences from perceived severity and vulnerability.
... The pandemic is moving like a wave. Some countries have effectively contained the pandemic, while others have been slow to react, and the consequences of such delay in responding to the challenge are obvious.40 Elaborating further, he states that the modern world is becoming a viral superhighway. ...
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The COVID crisis in India has been very harsh. The country of 1.4 billion had passed over 28 million Covid-19 infections and over338, 000 deaths. Even government figures are likely underestimated due to problems with testing and reporting in the country. Reasonable estimates due to under reporting and lack of testing put these figures at three times higher. The total deaths may reach 1.7m by September 2021. The situation is bad in the main cities, but also that it is worse in the poorer and rural areas where lack of healthcare resources and the availability of the vaccination programme have made those populations most vulnerable to the disease. B.1.617 is now being seen as three variants of interest, B.1.617.1, B.1.617.2 and B.1.617.3, the middle one of which officially became a variant of concern (VOC). This variant seems more transmissible than 'wild-type' SARS-CoV-2. In traumatised India, saving lives has become the highest priority to be achieved by vaccinating 70 per cent of the adult population or 654 million people. Over 200m population have been vaccinated. India's monthly COVID vaccine manufacturing capacity is about 60-65 million doses against the final requirement of 1.45 billion doses to cover 70 per cent adults. India has been chronically underspending on health, and Covid-19 has put in stark focus the damage that can do. Investing huge amounts of money on health is crucial. India's health system is on the brink of collapse. Hospitals across the country are running out of oxygen supplies, ventilators and beds. Politics has played and continues to play a big part in the spread of the virus but it is a situation that needs a global approach.Tiding over a pandemic requires detailed preparation at multiple levels on the part of the State.
... This study claims that public health has unsuccessfully convince politicians to take quick action on prevention of transmission or get ready for necessary treatment arrangements. Several studies stated that the structure and capacity of countries exhausted healthcare system are now mostly guiding the response to this epidemic and most likely it will remain doing the same until services that help local communicable disease control are restored and work cohesively (35,36,37). ...
Article
Background: In February 2020, world health organization has announced coronavirus outbreak (COVID-19) as a world pandemic. COVID-19 vaccines have recently been developed and approved by many countries for immediate distribution and use to contain the disease transmission and control the pandemic, however, the world is still at very early stages of ensuring vaccines’ effectiveness and their accurate positive impact on bringing COVID-19 pandemic under control. Therefore, using social distancing and behavioral measures to reduce the transmission of the virus within the residents are continued to be important tools in lessening the consequences of this pandemic. As a result, social distancing measures are employed globally and have been an efficient tool in reducing the comprehensive virus spreaders. Objective: This study is a systematic review to evaluate the effects of social distance measure such as isolation, quarantine for decreasing the spread of COVID-19 during the pandemic era 2020. Methodology: A systematic review is performed in accordance with guidelines for best practice. Literature searches is done using online databases sources. Databases includes Medline, Web of Science, Embase, alongside relevant pre-print servers. PRISMA-P checklist is used in the planning of this study from 1st March to December 2020. The study examines the evidence-based guidelines for community protection issued by different health authorities affecting COVID-19 pandemic and compare the published articles from different countries. A narrative synthesis, using thematic analysis, is performed for the included studies. The study also offers a descriptive numerical summary using risk ratios (RRs), mean differences (MD), standardized mean differences (SMD). Conclusion: This study may expedite the systematic advancement of behavioral interferences to increase social distancing measures importance. Moreover, this study could improve the literature on emphasizing the major social distancing measures in influencing COVID-19 in public health policy and interventions. Keywords: COVID-19, Pandemic, Prevention, Infection, Coronavirus, SARS-CoV-2, COVID-19, Protection, Social distance, Transmission.
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Background: The mental health and well-being have been severely impacted by the COVID-19 crisis. People are distressed due to the immediate impacts as well as the consequences of physical isolation, which could have lasting effect on overall well-being. The study aimed to assess the psychological effect of the pandemic on the general population of India using COVID-19 specific scales. Method: An online, cross-sectional study was conducted from 20th June 2020 to 4th July 2020 on persons of both sexes and aged 18 years or more. A convenient sampling method was used for recruiting participants. An online Google form was designed and distributed using social media platforms. The psychological effect of the pandemic was assessed using validated scales of coronavirus anxiety scale, obsession with COVID-19 scale, and fear of COVID-19 scale respectively. Result: The study received responses from 2004 participants from 31 states and union territories of India. The overall prevalence of psychological disorder due to COVID-19 was 53.3% (n=1068). The prevalence of anxiety was found to be 3.29% (n=66), obsession 13.47% (270) and fear 46.9% (1045). Around 2.8% (55) of the participants suffered from all three psychological disorders. Pearson correlation test showed a significant positive correlation between all the three psychological morbidities. Conclusions: The study findings showed high prevalence of mental health problems among Indian population during the COVID-19 outbreak with a positive correlation between them.
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The world is engaged in containing the COVID Pandemic and controlling further spread and deaths. The global spread of the virus has overwhelmed health systems, and caused widespread social and economic disruption. Some nations have done a better job than rest of the world. The global spread of the virus has overwhelmed health systems, and caused widespread social and economic disruption. There is a strong case that COVID-19 could be with us in one way or another until a vaccine comes on the market or herd immunity is achieved. A long crisis, could stretch the international order to its breaking point. The virus has succeeded in confining almost all human beings in their homes. Balancing act between public health crisis and complex societal implications is an inescapable necessity. The pandemic will alter the world forever. An economic slowdown, severe recession, plummeting revenue, increased expenditure, and mental health issues could be the emerging challenges. There will be increased confidence in technology and nations will invest more in public health. We are passing through fragile and critical times in history. People around the world can prevail in response to this extraordinary challenge. Investing in public health, preparedness, and relying on science will bring a better future. Think of one world, one humanity to shape and secure our future.
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We estimated the case-fatality risk for 2019 novel coronavirus disease cases in China (3.5%); China, excluding Hubei Province (0.8%); 82 countries, territories, and areas (4.2%); and on a cruise ship (0.6%). Lower estimates might be closest to the true value, but a broad range of 0.25%-3.0% probably should be considered.
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Teaser: Our review found the average R0 for 2019-nCoV to be 3.28, which exceeds WHO estimates of 1.4 to 2.5.
Responding to Covid-19 -A Once-in-a-Century Pandemic?
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