Part 53--COVID-19: Precautions, Governmental Actions and Inactions [Part 7]

As we discussed in the previous six COVID-19 articles, it is utmost important to take all precautions and appropriate steps but without going overboard or getting panic, to reduce risks of the disease and its spread. Positive attitude and compliance with local regulations are essential to prevent new outbreaks. In the absence, second and subsequent peaks of outbreaks are inevitable. Healthcare and law enforcement staff are stretched to the maximum; they need a break and we need to comply with all guidance to prevent new outbreaks. 

Although it is a great inconvenience to the populous but adhering to preventative measures and following local laws in social distancing are essential. However, this must be done in a humane manner without causing panic. Only a fool would jump into a well to see how deep it is.  COVID-19 is not a common cold virus that to take granted for. 

Although 97% of those who recover from it, 3% still die. Presumably, many of these deaths could have been prevented if they strictly followed the basic public health guidelines, that are specific to the current pandemic. Kindly note that there are few duplications in some of the current articles; however, they are designed to reemphasise essential facts and the precautions that people should be taken.

The importance of washing hands with soap in running water:

The use of soap or detergents, rubbing hand (7 to 8 times, both sides) under running water for 20 seconds is very efficient in removing COVID-19 that are attached to fingers and hands. Alternative option is to an alcohol-based hand sanitizer, as used in hospitals; both are equally effective. However, if hands are truly contaminated or dirty, handwashing must be done first.

Wash hands thoroughly with soap and water, each time one returns home or to the workplace is essential. In addition to a envelop of lipid layer, COVID-19 has a protein spikes around it.  Consequently, it easily sticks to most surfaces, including fingers and hands. With the use of soap or any detergent with running water, lipid layer around the virus get weekend and damage, and COVID-19 will be released into water promptly. Thus, washing hands with any type of soap in running water for 20 seconds is a fundamental process for removing contaminants from the hands and to keep safe.

Avoid handshaking and use face masks:

Despite erroneous propaganda by politicians and the World Health Organization, the proper use of face masks is critical when you are going out of your home. Face masks are personal items and should not be shared with others, not even with any family members. Because of contaminations, wearing two masks is not recommended. 

Because hands are one of the most common sites to get dirty and contaminated with the virus, do not shake hands; instead, greet others verbally; say, Ayubowan or whatever used in your culture.  Some over the counter medications such as anti-inflammatory agents (e.g., ibuprofen) and herbal preparations could make the condition worse. Therefore, avoid taking such and any unnecessary or excessive medicines, other than those you are taking routinely, including vitamins and supplements.

There is no evidence to-date that taking angiotensin receptor backers (ARBs) for hypertension and to protect kidneys in those with renal impairment worsening the COVID-19 infections. On the contrary, it is likely taking ARBs will reducing the severity to the disease by reducing the viral load and pulmonary hypertension, thus, reduction of the incidence of acute respiratory distress syndrome (ARDS).  In fact, Colleges of Cardiology in several countries have now recommend not to discontinue, if anyone already on ARBS. Whereas, the effect of angiotensin converting inhibitor (ACE) is controversial. Nevertheless, you need to consult your own healthcare provider regarding this or any other medication.

Failure to take proper disease prevention actions:

Non-adherence to guidelines and local laws can be seriously consequential. One example of a failure to take disease prevention actions is that no country is taking public health-related steps to protect those who are leaving the country.  One hundred percent of the focus of health authorities is on those who are “arriving” from other countries. Why aren’t they protecting their own citizens who are going out of the country? This inaction makes no sense. 

It would have been much more effective to identify those potentially having COVID-19 before they leave home, to the airport. At least using a system, by questioning via telephone of their current health and a history of an exposure to a suspected or a persons infected with the virus, etc. Taking basic steps to measure temperature and review the history and symptomatology, as is done with those who are arriving at each entry point could be done at the airport, on every person prior to their departure from the country.  

However, isn’t that easier and safer for everyone to check potential passengers, before they leave home?  Author strongly advice to initiate a system of telephonic screening to be done at home via telephone, the day prior to their departure. The mentioned physical measures should be conducted with each passenger, at the entrance to in the airport. This is good for the person, the country of origin and the destination country. This is doable in smaller countries like Sri Lanka, Maldives, Singapore, etc., but impractical in larger countries with hundreds of airports, where half a millions of passengers travel, each day. 

Taking effective governments actions to prevent spreading the disease by its own citizens:

Now a day, everyone who is flying out of the country, have cell phones and access to social media. Government has the access to the obtain the passenger list including and their cell phone numbers via airline records. Thus, it is easy to set up an affirmative program to contact passengers via telephone, who are intending to travel on the following day prior to passengers turning up at the airport.

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Professor Sunil J. Wimalawansa, MD, Ph.D., MBA, DSc, is a physician-scientist, educator, social entrepreneur, and process consultant. He is a philanthropist with experience in long-term strategic planning and cost-effective investment and interventions globally for preventing non-communicable diseases [recent charitable work]. The author has no conflicts of interest and received no funding for this work.