Wednesday 25 March 2020

Combatting the Novel Coronavirus (COVID-19): Use IPP mnemonic (Part 1)

Novel Coronavirus. It’s a global pandemic ravaging the world. It started in December, 2019 in a city named Wuhan in China, and then the disease spreads rapidly across the globe. In order to avoid discrimination, the World Health Organization (WHO) named it Coronavirus Disease 2019, shortened as COVID-19. The disease is caused by a virus named SARS-CoV2. Currently, according to the worldometers.info (March 24, 2020, 21:30 GMT), total cases of Coronavirus worldwide is 417,663. Total deaths stand at 18,605, while the number of persons who have recovered is put at 108,312.

The disease has spread to Nigeria. The index case (first case) in Nigeria was a 44-year-old Italian man who was diagnosed of COVID-19 on the 27th of February, 2020. Since then, the total number of confirmed cases in Nigeria has risen to 44 (latest tally released by ncdc.gov.ng as at 6:15pm, 24th March, 2020).

COVID-19 is a viral infection and viruses, unlike bacteria and fungi, are notoriously difficult to treat. For example, take HIV. It took years to get effective HIV medications. However, this virus has an important difference when compared to HIV. While HIV is spread by blood and bodily fluids, COVID-19 is spread mainly by respiratory droplets. That means an infected person spreads it by coughing or sneezing. This mode of transmission makes this Coronavirus spread quite rapidly. Currently, there is no effective or approved medicine or vaccine that can be used to combat COVID-19. The treatment of patients is largely supportive, meaning that you treat the symptoms: if the patient has fever, you treat the fever, if he/she has difficulty in breathing, you treat that, with the hope that the person can eventually make enough antibodies that can overcome the disease.

It most be noted that 80% of those who have the disease will experience no or mild symptoms. So, someone can have the infection without knowing he or she has it. Such an individual can transmit the virus to others, even though he/she feels just fine. However, most of the transmissions are caused by persons who are symptomatic. The commonest symptoms are fever, cough and difficulty in breathing. Now, of the remaining 20% (remember we said 80% will do well even when infected), about 15% will require admission to the hospital, while 5% will be so sick that they have to be admitted for intensive case in ICUs (intensive care units). As at March 3, 2020, WHO put the case fatality rate at 3.4%. That means, if 100 persons were to get infected, about 3 to 4 persons may die from the disease.

Majority of deaths occur in the elderly, those aged 60 years or more. Also, many of those who die have what we call an underlying condition or comorbid illness. What that means is that many of the patients who succumbed to COVID-19 have other diseases, chronic illnesses, before they contracted the Coronavirus. Examples of these chronic illnesses include hypertension, diabetes, cancer, etc. These illnesses tend to weaken the immunity of these patients, and that makes them much more vulnerable to the devastating effects of the Coronavirus. That said, people younger than age 60 still get infected, still get sick and still die from the disease, just not as high as the rates seen in the elderly populations. More importantly, young persons are capable of transmitting it to others. So, if you are young, don’t think that you are scot-free and that you can do whatever you want. Don’t be selfish! Think of your health and that of others as well.

Interestingly, children younger than 19 years do quite well when infected. The number of children that die or get very ill with the Coronavirus is low. Some studies report no deaths amongst children who are infected. It is a fortunate development and researchers are intrigued by it. Research is been done to find out why children are largely spared. However, everyone is capable of transmitting the virus to others. Let’s always remember that.

Now, seeing that the best strategy we have in dealing with the Coronavirus is prevention, what can we do in this regard? I have coined the mnemonic IPP. It’s easy, catchy and effective in getting ready for the fast-spreading COVID-19.

IPP stands for Inform, Prepare, Protect. It can be used by individuals and heads of any organization or of a group of persons.
Individuals. Ask yourself these simple questions:

Am I Informed (well-informed) about COVID-19? (I)
Am I Prepared for COVID-19? (P)
How can I Protect myself? (P)

I
Information is key. Get yourself informed about the Coronavirus. There are lots of reliable sources of information online. For example, WHO has a link on WhatsApp. You can use that link and by typing ‘Hi’, you get automated responses with correct and authentic information. The link is http://bit.ly/who-covid-19-whatsapp. Other credible online sources include: ncdc.gov.ng, who.int, google.com/covid19, cdc.gov, etc. if you don’t have access to the internet, you can listen to news program on radio or television.

P
Preparation is important. A whole town, State or Country can be put on lockdown, as a way of mitigating or slowing down the rate of spread of COVID-19. That means no movement, except for essential services. So, ask yourself, if you are asked by the authorities to stay home for 2 weeks or 1 month, if not longer, do I have the basic essential items I need at home? Do I have food stuff that will last for 2 weeks or 1 month in case the marketplaces are closed? Do I have water, toiletries, alcohol-based hand sanitizers? Do I have some drugs at home, things like paracetamol, cough syrup, and other over-the-counter drugs? Am I hypertensive, diabetic, asthmatic, do I have medications that will last for at least a month? Preparation involves getting all these things, and keeping some money with you for emergencies. Remember, the banks, pharmacies, markets, and other business places may be shut in a quarantine.

P
How do I protect myself? What are those preventive measures I can take to protect myself from getting infected?
Thorough and regular handwashing with soap and water. If soap and water are not immediately available, use an alcohol-based hand sanitizer as often as possible. Remember to also wash your hands with soap and water as soon as they are available to you. Handwashing kills the virus.
Stop touching your face with unclean hands.
Learn cough etiquette. When coughing or sneezing, cover your mouth and nose with tissue. Dispose off the tissue immediately, then wash your hands. If no tissue is available, don’t cough into your hand, rather, use your bent elbow.
Practice social distancing everywhere you go. Social distancing means keeping a distance of at least 1 metre (3 feet) between you and others, so that if the other person coughs or sneezes, the droplets won’t land on your body.
You can’t maintain social distance in a large gathering. So, avoid large gatherings. The COVID-19 has been spread widely by large gatherings. In Uruguay, an infected individual hosted a large party. Of those who attended that party, 44 persons ended up testing positive to the Coronavirus. In South Korea, an elderly lady, coded Patient 31, who had the disease attended a service in a secretive Church, Shincheonji, and ended up infecting so many people. More than 60% of the confirmed Coronavirus cases in South Korea can be traced to that Church.
Avoid handshakes, hugs, kisses, or personal contact, except with uninfected close family remembers. Don’t forget, some persons are asymptomatic, and yet transmit the virus.
If you can stay at home, please do. If you can work from home, please do. It helps to limit your contact with others.
Avoid the custom of visiting every sick person you know, except you are the direct caregiver. Call them, even video call them, instead.
Limit visitors and guests to your house or workplace.
Have a good night sleep of about 7 to 9 hours. Adequate night sleep helps your body to build immunity to viral illnesses in general.
Stay physically, spiritually and mentally fit. Do your exercise at home. Use your phone and social media to stay in touch with others. Read books and watch programs that will uplift your spirit. Take the time to develop your spirituality and other healthy personal practices. Pray. Meditate. Be gracious. Take the time to know your spouse and kids better. Please, keep your mind and body healthy even while at home.

Remember

I.        Be informed
P.       Be prepared
P.       Protect yourself

May God help us!

……To be continued….

@ Dr Eugene Ojirigho (just a concerned physician) eugeneojirigho@yahoo.com, dreugeneojirigho@gmail.com, @EugeneOjirigho (Twitter)