Humanity is confronting a pandemic in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus infection disease (COVID-19). Kashmir, like many other parts of the world is under the threat of natural calamity COVID-19 that has already engulfed many parts of the world. The recently declared pandemic COVID-19, actually the first pandemic coronavirus in the history, has created chaos around the globe affecting day to day norm, healthcare, education, travel, business and what not. Global efforts are being made to contain this emerging contagious zoonotic disease that spilled over from animal kingdom to human population and is now rapidly spreading among the masses through droplet infection or contact between healthy and infected persons. Severity of disease, lack of vaccines or specific antiviral, person to person transmission and global spread had ensured pandemic nature of the disease well before the declaration and thus raising global public health concerns.
A pandemic has four stages. Stage I represents cases imported from affected countries while the Stage II indicates local transmission from positive cases. In case of Stage III spread of disease occurs within community affecting large areas and when the disease takes the shape of an epidemic with no clear point it has reached Stage IV. Status of pandemicity varies with respect to different countries, some being at initial stage and some at peak. Countries like China and Italy have reached stage IV while as India is at stage II. Hence measures are being taken to control this pandemic or to restrict it at the most stage II or III.
International agencies like World Health Organization (WHO), World Organization for Animal Health (OIE), Centre for Disease Control and Prevention (CDC, USA), European Centre for Disease Control and Prevention (ECDC), Food and Drug Administration (FDA), Food and Agriculture Organization (FAO) in collaboration with many national authorities of the affected and under threat countries and private partners are trying to draft the suitable and adaptable prevention and control strategies for COVID-19. Respective guidelines are being issued by these agencies. However with alarming levels of spread, severity and inaction, the implementation of these guidelines is proving difficult considering the constraints of local, administrative, and community issues in some countries and population and infrastructure issues in others thereby raising global concerns. Responding to community spread of COVID-19, WHO has provided interim guidance and trainings that are grouped into classes including national coordination, risk communication and community engagement, public health measures, case management and health services, infection prevention and control, surveillance, risk and severity assessments, national laboratory systems, logistics, procurement and supply management, maintenance of essential services and research and development. These measures can help to detect, test, treat, isolate, trace and mobilize the people in the response which can help in prevention of future cases and minimize existing cases and take the form of personal protective, environment, social distancing and travel related interventions. Healthcare, community and administrative settings are vital for implementation of these recommendations.
Putting it in simpler words, quarantine of affected persons or persons coming from affected countries for fourteen days regardless of symptoms, should be followed by contact tracing of the persons that have come in contact with the affected persons or cases showing positive tests and applying similar quarantine measures. This will help in the earliest detection. Stopping of mass gatherings like closing of schools, cinema halls, not organizing public event will prevent spread of disease. Awareness through media or trainings about hand hygiene and respiratory etiquette will minimize risk. Finally preparation for pandemic involves scaling up of infrastructure-testing facility, isolation beds and acute management of positive cases which take place simultaneously. Having confirmed more than 100 cases of COVID-19 in India, the apex medical body Indian Council of Medical Research (ICMR) has set up 51 testing labs across the country where 90 samples can be tested in each lab on daily basis thus having overall capacity of testing 4590 samples. As per ICMR, there are around one lakh testing kits and additional two lakh have been ordered. However testing strategy of focusing on only symptomatic cases or cases with history of contact or travel to affected countries may not suffice. Administration in Kashmir is also taking all the necessary steps for the prevention and control of COVID-19. However relying solely on whole-of government approach may not be sufficient for all hence society or individual based approaches need also be implemented that can help in safeguarding the people. Under the current circumstances everyone has to take steps at individual or society level for the protection of self and the society. These steps especially involve routine daily hygienic procedures at home, work or office.
Some of the basic hygiene strategies must be followed like hand washing with soap for 20 seconds or using 60% alcohol based sanitizers, using medical mask or covering mouth by tissue paper, towel, handkerchief or cloth during sneezing or coughing. Additionally, avoid frequent contact with infected inanimate objects and prefer to stay at home and maintain a distance of 1-2 meters from affected persons, avoid crowded places or travel during the times of outbreak in order to minimize the risk of transmission.
Pre-eminent method to prevent illness can be acquired through use of personnel protective equipments like masks, goggles, gloves, face shield, apron, and gowns. It’s important for the public to understand that healthy folks do not need to wear medical masks if not exposed to risk environment as unnecessary use of medical masks causes depletion of resources and exposes risk groups including healthcare providers to infection. Being at higher risk, older adults and those with severe underlying chronic medical condition need to take extra precautions. Society based approaches enforced by authorities though may seem hectic but are essential in the context of prevention and control of pandemic. One example is recent closure of schools by administration that was need of the hour and among the recommended protocols of the World Health Organization.
Similarly World Organization for Animal Health also called as Office International des Epizooties (OIE) endorses recommendations of the WHO and further stresses on food hygiene and environmental hygiene. During the times of outbreak, avoiding visit to infected areas, crowded places, hygienic precautions at live animal market, wet market or animal product market, avoiding direct contact with affected animals, animals living in the market (e.g. stray dogs, cats, rodents, birds, bats) or surfaces in contact with such animals, avoiding consumption of uncooked or raw animal products (meat, milk, eggs) or contaminated food, avoiding contact with potentially contaminated animal waste or fluids on the soil or structures of shops, and market facilities and isolation of infected cases can help in prevention and control of COVID-19. As per general good food safety practices, raw meat, milk, or animal organs should be handled with care, to avoid potential cross-contamination with uncooked foods. Meat from healthy livestock that is cooked thoroughly remains safe to eat. Further there is no evidence that companion animals/pets can spread the disease. The current spread of COVID-19 is a result of human to human transmission though the initial spillover is believed to be from unknown animal source. Hence OIE recommends precautionary measures while handling companion animals especially limiting contact when sick and following basic hygienic measures.
Need of the hour is to follow the strategic plans like application of ‘One Health’ approach involving human and animal professionals, public health professionals and other scientific fraternities to combat the nuisance of health hazards like COVID-19. Collaboration with various platforms of print and electronic media, including social media can help in dissemination of information about these pandemic preparedness measures.
(Author is Assistant Professor, FVSc & AH, Shuhama (SKUAST-K) and is the Principal Investigator of DST/SERB Sponsored Projects on Infectious Animal Diseases)