On 31 December 2019, the World Health Organisation was informed about the detection of a group of pneumonia cases of unknown cause in Wuhan City, Hubei province of China. A series of laboratory investigations were triggered to know the cause. Resultantly, a novel pathogen belonging to the coronaviruses family was identified by Chinese authorities on 7 January 2020 and named it 2019-nCoV. It was a local outbreak started with a cluster of 27 people that soon turned into a global epidemic infecting thousands of people globally. Within a period of two and a half months; this deadly pathogen, later named SARS-CoV-2 infected around 137445 with 5088 deaths in 125/195 countries globally. Keeping in view the global spread and the high transmission potential of this virus, Dr. Tedros, DG World Health Organization announced it a “pandemic” and urged countries to take urgent and aggressive action against the deadly pathogen. He further added that 57 countries have less than 10 cases if these countries can detect, test, treat, isolate, and trace the suspected people, can prevent those few cases becoming clusters, and subsequently those clusters becoming community transmission.
Before discussing the situation in Pakistan, let us first understand a few epidemiological terms and based on them, I will put forward the measures to control further spread of this virus in Pakistan. Globally, many countries have “community transmissions” of the virus but fortunately, Pakistan has imported cases still. Community or local transmission means the virus has spread in workplaces, schools, and households. It is hard to control the community transmission of the virus but still, we can mitigate the mortalities and morbidities caused by the virus. China, South Korea, Japan, Italy, Iran and now Germany, France and Spain are considered the major epicenters of the virus and have the highest community transmission. These countries have more than 90% of the disease burden of CoVID-19 including China. The abovementioned countries have passed the stage of “containment” as they are facing local/community transmissions so they should focus more on disease mitigation and stopping further transmission. However, more than 57 countries can still contain the virus and avoid community transmissions; thus protecting their citizens from this deadly pathogen. It could be the lesson learned from this pandemic that containment is a crucial part once the health authorities come to know that the novel virus or the disease of unknown etiology has surfaced and is infecting people. That area should be bordered immediately and rigorous contact tracing should be started. If Wuhan was locked on 31st December 2019,the world would have witnessed a far fewer number of cases than today.
The situation in Pakistan is also getting worse but still, we are in the first phase of “containment” and this deadly pathogen can be controlled
The situation in Pakistan is also getting worse but still, we are in the first phase of “containment” and this deadly pathogen can be controlled. Pakistan announced its first case on February 26 and within a period of 2 weeks, the cases rose to 21 and much other still under investigation. However, those all confirmed cases are imported from Iran, Syria, and few other countries and there is no local transmission. Keeping in view the fragile health system of Pakistan, it must be noted that here the word “pandemic” must not be considered lightly. Pakistan can become another epicenter of the virus if people are not taking necessary measures and following guidelines by the health organizations. Europe being equipped with high hospital capacities and well-established health systems, couldn’t control the virus then we are least prepared compared to them. Therefore, we have to take extra measures and follow the guidelines given by the World Health Organisation. The government of Pakistan has taken serious steps and the Prime Minister has called an emergency meeting of health officials to discuss the future control strategies to cope with the pandemic. Simultaneously, the provincial health ministries have also taken aggressive steps against the spread of coronavirus. However, weak health systems need extra care as once the virus is unleashed within communities; it is very hard to control. The government of Pakistan needs to take the following measures to “contain” the novel coronavirus (CoVID-19) pandemic.
Firstly, Points of entries i.e. international airports, seaports and ground border crossings must be strengthened and the ill patients should be screened and managed there.
Secondly, the surveillance system, case finding and detection should be scaled up. Reporting cases to WHO will help to conduct a risk assessment and further spread of the virus.
Thirdly, Infection prevention and control / WASH is the most important step to take and it should be emphasized by the Risk Communication Team. IPC measures should be followed in schools, hospitals, homes and by healthcare workers in close contact with suspected and confirmed cases.
Fourthly, strengthening laboratory testing for (COVID-19) in suspected human cases.
Fifthly, proper patients’ clinical management of the confirmed cases in hospitals and at homes. No vaccine or drug is developed yet; however, ongoing clinical trials have three significant treatment practiced in outbreak countries should be followed. These measures and other strategies will be discussed in detail in upcoming articles so that health professionals may be updated with the ongoing international efforts to control the CoVID-19 pandemic.
The writer is Research Fellow at EMRO, World Health Organisation