Global strategy to respond to Covid-19

Photo: WHO

SARS-CoV-2 is a new kind of virus which is distinct from two other noted coronaviruses that cause Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

“The virus spread rapidly, and outbreaks can grow at an exponential rate,” said a new report just released by the Geneva-based World Health Organization (WHO).  “At present, there are no therapeutic or vaccine proven to treat or prevent COVID-19.”

COVID-19 is the disease caused by SARS-CoV-2, which stands for coronavirus disease 2019.  The new coronavirus was reportedly first isolated from stallholders who worked at the South China Seafood Market in Wuhan, China.

Last March 11, the United Nations health agency declared COVID-19 a pandemic.  “The disease has spread quickly to all corners of the world, and its capacity for explosive spread has overwhelmed even the most resilient health systems,” said the report entitled, COVID-19 Strategy Update.

Data from countries affected early showed about 40% experienced mild disease and another 40% experienced moderate disease including pneumonia.  About 15% of cases experienced severe disease and the remaining 5% suffered critical disease.

“The crude mortality rate varies substantially by country depending on the populations affected, the point a country is at the trajectory of its outbreak, and the availability and application of testing,” the report said, adding that countries that only test hospitalized cases will have a higher reported crude mortality rate than countries with more widespread testing.

Currently, the crude clinical case fatality is over 3%, increasing with age and rising to approximately 15% or higher in patients over 80 years of age.  “Morbidity associated with COVID-19 is also very high,” the report said.

“Underlying health conditions that affect the cardiovascular, respiratory, and immune systems confer an increased risk of severe illness and death,” the report pointed out.

According to the report, physical distancing measures and movement restrictions, often referred to as “shut downs” and “lockdowns,” have slowed COVID-19 transmission by limiting contact between people.

But such measures have a cost.  “These measures can have a profound negative impact on individuals, communities, and societies by bringing social and economic life to a near stop,” the report said.  

“Such measures disproportionately affect disadvantaged groups, including people in poverty, migrants, internally displaced people and refugees, who most often live in overcrowded and under resourced settings, and depend on daily labor for subsistence.”

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, admitted that since SARS-CoV-2 was reported the world have learned so much about the virus and “still learning.”

“This pandemic is much more than a health crisis,” Dr. Tedros pointed out.  “It requires a whole-of-government and whole-of-society response.  The resolve and sacrifice of frontline health workers must be matched by every individual and every political leader to put in place the measures to end the pandemic.”

The report listed six global strategic objectives which countries can adopt.  “The overarching goal is for all countries to control the pandemic by slowing down the transmission and reducing mortality associated with COVID-19,” it said.

The report recommends the following:

·         Mobilize all sectors and communities to ensure that every sector of government and society takes ownership of and participates in the response and in preventing cases through hand hygiene, respiratory etiquette and individual-level physical distancing.

·         Control sporadic cases and clusters and prevent community transmission by rapidly finding and isolating all cases, providing them with appropriate care, and tracing, quarantining, and supporting all contacts.

·         Suppress community transmission through context-appropriate infection prevention and control measures, population level physical distancing measures, and appropriate and proportionate restrictions on non-essential domestic and international travel.

·         Reduce mortality by providing appropriate clinical care for those affected by COVID-19, ensuring the continuity of essential health and social services, and protecting frontline workers and vulnerable populations.

·         Develop safe and effective vaccines and therapeutics that can be delivered at scale and that are accessible based on need.

Earlier, a group of experts with diverse background worked towards the development of vaccines against COVID-19.  In a statement released to media, the group stated:

“While a vaccine for general use takes time to develop, a vaccine many ultimately be instrumental in controlling this worldwide pandemic.  In the interim, we applaud the implementation of community intervention measures that reduce spread of the virus and protect people, including vulnerable populations, and pledge to use the time gained by the widespread adoption of such measures to develop a vaccine as rapidly as possible.”

Meanwhile, for countries that have introduced widespread physical distancing measures and population-level movement restrictions, the report urged to plan for a phased transition away from such restrictions.

“Without careful planning, and in the absence of scaled up public health and clinical care capacities, the premature lifting of physical distancing measures is likely to lead to an uncontrolled resurgence in COVID-19 transmission and an amplified second wave of cases,” the report said.