Over a month since our country was sucked into the COVID-19 pandemic, ambiguities persist about the new strain of the virus. Epidemiologists believe that the latest version being novel, there are things which are yet to be known about its behaviour. But previous strains provide clues to guide us on the current disease. The world is learning a lot from China which has successfully wiped it out.
The information coming from multiple quarters could lead to consternation even if it is not misleading. The answers of crucial queries are being answered in bits in a piecemeal and sporadic fashion. The people are trying to fill in the information gaps through search engines on the internet. A big chunk of information is being shared on WhatsApp but there is fear of people receiving myths and rumours that may land them in greater trouble. People are also visiting Facebook’s messenger community hubs. On its part, the World Health Organisation has initiated an online service to respond to the issue of what it terms as “massive infodemic”, but not all people approach this portal.
In order to address this on the national level, our Ministry of National Health Services has launched a WhatsApp corona helpline in addition to a chatbot on Facebook’s messenger app. The need of the hour is to have more specific information on the pattern of America’s Centre for Disease Control (CDC) or the European Centre for Disease Prevention. This will resolve ambiguities that are intensifying the anxieties related to precautions and management of the familiar yet simultaneously mysterious disease. This would also reduce the credibility gap as a large number of people think that the efficacy of masks, sanitizers, and need for PCR tests is being downplayed due to shortages of testing kits and protection materials. Some frequent questions are as follows.
Do we need to wear masks? Our health department says that mask is not required to be worn by healthy persons. It should rather be put on by persons having flu or cold to save others around them. But the question is why everyone in developed countries including China is wearing masks. America’s CDC is considering allowing masks made at home from T-shirts and other garments but it is feared that a false sense of security by masked men and women could make them act recklessly in public places.
Another query is about the use of latex gloves. Health officials maintain that gloves are required by professionals treating patients and can’t guarantee protection to other people. If it is so then why we are witnessing government officials and media anchor persons wearing gloves? One often watches people applying sanitisers on the glove-clad hands, but that can be more effectively done on bare hands. Has someone from the health department briefed the people about the use of gloves and their disposal after onetime use?
People are told to wash hands many times a day. But if someone is staying at home for days and no one has visited him, does he or she still need to wash hands repeatedly? We know that coronavirus sits happily on oily surfaces, but washing hands every 45 minutes without touching contaminated surfaces may lead to obsession. Why not educate people about when to wash hands and for how many times a day?
Almost half of public health guys are advising to keep a safe distance of at least one meter but the other half is recommending a distance of two meters. This discrepancy stems from another ambiguity on the virus’s ability to remain suspended in air. According to the World Health Organisation, the virus is mainly transmitted through droplets too heavy to hang in air, but virologists warn about much tiny droplets able to float in air for several minutes. If the latter is true, then wearing masks could be a necessary measure.
While protective measures are in place in stores, there are still lingering doubts about the hygiene of products in shelves and the process of packing the purchased goods in bags. While fruit and vegetables could be washed in warm water, what about dry grocery? There are hardly any guidelines on when to apply sanitiser. We come across people massaging their hands with a variety of sanitisers every thirty minutes. There is a exists to know when a sanitiser needs to be applied and for how long one application works. Focus should be shifted from disinfectants’ use to the issue of touching one’s face with their hands.
There are doubts on the advice regarding the use of currency notes as the virus is believed to survive for several hours on paper. Though the State Bank of Pakistan has assured it will sanitise currency notes coming out of quarantines and hospitals, what about the notes and coins exchanged in shops, stores and other places? It is though heartening to hear that chances of getting infected by touching contaminated surfaces are much less than transmission from direct contact. Debit/Credit cards and ATM machines are better options, but what about people without access to such facilities?
The information from public health officials is vague as to when a person thought to be exposed to the virus or suspected of getting infected should be quarantined or isolated. Used interchangeably, the subtle difference between quarantining and isolating is also not well-understood. Many people deem quarantine to be something more serious than isolation and have attempted to escape from quarantines. Health professionals have so far been unable to allay apprehensions of healthy but suspected cases getting infected in quarantines.
No comprehensive information is available regarding the definite symptoms of COVID-19 as the usual symptoms are thought to consist of dry cough, fever and difficulty in breathing. But there are several other mild symptoms that have been reported in China including muscle aches, loss of taste and smell, fatigue, gastric disturbance, loss of appetite and nausea. There is similarity between the symptoms of common cold and seasonal allergies with initial indications of coronavirus. People may take actual corona symptoms for seasonal flu and allergies and may infect others. There is still no well-defined line crossing beyond which a person with symptoms should isolate himself or herself at home. There is still no brief on how to identify around 40 percent of positive cases who may be asymptomatic.
Though the Health Ministry has explained what category of people could be entitled to have PCR test and hospitalisation, there are still grey areas. The confession of health department that these categories have been chalked out in view of scarcity of test kits has deepened mistrust.
This ‘infodemic’ could be tackled with trusted one-stop points of community engagement in four categories, i.e. prevention methods, symptoms check-list, things to do in self-isolation and information on nearby genuine labs and quarantine centres. The emergence of telemedicine helpline centres, web portals and mobile apps for instant advisories is a useful initiative. But the satisfaction index of the callers on these centres is not yet known, though they have reduced pressure on hospitals.
The responses of online guidance providers should not be at variance with each other. There is a growing perception that PCR tests of less than two percent people are being recommended by telemedicine centres whereas testing of more and more people is thought to be the only way to eradicate the menace. Telemedicine centres may also develop online self-screening questionnaires in Urdu/regional languages as has been done by Dr Ziauddin Hospital in Karachi.
As the country has entered into critical phase in its fight against COVID-19, electronic media should dedicate a portion of its air time in peak hours for answers to general and specific queries. The viewers are more keenly interested in getting satisfying answers to their questions rather than watching minute-by-minute updates on rising numbers of corona-positive cases and fatalities.
Shakeel A. Malik
The writer is an Islamabad-based freelancer.