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‘The next 2-3 weeks will be defining’

01 Apr, 2020 - 00:04 0 Views
‘The next 2-3 weeks will be defining’ Dr Manangazira

The Herald

As of yesterday, Zimbabwe had eight confirmed cases of coronavirus disease, including one death.

This new coronavirus disease, which has since been renamed Covid-19, belongs to the family of viruses called coronavirus.

The first time this kind of virus was discovered was around 2001-3 with the coming in of the Severe Acute Respiratory Syndrome (SARS), which was discovered in Asia.

Another encounter was around 2012-13 in the Middle East, which saw the emergence of the Middle East Respiratory Syndrome and now the world is grappling with this latest virus, which was discovered late last year in China’s Hubei province but affecting one of the metropolitan areas there called Wuhan.

Initially, the virus was called the Wuhan Coronavirus but after it was declared a public health emergency of international concern the name was then changed to Coronavirus Infectious Disease, shortened-Covid-19, since it was also discovered in 2019.

Our Senior Health Reporter, Paidamoyo Chipunza (PC) spoke to public health expert Dr Portia Manangazira (Dr PM), who is also Director for Epidemiology and Disease Control in the Ministry of Health and Child Care on issues surrounding Covid-19.

PC: How exactly does the Covid-19 spread?

Dr PM:  This is a disease that spreads quite rapidly, the same way as our influenzas and common colds. The virus is droplet spread and the sources of infection are the organs that are primarily involved when somebody catches the disease which are the lungs, throat, mouth and nose. This means anything that comes out of those areas becomes infectious and thus what you sneeze or cough out. Sometimes when we speak we also spit saliva, those droplets can carry the virus and sometimes when you cough you spit droplets on your phone, desk, chair, computer, car or door handle. It means if somebody then makes contact with any of these surfaces, they can get infected through direct contact but initially it’s droplets.

We have also had in recent times some research that is also pointing towards some airborne type of spread. This means that if somebody who is infected gets into a room and then you get into the same room, you can still catch it. So now it becomes different from being droplet spread to airborne.

So what this means is that we need to tighten our prevention measures. We need to ensure that social distancing is strictly observed because we want to minimise any chances of contact. As I said, this disease is called novel, novel means it’s new, so there is still a lot that we do not know about it. Scientists have been trying to bring us a lot of information but still a lot remains unknown. We still have a lot of information that we are not sure of.

PC: You mentioned that if somebody gets in a room which was previously occupied by someone with Covid-19 there are chances of airborne infection. What then is the basic hygiene advice that people can employ at individual level in such cases?

Dr PM: People should make sure that they abide to basic hygiene practices and these include allowing fresh air to circulate in that room by opening all windows and doors thorough cleaning our places of dwellings or offices. In fact, a lot of the measures that His Excellency President Mnangagwa propounded becomes handy, that is, reduce the number of persons in one place, at home sit outside as much as possible in the sun.

During this lockdown, try and minimise visitors, staying home is one of the measures that work in containing this outbreak. Decongest, a lot of stuff that we keep in our houses are not necessary, get rid of all that stuff so because of the outbreak you will realise that we need all the space to ensure free flow of air, that minimises the chances of that droplet getting to you. Even in a shop, there are some people who are in the habit of touching different items on the shelf, they also have potential of leaving the virus on each item they touch if they are infected.

PC: And the lockdown itself, how does it assist in containing the outbreak?

Dr PM: We spoke about the coronavirus family coming on this planet about 20 years ago. We had influenzas dating back to about a 100 years ago. We had the 1980 influenza pandemic and lessons were learnt each time there were those outbreaks. We had Avian influenza, there was the H1N1 and now we are into this, so we know a lot of scientific facts that if we do not decongest those public places. If we do not congest that commuter omnibus, that workplace, it can be a source of disease spread. So the lockdown essentially means people must stay apart, decongest as much as possible.

Here in Zimbabwe, we have heard imported cases of Covid-19 up to last week but we have already started getting cases of local transmission so you never know who else is carrying the virus currently. So if people continue converging the likelihood of meeting someone with the virus is high and likelihood of them passing it to someone not yet infected is high, not one person, not two people but many in the proximity. So those measures as part of the lockdown prevent further spread of the disease and we hope everybody will comply for the good of everyone and indeed for the country.

PC: Is it possible for someone to carry the virus but not exhibiting any symptoms?

Dr PM: Yes, indeed, it’s possible. Remember there is an incubation period but sometimes depending on your immune system we also hear there are some people who do not get sick. However, the very young, the old, pregnant women get the infection and fail to fight it and start exhibiting signs earlier than anyone else. At this stage, I am not sure of asymptomatic cases like we have seen in other outbreaks like typhoid and so forth. For now, the incubation period of Covid-19 has been set at 14 days. So if someone gets tested on day 1 or 2, the test itself can even say you are negative.

So responding to the pressure that we have been getting from the public, to say why are you not testing many people, the test may come out negative now but if done again in the next 72 hours or so, it becomes a different story altogether. You will find that even with our second case, there are some people whom we might want to test again because maybe we tested them too early.

PC: Can someone who is asymptomatic still transmit the virus?

Dr PM: Yes, it is possible because some people are healthy, with very good immune systems, they might be exposed to the virus and not show any symptoms but the virus can still be transmitted when they cough, when they sneeze when they interact with people in close proximity.

PC: So during the lockdown, how then do you identify suspected cases?

Dr PM: We have already been running a call centre and it is very busy. We are happy a lot of the calls have been very sensible but we now know that we have a firm communication linkage with the communities. We are now in the process of sensitising healthcare workers across the board, public sector, private sector and all the other stakeholders.

We also have a surveillance system that is monitoring people who might have returned from hotspots or who might have had contact with such people.

PC: So far we have eight confirmed cases, what should we anticipate say in the next two weeks as far as contact tracing in concerned.

DR PM: From my experience with outbreaks and studying outbreaks elsewhere, the coming two weeks are going to be very difficult. Countries were starting with a single-digit case and this would skip into a double-digit in less than few weeks. For Zimbabwe, if you look at some of the water and sanitation issues, we really have a difficult time ahead of us if strict hygienic practices and adherence to the lockdown is not observed. We know from other country’s experiences that one positive case can infect at least three or four others and in our case where provision of clean and adequate water supplies is erratic, one person can actually infect the whole family. So for me the next two-three weeks are going to be telling and unless people adhere to the lockdown, self-isolation, self-quarantine we might be heading for disaster.

PC: We see people wearing masks, gloves, how effective are these in the Covid response?

Dr PM: We have agreed that we need to provide a guideline on the rational use of personal protective equipment. There are people who are wearing very expensive PPE yet we have frontliners who do not have these. We also have some people wearing masks wrongly, some on their foreheads, others around their necks and others covering the mouth only leaving the nose.

People at minimal risk must wear the appropriate PPE, same as those managing suspected or confirmed cases. We have different types of masks and they work for different purposes, which people should know. The health workers using this PPE must also learn to don (putting on PPE) and doff (removing) for them not to get the virus. If it’s done wrongly, we end up having positive cases of health workers who get infected in the line of duty.

PC: So, those who can afford can wear masks?

Dr PM: Yes, but do not wear an N95 mask. If you have it, donate to those taking care of the sick where it’s most needed but people can wear any other masks, they still work fine.

PC: Your parting note to this discussion.

Dr PM: I think I need to acknowledge the support we have been receiving from all quarters of the society all the way to the highest office in the country. We really appreciate all that support and assure the public that we are doing everything possible to ensure that we are not heavily impacted by Covid-19.

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