Do we have to fear a second wave
The local approach to containment has been able to keep the pandemic under control – though we still have to maintain vigilance
By Dr R Neerunjun Gopee
As at Sunday May 17, according to Covid-19 statistics released by the Ministry of Health and Wellness, there have been no new cases detected since the last positive one of April 28. The total number of positive cases registered remains at 332, with 10 deaths, leaving 322 cases that have been successfully treated, and the total number of Covid-19 tests done was 87,177.
“As the mixing of people has been limited, herd immunity may not have occurred. Nevertheless, as the incubation stage of the disease is 2-14 days and as we have not had any case for 21 days, according to sound epidemiological opinion this shows that there are no cases in the community. This makes a ‘second wave’ unlikely, and what we must do now is to beef up surveillance at the port and airport if we plan to allow entry of tourists. There are tools and mechanisms to do this…”
In an article on April 03, I had expressed my apprehension that the opening of supermarkets posed a risk of accelerating towards Phase 3 of pandemic (when the health system begins to be overwhelmed, as happened in e.g. Italy, Spain) from the Phase 2 that we were in, that is, the situation was still manageable: the health system was coping though under strain.
I had thought of two possible scenarios:
- Best case: If we are lucky, and people behave themselves throughout these two weeks – a risky assumption since at some stage nerves may get frayed from prolonged waiting, etc – herd immunity may develop;
- Worst case: infection spreads rapidly and we precipitate headlong into Phase 3.
I had also noted that ‘the good thing is that people are wearing masks, and some wear gloves too. However, the recommended social distance of one metre may not be enough to prevent spread. Queues of up to a km have been seen, and clusters too with people chatting’.
“While from the drug treatment point of view there is a glimmer of hope, as regards vaccine prevention we may have a long wait. But the good thing that is worth repeating is that we have simple, powerful and proven tools at our disposal by way of the authoritative advice that is being repeated to us every day since the pandemic struck. Perhaps there is a need to uptick the communication of this advice so that it really sinks into our psyche and becomes an effortless and integral part of our daily living…”
It is a relief therefore that the worst case scenario has been averted, and that by and large people began to be more attentive to the advice given. Gradually the long lines at supermarkets have dwindled, as people must have realised that there was no need to panic-buy or stock up as they could shop more regularly.
There is no doubt that the local approach to containment has been able to keep the pandemic under control, though we still have to maintain vigilance. There is a caveat about herd immunity – usually it is related to a context where there is a vaccine available, and a significant proportion of the population has been vaccinated. In the present situation that developed very rapidly, there is only a hope that enough people would have caught the infection through the interactions that were allowed, and developed immunity, the sum total of which would add up to the herd immunity wished for.
However, as the mixing of people has been limited, such herd immunity may not have occurred. Nevertheless, as the incubation stage of the disease is 2-14 days and as we have not had any case for 21 days, according to sound epidemiological opinion this shows that there are no cases in the community. This makes a ‘second wave’ unlikely, and what we must do now is to beef up surveillance at the port and airport if we plan to allow entry of tourists. There are tools and mechanisms to do this.
Question is: are the harsh amendments brought to the Public Health Act really justifiable in our democratic country?
Especially if we commit to abide by all the measures that have been recommended and are meant primarily for our self-protection – which is first and foremost our responsibility.
When we think of it, it boils down to just a few really simple steps: wear a mask when in public, keep a safe distance (at least one metre or more if possible), wash hands frequently with soap and water, stay at home in self-isolation if we have any symptoms. I know a senior Mauritian nurse who travelled back to London at the beginning of the epidemic who tested positive on reaching there, self-isolated at home, was served in his room which he did not step out of, sipped hot lemon water with honey several times a day – and was cured in 15 days, testing negative.
So the message is clear and one of hope: these small practical steps are easy to follow, and lead to cure – and prevent others from being infected.
Let’s adopt President Barrack Obama’s catchphrase for his first election: Yes we can!
For ourselves, our family and the community at large. If we go about in this spirit from now onwards, we can look forward with confidence towards resuming activities when the lockdown is over. It will be accompanied by arrangements to maintain social distancing, both physically where needed, as well as through new frameworks for wider use of telecommuting, teleworking and telelearning that are set to become mainstream in future.
In the meantime a global network of scientists and doctors are busy working on possible treatments and vaccines. As regards drugs, the antimalarial hydroxychoroquine that in earlier studies seemed promising has been discredited with reports of severe and in some cases lethal cardiac complications. The only drug that has been shown in a rigorous trial to have benefit in the sense of reducing the duration of the disease by about four days is a medicine used to treat Ebola, remdesivir, and it has been recommended for use.
But this will be done under strict conditions of clinical surveillance for any side effects or complications that will be promptly brought to the attention of the medical fraternity. Along similar lines, several other drugs used for other conditions are being studied for use against Covid-19, what is termed as ‘repurposing’ the drugs.
As regards a vaccine, all the experts are agreed that it is impossible to give any realistic timeline as yet. All told, therefore, we are not out of the danger zone yet.
So while from the drug treatment point of view there is a glimmer of hope, as regards vaccine prevention we may have a long wait. But the good thing that is worth repeating is that we have simple, powerful and proven tools at our disposal by way of the authoritative advice that is being repeated to us every day since the pandemic struck. Perhaps there is a need to uptick the communication of this advice so that it really sinks into our psyche and becomes an effortless and integral part of our daily living.
We can help and protect ourselves further by keeping physically fit through daily exercise, as also enhance our lung function through yoga breathing techniques such as pranayama, anulom vilom, kapalbati, etc.
Let’s show that we can take responsibility for our own health and safety – with help from the State where needed.
* Published in print edition on 19 May 2020
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