Thus far, the U.S. Centers for Disease Control andPrevention (CDC) and other health agencies insist that primary route oftransmission for SARS-CoV-2 is through the larger respiratory droplets, up to1mm across, that people expel when they cough and sneeze. Gravity grounds thesedroplets within 1 or 2 meters, although they deposit the virus on surfacesand fomites, from which people can pick it up and infect themselves by touchingtheir mouth, nose, or eyes. But if the Coronavirus can be suspended in theultrafine mist that we produce when we exhale, protection becomes moredifficult, strengthening the argument that all people should wear masks inpublic to reduce unwitting transmission of the virus from asymptomaticcarriers. The home made cotton masks should frequently be ironed todecontaminate these by heat. The other possible mode of transmission could befecal-oral route which emphasis on proper hand washing. Though + sense RNA viruses in animals havebeen found even to travel through air to a distance of 1km or more. Thanks toGod such evidence is not so for available for COVID-19 virus which makes us tohave a sigh of relief? The limitedtransmission investigations in China and Singapore have indicated that about 33to 50% spread of present COVID-19 virusis by pre-symptomatic individuals and about 18% spread is by Asymptomaticindividuals. Some predict that it couldbe even more by both of these. This speaks that the virus is more ambitious to attractnext victim than producing symptoms in already one. Symptomatic individuals andenvironmental contamination of the surfaces which could be any metal surfacemay be door handle, water tap, ATM, mobiles, door curtains, shopping desks etc. do contribute rest of thespread. One can pick up the smell of asmoker in close range. Similarly virus reaches to a close one but withoutproducing any smell, sound, taste and prick. This also answers when it isreported that an infected person had no travel and contact history. What cannotbe imagined can’t be avoided. That is why we are being asked to followmeticulously most effective tool of blindfolded social distancing. Thisexplains the importance of social or physical distancing, hand washing, digitalcontact tracing, quarantining and screening. The Allah’s Apostle (PBUH) hassaid that do not enter or leave the place of epidemic (Bukhari: 6973).
There was a time when travel restrictions and border closing was of help. But this stage is already over,now the focus should be on mitigation by distancing, isolation, quarantine,hygiene, and screening and hospital preparedness. In my opinion it needs to bememorised for future as the history getsrepeated. In our situation the socialdistanceing is the the major tool followed by contact tracing, isolation andquarantine. Screening tests coupled with electronic surveillance and artificialintelligence will boost all this. Speed is vital to all these procedures.Further, observing hygeinic measures at all times are indispensable. Ironing ofcloth made face masks, handkerchiefs etc. Use of citrus fruits lemon andoranges can be used when available. If we don’t follow advisory it is suicidal,if we confine to advisory alone it is imperfect, if we turn to Allah to coverour weaknesses it is wise. Once Allah does, it is perfect. This turning shouldbe with lot of wisdom, commitment and actions. Islam teaches us that there are two occasions when one can earneffortless. One is to gaze upon the parents and looking towards holy Kaba. May be Allah has given us another choice ofeffortless earning i.e., to remain contactless with the intension of curbingthis disease. Whosoever kills a soulunless for a murder or spreading mischief, it is as if he had slain mankind entirelyand whosoever saves one, it is as if he had saved entire mankind(Quran5:32).The Prophet Muhammad(PBUH) said refrain from harming others for this willbe regarded as a charitable deed for your own good (Bukhari:2518).
We are observing lockdown and it has helped us a lot but yet we are far away from the target. Lockdown should be takenas the training period to prepare wiselyand optimally. The more we prepare the more we can limit the cases. Lockdown doesn’t mean the simple announcement or what is visible to a policeman but our commitment to follow it at ground level when we are not in thesight of police. Every individual big or small, rich or poor can contribute.Even remaining contactless means a lot in terms of contribution. To co-operate with authorities and valuetheir instructions is itself a contribution. The mitigating efforts ofhealthcare workers be considered sacred and respected religiously without anyviolation. Unveiling our all individualdetails, required to curb the spread is most wanted thing and a service tomankind.What’s required is a determination to find every single infection andfollow up on every potential exposure and break every possible chain oftransmission. To loosen thelockdown needs a comprehensive wisdomfor a broad spectrum scenario and is the job of authorities.
The experts who visited the China under the aegis of WHOrated the Chinese efforts to control the epidemic as the most ambitious, agileand aggressive disease containment effort in history. Lawrence Gostin a globalhealth law scholar at Georgetown University, then said the Chinese policies though “astounding,unprecedented and medieval” but the physical and mental being of the people remains concern.There are some startling observations in the report released on 28th February by the team on COVID-19 epidemic. The team learned thatabout 80% had mild to moderate disease, 13.8% had severe symptoms, 6.1 % had lifethreatening episodes of respiratory failure, septic shock or organ failure. Thecase fatality was highest for the people over age 80(21.9%) and people who hadheart disease, diabetes or hypertension. Fever and dry cough were most commonsymptoms. Surprisingly only 4.85% of the infected people had runny noses.Children made up a mere 2.4% of the cases and almost none was severely ill. Formild to moderate case it took about 2 weeks to recover. But how many mild or asymptomatic cases occuras they remain below radar and hamperisolation of infectious people. One positive thing which emerged from Chineseexperience was that people don’t get the disease second time which makes us tothink of a vaccine. Other than Wuhan, people voluntarily quarantined and monitored themselves.
The Chinese Govt did a lot in contact tracing that proved abig tool in curbing the spread. Two mobile phone apps, Alipay and WeChat –whichin recent years have replaced cash in China –helped to enforce the restrictionsas these helped the authorities to keep track of people’s movements and even stop people with confirmed infectionfrom traveling. Every person had a sort of traffic light system. Colour codes(Green, Yellow and Red ) in mobile phones designated person’s health status.This made guards at check points to decide whom to let through. However, onebig questions remains unanswered as where from it jumped from animals to humans. What species of animals it was?Answers to these are important for our better future. They were aggressive intheir intensive care using ECMO (Extracorporal membrane oxygenation) and peoplewere surviving.
After China, South Korea emerged as a sigh of hope and amodel to emulate. South Korea learned the importance of preparedness in 2015,when a South Korean businessman came down with Middle East Respiratory Syndrome(MERS) after returning from a visit to three Middle Eastern countries. He wastreated at three South Korean health facilities before he was diagnosed withMERS and isolated. By then, he had set off a chain of transmission thatinfected 186 and killed 36, including many patients hospitalized for otherailments, visitors, and hospital staff. Tracing, testing, and quarantiningnearly 17,000 people quashed the outbreak after 2 months. Korea Centers forDisease Control and Prevention (KCDC) approved its first test on 7th February,when the country had just a few cases. By 17th February they had done 270000tests. However, 11 days later, a 61-year-old woman, known as “Case 31” testedpositive. She had attended then services at a megachurch in Daegu. With a comprehensive plan of contact tracing, isolation and aggressive quarantining it took less than 1 month to bring the cluster of Case 31 under control. Then there were 43drive-through testing stations nationwide, a concept copied by United States,Canada, and the United Kingdom. The country also rolled out then a smartphoneapp that could track the quarantined. By 16th March South Korea had tested morethan 270000 people. South Korea achieved a drop, of 909 cases on 29th Februaryto 74 cases by 16th March.Similarly Hong Kong, Taiwan and Singaporeseem to hold important lessons, having turned their epidemics around withoutthe aggressive lockdowns.
After Wuhan, Europe became the epicenter of the COVID-19pandemic in early March. But theirresponse remained much below the expectations. A modeling study at imperialcollege of London, posted online on 16th March, concluded that even a mitigatedepidemic would still overwhelm health care system and cause at least 250000deaths in UK and more than 1.1 million in United States. However, Germany becamefront-runner, with more than 100,000 tests processed per week. Italy, shockedby the strain on the health care system in the north of the country, followedsuit on 9th March. Before this anItalian physician carried the virus to Spanish Island Tenerife, a popularholiday spot for northern Europeans and Austria and Croatia reported firstcases. Italy became hardest-hit to compel its doctors to make heartbreakingdecisions about whom to treat and on whom to give up. In France, 100,000 police officers began topatrol the streets on 17th March to make sure people stay inside except foressential trips. Due to domestic violence, it saw women coming out inprocessions in Paris, on 5th April saying that they are safer outside than inside. Similarly some countriesreported 30-40 % increase in domestic violence and even a 35 year old lady withtwo children was killed by her partner. This makes us to understand the otherman made edge of the sword. But coerce us to think differently with enduredpatience to save ourselves.
Every bodies experience shows that “diagnostic capacity iskey to epidemic control. WHO Director-General Tedros Adhanom Ghebreyesus stressed “Not testing alone. Not contacttracing alone. Not quarantine alone. Not social distancing alone. Do itall. I say nothing works in isolation. The bright sun cannot makephotosynthesis to happen if tiny leaf does not co-operate along with others.
Can the virus go
It’s now clear that humanity won’t get rid of COVID-19 as itdid with SARS in 2003, says Mark Woolhouse, an epidemiologist at the Universityof Edinburgh. Keeping it at bay might require locking down society for manymonths, at staggering costs to the economy, social life, and mental health, atleast until a vaccine is available. Feware of opinion to build the immunity by relaxing the lockdowns for briefspells. But still some say that suppressing the virus by combining allavailable measures, especially lockdowns and social distancing of the entirepopulation, is the “only viable strategy at the current time,”
How to compensate social distances
In the present situation a strong will and optimism will work. Studies on prisoners of Vietnam war and religion is witness to it. This can be boosted by exemplary religious thoughts. On such occasions Allah says us I will test you by several means(2:155) and how should you react ( Patience, Salat and faith 2:153 &156) and for them is the reward (2: 157). Similarly remember crucial times of the beloved prophetPBUH when he said to his companion “Do not grieve Allah is with us (9:40) and Prophet MosesPBUH when he said to his people “Indeed with me is my lord he will guide me”(26:62). Death comes only by will of Allah and at the specified time (3: 145) as our lifespan is designed by Allah (35:11). Whatever comes to us is our destiny (57: 22). Hazrat AliRA interpreted it as “Death protects the life as it does not allow to die before”. Prophet Muhammad PBUH said your belief is perfect only when you believe that whatever you faced was to be faced and whatever eluded had to elude. But these noble things are to boost our morale but never meant to violate advisory/ precautions. There are several glaring examples of observing precautions along with trust as taught by Prophet YaqubAS when he was instructing his children how to enter Egyptian gates(12: 67) and as explained above (9:40). “To demonstrate patience and seek Allah’s help at the time of misery is Realtime-worship and most rewarding” Hazrat Ali ibni Talib RA. It is similar to real time Salat or the fasting. We have to rise to the occasion as per our faith otherwise it will add salt to injury here and hereafter (2:140,159 etc.) So one can remind and revive his faith to seek remedy of ill effects of social distancing. To limit to one’s own safety and not to aspire the same for others is itself an egotism and is quite contrary to the character of a believer (59: 9). This time such act could prove suicidal or more. Last but not least shun away from spreading rumours and don’t defy the commands of thy Lord (49:6). Rather under these circumstances we have been asked to bring any such news before the authorities who would draw correct conclusions (4:83). This also advocates not to hide your travel history etc. relevant to context.
Some people may conduct their office work from home andengage online classes. Some may develop apps for facilitating the essentialsupplies, compiling and deciphering relevant information as well as for futureuse.
Prof. Shakil Ahmad Wani, is former Head, Veterinary Microbiology & Former Director Education, SKUAST-Kashmir.