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VIEWPOINT
Year : 2020  |  Volume : 13  |  Issue : 3  |  Page : 202-203  

Scaling up preparedness activities for responding to the stage of community transmission of coronavirus disease 2019 globally


1 Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Chengalpet, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Chengalpet, Tamil Nadu, India

Date of Submission14-Apr-2020
Date of Decision29-Apr-2020
Date of Acceptance06-May-2020
Date of Web Publication3-Jun-2020

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur, Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet, Chengalpet - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_181_20

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How to cite this article:
Shrivastava SR, Shrivastava PS. Scaling up preparedness activities for responding to the stage of community transmission of coronavirus disease 2019 globally. Med J DY Patil Vidyapeeth 2020;13:202-3

How to cite this URL:
Shrivastava SR, Shrivastava PS. Scaling up preparedness activities for responding to the stage of community transmission of coronavirus disease 2019 globally. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Jul 5];13:202-3. Available from: http://www.mjdrdypv.org/text.asp?2020/13/3/202/285758




  Introduction Top


The pandemic of coronavirus disease-2019 (COVID-19) continues to expand in terms of geographical distribution, caseload, and associated death rates worldwide.[1] In fact, a total of 1,773,084 cases and 111,652 deaths have been reported, which amounts to a global case fatality rate of 6.3%.[2] In a single day, 76,498 cases were reported, of which 48.1% of cases were from the American region whereas 43.4% of cases were from the European region.[2] Already, the overall risk for the global transmission of the infection has been rated as very high, and it is the need of the hour to take urgent steps for the mitigation of the disease.[1],[2]

Preparedness for COVID-19

Even after the disease has been known for >3 months, it is a fact that many of the attributes about the disease pertaining to the epidemiological or virological or clinical aspects of the infection are not known.[1] However, that cannot be considered as an excuse, and we should take all the required steps to prevent the community transmission of the disease.[3],[4] This readiness should essentially start with the management of the incident, proper planning, and multisectoral coordination, and wherein all the concerned sectors should work together for the successful implementation of public health strategies.[3] It is important to understand that once community transmission sets-in, the role of individual case identification, contact tracing, and quarantine of healthy contacts does not deserve any significance.[3] On the contrary, the surveillance activities should mainly focus on the geographical distribution, speed of transmission, type of population groups affected, and the impact produced on the health-care delivery.[3]

Strengthening of case detection and management

From the case detection perspective, it becomes quite obvious that laboratory capacity needs to be strengthened immensely as the caseload will be very high, and thus, the arrangement for testing should be made within the nation or through collaboration with reference laboratories.[3],[5] The laboratory testing activities have to go hand in hand with the training of the staff and arrangement of logistics for carrying out the diagnostic tests.[4] Even on the case management perspective, the infrastructure in the health-care facilities needs to be strengthened extensively to respond to the needs of people presenting with the disease symptoms.[4],[5],[6] The triage mechanism should be made functional to decide on the order of preference to treatment and the potential chances of survival of patients. It will become a necessity that mild cases should be managed at home level with family members acting as caregivers.[5],[6] Further, steps should be taken to share updated knowledge with health staff and strengthen the referral system and logistics support.

Infection prevention and Research

Even now, the role of infection prevention and control practices is crucial, and in case of the onset of community transmission, it has to be further enhanced to ensure that the infection is not getting transmitted further to anyone.[4] This will obviously require facilities for isolation of patients, better supply of personal protective equipment, and improved administrative (such as triage of patients in waiting areas, not allowing visitors in the hospital, etc.) and environmental control (like improved ventilation) measures.[1],[3],[4] Among no availability of a potential drug or vaccine, the treatment of infected patients at present predominantly depends on the use of nonpharmaceutical measures such as hand hygiene, respiratory hygiene, use of face masks by symptomatic people, isolation of known patients, environmental disinfection, closure of educational institutions, avoiding social gathering, and workplace measures.[3],[4],[5]

Risk communication and Point of entry

As the on-going pandemic is occurring because of a novel virus, it is essential to provide reliable and transparent information through trustworthy resources to the community to deal with any rumors or misinformation.[4] In other words, the risk communication system should be established, and it should provide correct information to the public, and this information should be based on the needs assessment of the community.[3],[5] Further, health promotion and early detection measures should be strengthened at the point of entry to identify the ill travelers at the earliest, and it will minimize the possibility of another new chain of infection transmission.[3],[4] Finally, the outcome of all these measures cannot be sustained if we fail to ensure the continuous supply of logistics and adequate workforce to carry out these activities, and thus, it should be given utmost attention.[1],[3],[4]


  Conclusion Top


In conclusion, in the battle against the COVID-19 pandemic, all of us should work with an aim to prevent the stage of the onset of community transmission. However, the possibility of the onset of community transmission can become a reality in many settings and thus it is extremely important to be prepared for the challenge and plan our response well in advance.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ward MP, Li X, Tian K. Novel coronavirus 2019, an emerging public health emergency. Transbound Emerg Dis 2020;67:469-70.  Back to cited text no. 1
    
2.
World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report – 84. World Health Organization; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200413-sitrep-84-covid-19.pdf?sfvrsn=44f511ab_2. [Last accessed on 2020 Apr 14].  Back to cited text no. 2
    
3.
World Health Organization. Preparing for Large-Scale Community Transmission of COVID-19 – Guidance for Countries and Areas in the WHO Western Pacific Region. Geneva: WHO press; 2020. p. 1-6.  Back to cited text no. 3
    
4.
World Health Organization. 2019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan. Geneva: WHO press; 2020. p. 1-20.  Back to cited text no. 4
    
5.
Ebrahim SH, Ahmed QA, Gozzer E, Schlagenhauf P, Memish ZA. Covid-19 and community mitigation strategies in a pandemic. BMJ 2020;368:m1066.  Back to cited text no. 5
    
6.
Kwon KT, Ko JH, Shin H, Sung M, Kim JY. Drive-through screening center for COVID-19: A safe and efficient screening system against massive community outbreak. J Korean Med Sci 2020;35:e123.  Back to cited text no. 6
    




 

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