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LETTER TO THE EDITOR
Year : 2021  |  Volume : 14  |  Issue : 4  |  Page : 474-475  

Strengthening outbreak readiness and emergency response to COVID-19 in cities and urban pockets


1 Department of Community Medicine, Medical Education Unit and Institute Research Council, 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 Submission30-Apr-2020
Date of Decision26-Jun-2020
Date of Acceptance20-Jul-2020
Date of Web Publication17-Jun-2021

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_218_20

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How to cite this article:
Shrivastava SR, Shrivastava PS. Strengthening outbreak readiness and emergency response to COVID-19 in cities and urban pockets. Med J DY Patil Vidyapeeth 2021;14:474-5

How to cite this URL:
Shrivastava SR, Shrivastava PS. Strengthening outbreak readiness and emergency response to COVID-19 in cities and urban pockets. Med J DY Patil Vidyapeeth [serial online] 2021 [cited 2021 Aug 4];14:474-5. Available from: https://www.mjdrdypv.org/text.asp?2021/14/4/474/318686



Dear Sir,

The Corona Virus Disease-2019 (COVID-19) pandemic has affected all the regions of the world, while the incidence of the disease is more in cities and the urban pockets. Till date, 9296202 cases and 479133 deaths have been attributed to the infection on the global scale, while the overall case fatality rate has increased to 5.1%.[1] In general, cities have high population density, and considering the fact that the disease is transmitted through close contact, the incidence of the disease in the cities has been high.[2] At the same time, most of the cities are not planned and established and thus there will be substandard housing standards, slums, and loads of congested areas which together play an important role in enhancing the risk of transmission of the infection.[2]

The COVID-19 infection is a novel virus infection which predominantly infects humans, but the infection has been reported among various animals as well. The infection is mainly transmitted by close contact and through droplets and thus it becomes essential to practice physical distancing. Accordingly, the risk of acquisition of infection and propagation is very high in overcrowded settings as it favors close contacts. The epidemiological determinants of the infection are summarized in [Table 1].[1],[2],[3] Owing to the novel nature of the infection and lot of uncertainties about the infection, the activities in the field of molecular epidemiology, social epidemiology, and infoepidemiology have been intensified.
Table 1: Epidemiology of Corona Virus Disease-2019

Click here to view


Further, cities also act as the major points of entry through the airports, seaports, or ground crossings and thus the risk of import or export of cases through the travelers remain very high and that remains the primary reason for suspension of all modes of transport in most of the nation.[3],[4] In addition, most of the settlements in the cities have to face the problem of suboptimal water-sanitation and hygiene facilities, which in turn makes the process of maintenance of personal hygiene (frequent hand washing) quite difficult.[2] Moreover, we cannot ignore the presence of a wide range of subpopulation and vulnerable groups (such as urban poor, migrants, refugee, elderly or people with underlying medical conditions who live in isolation, and long-term care facilities) in the cities, who are all very much predisposed to acquire the infection and this makes the entire process of containment of the novel viral infection very challenging.[2]

Acknowledging the presence of all these attributes in the city, it is extremely crucial to improve the outbreak readiness and emergency public health response to an outbreak of COVID-19. However, the process of preparedness is not simple and it should essentially be done through the adoption of a multisectoral (such as health, transport, travel, education, trade, and communication), politically led and a whole-of-community approach.[2],[5],[6] In addition, the coordination of measures should be encouraged across different levels of government and steps should be taken to identify the existing hazards and vulnerable population groups. Further, while planning for the containment, the urban health authorities should understand the presence of socio-cultural factors, ascertain the media of communication, and anticipate the outcome of planned strategies (like outward migration of daily wagers) on the informal sector, the livelihood of poor people, and on the economy.[5],[6]

However, regardless of the planned measures, the government should ensure the delivery of essential services, mobilize resources, prepare health facilities to a large-scale community transmission, arrange for required logistics, and take appropriate measures to strengthen the mental wellbeing of the community as well as the health-care professionals. Moreover, the urban authorities should aim for implementing a coordinated plan to mount an effective response to the disease, strengthen the risk communication mechanism to avoid spreading of rumors and misinformation, create adequate awareness about the need for physical distancing, hand hygiene and respiratory hygiene, and finally promote easy access to the health services. Finally, during the periods of reduced caseload, the cities can plan to relax the restrictions in a thoughtful manner, but then be well prepared to respond to the resurgence of the cases.[2],[4],[5],[6]

In conclusion, the potential risk of COVID-19 infection in cities and urban pockets is extremely high. Thus, the need of the hour is to improve our preparedness and aim for the sustainable capacity development and a holistic public health emergency response.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report 157; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200625-covid-19-sitrep-157.pdf?sfvrsn=423f4a82_2. [Last accessed on 2020 Jun 26].  Back to cited text no. 1
    
2.
World Health Organization. Strengthening Preparedness for COVID-19 in Cities and Urban Settings-Interim Guidance for Local Authorities. Geneva: WHO Press; 2020. p. 1-11.  Back to cited text no. 2
    
3.
Han Y, Liu Y, Zhou L, Chen E, Liu P, Pan X, et al. Epidemiological assessment of imported coronavirus disease 2019 (COVID-19) cases in the most affected city outside of Hubei Province, Wenzhou, China. JAMA Netw Open 2020;3:e206785.  Back to cited text no. 3
    
4.
Shrivastava SR, Shrivastava PS. Minimizing the risk of international spread of coronavirus disease 2019 (COVID-19) outbreak by targeting travelers. J Acute Dis 2020;9:47-8.  Back to cited text no. 4
  [Full text]  
5.
Escalon MX, Herrera J. Adapting to the Coronavirus Disease 2019 Pandemic in New York City. Am J Phys Med Rehabil 2020;99:453-8.  Back to cited text no. 5
    
6.
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. 6
    



 
 
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