Fast spread of coronavirus infection across the world has brought up several important questions. First and foremost, what countries should do in order to suppress spread of Covid- 19 and what methods have confirmed to be efficient so far?
The answer can partly be found in new studies on different measures implemented so far.
Prevention and suppression measures
In the absence of vaccines and anti-virus medicines, prevention and suppression measures are the only measures to be taken. In the second phase, when virus starts spreading in a country, then measures of alleviation are implemented.
Measures of prevention and suppression usually encompass the following:
- promotion and health work on the prevention of contagious diseases;
- early identification of the source of contagion and then ways of transmission;
- laboratory isolation and identification of causes;
- reporting the cases
- transport, isolation, hospitalization and treatment of patients;
- implementation of disinfection and hygiene measures
- health supervision, home isolation and quarantine;
- health supervision over the medical staff
Problematic examples of Asian cities
As expected, the virus is spreading in big cities with dense population, in public transport, schools, offices and coffee shops.
That’s why methods and results of some cities are being compared in the analyses of success in the prevention and suppression.
In that context, Chinese Wuhan is the example of a bad reaction of authorities, as they failed to release information on the infected persons. Consequently, rigorous measures came too late. However, one should bear in mind that the city had incomparably less time and information to efficiently suppress Covid-19 as the disease broke out during the period of influenza.
However, measures taken by other cities in China and outside China are not equally good. Hong Kong, among others, is cited as not very great example, the main reason being mistrust citizens have in the authorities and politicians.
Some experts believe that Tokyo can’t serve as a positive one. Tokyo cancelled marathon but failed to impose restrictions on public transport.
Singapore with excellent healthcare system
Generally, all experts and health organizations in the world agree that Singapore is the best example of success shown in SARS epidemic.
A recent study carried out by scientists from Harvard University has shown that Singapore is currently the best example of successful handling Covid-19.
According to that research, number of patients in the world would be 2,8 times higher if all countries had the same capacities as Singapore.
Singapore has one of the most efficient healthcare systems in the world, owing to great public means, low expenses of treatment and bunch of doctors, nurses and other health staff.
Until Tuesday, 90 cases of Covid-19 were confirmed in Singapore. The number is the result of a very successful detection and monitoring of their contacts.
Scientists from Harvard used historic data on the international air travels in order to find out the number of citizens who traveled from Wuhan to different cities outside China.
Authors suggest that one of the implications of their study is that the virus could have remained undiscovered.
Serious engagement of the authorities in Singapore
Numerous medical experts and organizations have praised Singapore.
Professor End Eong Ooi, deputy director of the program for contagious diseases of Duke-Nus medical school in Singapore, says that city’s reaction to the epidemic was easier and more coordinated in comparison to its response to previous epidemics.
“The main improvement is that Singapore accepts comprehensive approach which includes coordinated actions in several parts of the government”, Mr Ooi says.
Restrictions on travelling
Quarantines and closing borders have a long history. The first official quarantine was established in Dubrovnik, due to the plague epidemic.
According to the BBC analysis, closing borders has protected some Spanish villages during the pandemic of Spanish plague in 1918 and 1919.
Also, some rural communities and towns in the USA, which closed its doors and entrances, were protected. One of such examples is Gunnison, little town in Colorado, which placed barricades and guards on all access roads and organized quarantines for the railway passengers.
On the other side, Spain prevented Portugal from getting necessary medical resources from the rest of Europe by closing its borders. Some historians concluded that the blockage was of more political than health nature.
SARS-CoV-2 . It is spread and transmitted easily
A new research published in Science magazine has shown that SARS-CoV – 2 has by 10-20 times greater affinity to enter human cells that other coronaviruses. That means that it can easily be transmitted by coughing and sneezing. It was also shown that there were more cases of super-transmitters in this epidemic. Finally, that enables to establish how useful prohibition of travelling can be.
Mr Matteo Chinazzi, scientist from Northeastern University, developed an algorithm which discovers how efficient some prohibitions can be. Its model reveals the way people used to move before and after the establishment of quarantine and prohibition of travelling.
The model provided mixed results. On one side, quarantine in Wuhan was established too late. By then, the virus was already transmitted in the main Chinese cities.
The model shows that quarantine in Wuhan has delayed global spread of epidemic by five days maximum. That’s important, although it comes as no surprise that the quarantine wasn’t as efficient as expected.
Prohibition of travelling – short-term effect
Another research has shown that prohibition of travelling usually has short-term effect.
In case of influenza, the ban can delay epidemic by a week to two months. But total number of diseased persons is reduced by only 3%.
How efficient is airport control?
Process of the detection of disease at airports isn’t 100% effective either. For example, devices for measuring temperature manage to identify the person with high temperature in around 70% of cases. That means that every fourth person will go unnoticed.
It is interesting that one company from Singapore published to have developed an artificial intelligence system for checking temperature from over one meter of distance.
A research carried out by scientists from London School of Hygiene and Tropical Medicine has shown that around 45% of the diseased persons will be identified on their departures, and round 9% will be identified on their arrival, whereas around 46% will not be identified at all.
Very few people admit having the symptoms
According to a new research, every fourth person will tell the truth about his/her health condition. That’s quite expected, considering the quarantine measures and other complications the person could be exposed to if he/she admits the condition.
No method is 100% effective. But a combination of methods might produce good results and save many lives.
