Confusion, common sense and Coronavirus

Updated: Mar 13, 2020, 08:20 IST | T Sriraman | Mumbai

Not travelling and not going to work will not stop the virus from entering your home or town; soap is your only real magic pill

A man finds a novel way to use his mobile phone while wearing a mask at the airport. Pic/ Sayyed Sameer Abedi
A man finds a novel way to use his mobile phone while wearing a mask at the airport. Pic/ Sayyed Sameer Abedi

picAs A social sector professional, it is painful to see people suffering due to misinformation over a newly discovered illness. It is more painful to see that lack of state preparedness and response contributes to the ease with which such panic spreads and sustains. With Coronavirus, this is epitomised in the state-aided messaging to keep offices/campuses closed, leading people to believe that the best protection from infection is to stay home.

Many people – including, sadly, in our own sector – are too scared to travel, as if stepping out from our 'known' spaces will automatically render us immediately and certainly vulnerable to death. A tiny bit of reading, and resort to what we surprisingly still know as 'common' sense will show this is a fallacy.

The Coronavirus does not reside only in the 'other' space/body. It is now almost as common as the common cold, apparently. What is uncommon is that in specific conditions, the infection can grow from 'mild' to 'severe' very, very quickly, especially when the infection (not the virus) enters the lower respiratory tract.

What then happens to the severely infected person depends on the healthcare response the patient receives. Where there is good healthcare response – like in Kerala or Thailand, which saw the first person to be completely cured – through a regulated public health system that ensures high standards of hygiene, sanitation and nutrition, a person having severe or even critical infection can be completely cured and return 'home'.

Whose responsibility is this? The state's of course. Based on the work of my esteemed colleagues in this sector who have specialised in public health interventions (unlike me, who specialises mostly in holding state systems to account in the context of education and violence response), only the state can regulate and ensure standardised and high quality testing and screening, even before treatment begins.

In our work on violence against women (VAW) response, there is a relatively recent terminology of 'primary, secondary and tertiary prevention'; if treatment is tertiary prevention in the case of public health/Coronavirus response, then primary prevention will be the stage of screening, testing and treatment at arrival.

Back to the point about the stay-at-home messaging by the state, this is equivalent to a very poor strategy of secondary prevention (to continue the VAW response analogy), which comes after the primary prevention at influx/arrival stage has been royally messed up.

In fact, it is counter-intuitive and counter-productive. Research shows that handwashing keeps all kinds of infectious diseases and illnesses at bay to the greatest extent. In fact, it saves lives. I fail to see where provision of water and soap has been taken up by the state on a broad scale. More importantly, what is the state doing to mandate provision of adequate water and soap in all state and non-state workplaces, including schools and colleges? Why is it being left to common people to 'protect' themselves from infection?

A prime example is the working-class family and the child from that family, whose school has been closed for a considerable time. That child lives in a stuffy, sweaty environment, with five to 10 members of the family in a single 8ft by 12 ft kholi in a chawl, where constant running water and electricity is not a given, in one of the most densely populated cities in the world.

That child is more prone to being infected in contact with one of the adults of the family who cannot afford to stay at home despite the 'scare', as they are the daily wage earners. That child's infection is also more prone to grow from mild to severe or critical given humidity, missing nutrition of the egg from the daily mid-day meal at school, absence of common sanitation including handwashing facilities, limited availability of soap, in their chawl/kholi.

The 'stay-at-home' messaging only allows the government to wash its hands of (no pun intended) its responsibility.

It is also a myth that even above-poverty line (APL) people will be safer 'at home'. People wrongly believe they don't need to wash their hands as much at home because 'my/our home is clean'. So only everything outside our doorstep – the 'other' – is dirty and viral and infectious, is the false but popular notion.

We should know that all the stuff we bring into our well-off homes – including our own phones – also goes through multiple locations, and we are probably 're-infecting' our homes every few minutes ourselves.

How can the state intervene to stop people swinging between unnecessary panic and extreme paranoia? By remembering and practising the public health intervention strategies that wiped out or substantially decimated the mass murderers of yesteryear – from polio to cholera to the influenza itself.

In other words, to ensure people's safety and decrease risk by providing for and mandating in all public spaces handwashing with soap, as well as screening, testing and treatment, and thereby ensuring that people come out and get help if they need it, and not by encouraging them to sit at home and fester in family spaces that are not infection-free in the least.

Not travelling and not going to work/study is not going to stop the virus from coming to your town, city or home via people who have been travelling, and who also have all the right to come 'home' for treatment. That treatment, from the state, needs to be the best treatment possible.

T Sriraman is a social sector professional

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