COVID-19 Information: Part Two
Selected Information only:
In the second part of the COVID-19 course (Uni London) interesting facts and ideas emerged… moreso because they are similar to my own findings and ideas!! Below are some of these facts. I have isolated them from the much longer material I was given during part two of the course, so what I am presenting is more for practical use than for academic use…
Interestingly one unit began with reference to the Book of Leviticus (no – nothing really biblical) – how people dealt with leprosy by isolating sufferers. As the lecturer said, this was “long before the cause of infectious diseases were understood”. In this we find an almost tacit statement that God gave such knowledge at a time when nothing was known about real medicine. Anyway…
Each disease has its own incubation period (the time from catching the virus and the showing of signs and symptoms). With the present virus this is anywhere between 2 and 14 days (hence the usual advice to self-isolate for two weeks). Of course, this does not guarantee immunity! On day 15 you might still contract the virus! There is currently no knowledge of those who had the virus being immune to further attack. This is still ‘in the air’ until the spread has completed its course. Even when symptoms show there is another period in which we start to infect others. In other words having the virus has a time when it begins to pass on to others… different timing in each case.
Unfortunately, there is no way of knowing if someone is infected until symptoms are shown, so even when we shop amongst other people who appear to be virus-free, they/we may still be incubating COVID-19. But, that is how it goes. We should bear in mind that an infected person who has yet to display symptoms can still pass on the virus to others. What THIS mean is that the only way to be free of the possibility of infection is to be totally isolated. But, this is unworkable. As with the common cold (which is also a coronavirus), it is all the ‘luck of the draw’ because we might suddenly find ourselves close to someone who sneezes or coughs for the first time, not knowing they have the cold virus! Unless everyone literally is locked in, nothing can be done about it. And total lockdown of a country brings its own problems, medically, psychologically, socially and economically/financially.
No-one yet knows if the person who has recovered can still pass on the virus. Of course, some (possibly the majority) have the virus but no symptoms, so not only those who have been identified as having it can infect others. Knowing this should not bring about blind panic, but more of “Well, I am taking common-sense precautions, so let us hope we will be okay!”
There is no point in becoming anxious over what has been said – nobody in medicine knows everything about the virus and how people are affected. It is all still in a state of flux. For Christians the thinking should be that if we live righteously, we are likely to be protected by God (and if we obey the basic rules already known).
“Infection prevention advice to individuals has the potential to reduce transmission of SARS-CoV-2 causing COVID-19, and if the advice is timely, clear and easy to understand it may also improve confidence in the response and give individuals a sense of control. It is important therefore that any advice to individuals is considered, evidence based, rational and coherent.” (Emilio Hornsey, London Uni).
It is my own view that the UK government has made simple rules but do not consider that some of them can be over-simplified, making them onerous, anxiety-producing, unfair and out of step with the facts. I have already mentioned some of these elsewhere. A number of experts have called for measures to be graded so public policies keep in line with actual figures. This is exactly what I have called for.
Below notes are quoted from a course section (any numbers are references to study lists and sources). Where appropriate I have inserted my own comments, prefaced by KBN:
Cough hygiene: A cough should be caught in a single use tissue, or the crook of the elbow. The tissue should be immediately disposed of and hand hygiene performed. Coughing into bare hands means they can become heavily contaminated; unless immediate and thorough hand hygiene is performed, they can become a vehicle for transmission. Cough hygiene can reduce, but not totally eliminate, droplets being released by a cough or sneeze (3, 4). (KBN: Of course, if a person has even an irregular cough, he or she should not be out anyway)
Avoiding face touching: Avoiding face touching is a self-protective measure. The risk is that contaminated hands can contact mucosal surfaces and cause an infection. The extent of its role in transmission of infection has not been thoroughly investigated. People have been observed to touch their face 23 times per hour (5) and more in times of stress and in some social groups (6). (KBN: It is almost impossible not to touch our faces! It happens when we do not realise it. However, if we have a constant mind to do it, we will avoid so many touches).
Social distancing: Social distancing is a series of measures which include minimising social contact of large groups of people in crowded spaces. It may also involve minimising physical contact through actions like hand shaking and kissing as a greeting, depending on social norms, which are culturally specific. Social distancing can protect both the individual and others around them. While the principle behind the intervention(s) is sound, it is difficult to calculate the impact of each element7.
Self-isolation: Self isolation is a more extreme form of social distancing, it has been recommended for high-risk contacts and for those with mild symptoms who do not require medical care. The isolation of asymptomatic high-risk contacts is rational if there is strong evidence of pre or asymptomatic infection (8). However mass isolation may have major social and economic effects (9) so the risks and benefits should be balanced, and may be tailored according to risk, or consequences of, infection. (KBN: this is where I have more concerns, and why I have queried the mass-isolating demands made by police and government. The effect will become anti-government very soon; the policy needs more common sense and should follow actual science rather than be dictated by public anxiety. At the moment, what government is doing is panicky and is rather like putting a whole town in prison because a few people burgle houses!).
Hand hygiene: Frequent hand hygiene with either soap and water, or alcohol-based hand rub. Key moments are after using the toilet, coughing or sneezing, before preparing food or eating, after touching communal surfaces such as door handles and before touching your face. Hand hygiene should be thorough, to decontaminate all areas of the hands10. (KBN: hand washing is the better option. You should also hand wash after receiving and opening mail, and after receiving parcels or food).
Face masks: The value of wearing these outside health care settings is controversial (11) but it is one of the most visible features of the response in many areas. The evidence for the protective effect of asymptomatic individuals wearing masks is weak (12) and facemasks may change face touching behaviour if they become uncomfortable and need adjusting (13). There is evidence that wearing a mask reduces the droplet spray if individuals cough or sneeze (1). Social distancing and cough hygiene are other measures that can be instituted to control the effect of droplet spread. (KBN: I have seen some people in supermarkets pull a jumper up over the mouth and nose. There is no real proof this has any value. In fact, it is more likely to increase risk, because the virus is so small it will pass through wool or other woven fabrics! Wearing gloves is of far more value where those around us do not appear to have symptoms).
Other advice (less consistently seen) includes:
Avoiding wet/live meat markets: This is only relevant in areas where these exist. Many early cases were associated with the Huanan seafood market for this outbreak (14) but it is not clear that this is where zoonotic transmission (spread from animals to humans) occurred. Without evidence of multiple events where zoonotic transmission of SARS-CoV-2 has occurred in wet/live meat markets, this measure won’t affect the course of this outbreak, but it could reduce the risk of a similar future emergence. KBN: I am not so sure. The same Chinese market has gone back to lack of hygiene and selling dead bats, dogs and cats! In itself this could generate a strong mutation of the original virus).
Active monitoring of health after travel to areas with transmission: (15 )As areas of ongoing transmission shift this advice will need regular updating.
Avoiding close contact with anyone who is sick: (16) This is the other side of self-isolation but will be harder to adhere to for people with caring responsibilities.
Not spreading rumours: (17) This advice acknowledges the risks associated with misinformation, as described in the article on risk communication and community engagement in Week (1). (KBN: This is why I ignore or reject the fact that most ministries are trying to give their readers ‘advice’, when no-one in that ministry has authentic sources of information, and do not understand it anyway)
Regular household surface disinfection: (18 )(KBN: It is said that this must be deep cleansing and often. It is my view that if an individual or family are self-isolating and already follow advice, the reasons to clean several times a day are without real worth. If nothing new has happened, no-one else comes into the home, and there have been no new receipt of letters and parcels etc… why keep cleaning? In such a stable environment it is suffice to clean say twice – at start and end of the day. The rest appears to be borne of fear).
Avoiding spitting in public: (19) In some cultures public spitting is much less socially acceptable in general so a specific injunction isn’t required. (KBN: A disgusting habit anyway!)
And from another session (a summary rather than verbatim):
‘When a government forces measures on the public (as in the UK) suspicion and resentment (occurs) in an outbreak’ ‘Voluntary action should be promoted. Reinforced by persuasion, shared understanding and common ownership’ (Anna Seale, Educator, Uni London).
It is like parenting… those short tempered parents who want instant obedience tend to be angry all the time, shout a lot, and might even hit out. Their children will then grow up with similar attitudes and actions. But, parents who discuss matters, advise WHY something is wrong or right, and display a calm even approach will usually raise good children. Not always, but at least reasonably good!
Also, it is like sound Christian faith – show that God is in control, even when a virus ravages the world, and others get a far better perspective. Those who panic or believe in silly ideas will help society to degenerate.
As I have shown in a recent paper containing two arguments opposing government and police activity, policies at the moment are not in step with the facts, and instead of phasing measures, they are hitting society harder than is needed.
© 30 March 2020
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