The implications of Covid-19 on our society has now heightened in light of the World Health Organisation (WHO) declaring it a pandemic and the announcement of the first death attributed to the disease in Ireland. This means that we have moved to a new phase and that public health measures now need to take priority.
Italy is currently imposing unprecedented restrictions on its population to facilitate the sort of social distancing which has worked in China and South Korea. This is a further measure to add to what is already in place in Ireland and we should all be prepared to adapt to a new environment while we deal with this pandemic. New policies that may restrict movement and social gatherings will bring huge changes for all of us but can help to protect our population from this virus.
This strategy has been shown to work with controlling and eradicating other new infectious diseases in the past and it is particularly important for protecting those most at risk.
Best global strategies
Health systems put plans in place for public health threats such as new infectious diseases and this is what is currently being done here. The plans are in line with best global strategies and are guided by the WHO and the European Centre for Prevention and Disease Control as, daily, more scientific knowledge on this new infection emerges.
As a result of this international co-operation and collaboration the new virus called Sars-CoV-2 which causes the disease Covid-19 was identified. The prompt scientific, medical and public health response has led to new diagnostic tests, an understanding of its impact on human health and a multipronged strategy to reduce and prevent further spread of this infection.
In general, the way all infections are transmitted between people can be contained and/or mitigated by adopting public health measures, many of which are already evident here. Covid-19 appears to be transmitted by respiratory droplets through sneezing and coughing. However, as the virus is new there is not enough information to determine with certainty how easily it is passed between people.
The inevitable comparison is made between seasonal influenza and Covid-19. However, a fundamental difference is that flu is predictable
What’s different about Covid-19? By now most people are aware that the virus emerged in China in December 2019. The virus is only three months old, and our knowledge on how it is transmitted, and its effects on human health expands daily thanks to in-depth surveillance and reports. We know that it’s in the same family as Sars and while there are similarities in how both viruses affects humans, Sars was geographically confined, which allowed for easier containment and eventual eradication within eight months of starting. In contrast, Covid-19 has global reach and has infected many fold more people many of whom have mild symptoms. The importance of public health surveillance and research cannot be overstated as knowledge is power and control over emerging infections such as Covid-19.
The inevitable comparison is made between seasonal influenza and Covid-19. Both infections affect the elderly and those with chronic illness most severely. However, a fundamental difference is that flu is predictable. Flu will be gone, at least for this season, by springtime, and years of investment in scientific research and discovery has yielded vaccines to prevent it and drugs to treat it.
Currently there is no specific treatment for Covid-19. Trials have already begun on antiviral medication to combat the infection and work is under way to develop a vaccine. Vaccines are used to prevent the infection; however, development usually takes one to two years to ensure that the vaccine is safe and that it works against the infection.
In the absence of a vaccine, we look at the emerging evidence to see what works to limit the spread of the virus. There are many components and at this stage we know from China and South Korea that social distancing – fewer gatherings of people – has an impact on reducing transmission and spread of this viral infection.
Clear communication
Regular concise and clear communication is essential. Daily briefings and regular information updates from the expert team led by the State’s chief medical officer, Dr Tony Holohan, are providing the most accurate and up-to-date information on Covid-19 in Ireland.
These are extraordinary times. Rigorous infection control measures applied globally have been effective in controlling other infections such as Sars in 2003. With infectious diseases we need to expect the unexpected and be ready to respond to the unexpected when, and not if, it occurs. The tools that are essential in our fight to control and contain this virus are close monitoring, aligning our actions with best international practice and clear communication to the public to offset anxiety/panic.
Each of us individually and together as a society plays an important part in controlling the spread of the infection. We can forgo the social gatherings in favour of a social responsibility, to protect those for whom an infection could be critical. Everyone has someone who may be more vulnerable, an elderly parent, a friend with an underlying illness, a family member undergoing chemotherapy treatment. Let’s show how we as a nation can band together to protect those people and shine our light brightly, even in these difficult days ahead.
Prof Mary Horgan is president of the Royal College of Physicians of Ireland and a consultant in infectious diseases at Cork University Hospital