Containing Intensity of Covid-19 by Halting Community Transmissiom by Dr Emem Omokaro
The increasing reports of confirmed cases and deaths, long after the closure of international and inter-state boarders, reveal the glaring GAPS in the containment and mitigation strategies for COVID-19.
Increasing number of cases is proof of the intensity of coronavirus activity, where most people are still in doubt of the reality .
Infections are now showing up as sustained community transmission not just as common occurence, where hitherto, isolated cases were limited to import by arrivals from abroad and transmission to their contacts. Now, we see no new travels, yet the increasing incidence of infections, across the country.
Halting community transmission of the virus, through testing, isolation and contact tracing, is the mechanism for reducing infections; keeping to the minimum, the need for hospitalization and therefore reducing the pressure on the health system. Halting community transmission is to large extent, immobilizing the virus .
However, in Nigeria, the steep rise in the numbers of infections show that govt planners, community organizers and all concerned, must engage in very aggressive CAMPAIGNS, like it is done during political electioneering by politicians. Public enlightenment must be conducted from door to door, ward to ward within local governments , senatorial districts etc , to Inform & Educate the people about the virus. The intention should be firstly, to WIN their TRUST and then the community's compliance.
It has been confirmed that imposing restrictions without people understanding why, would be perceived as punitive and as infringement of freedoms. Where , restrictions are imposed without proper strategies for the immediate meeting of the need for support services and proportional palliatives, there is a likelihood for a push back. Where for instance, governments on subnational levels disrupt society by closing markets etc far ahead of distributing critically needed provisions to support the community, the need for self preservation by staying indoors during the lockdown, may fail to win the argument against the need for self preservation through guarantee of FOOD Security.
Commuity transmissions have been fettered where governments have delayed the setting up of infrastructure for testing , Isolation, contact tracing and Lockdown. Some State governments are seen to have eased the lockdown for commercial and religious purposes and, have given permission in a few instances, to allow convergence of large crowds
Large crowds have also been noticed, when distributing food items in most cases, without monitoring to ensure, the crowd observe Social distancing.
Mass gatherings magnify the spread of infectious diseases within communities. It is a silent transmission.
The National Primary Health Care Agency working in collaboration with National Orientation Agency is critical in the promotion of public health measures in all local languages especially in the city slums and rural areas
Stopping Community transmission would demand that community based actions become more extensive and aggressive. States and Local governments, should be seen to utilize every social, political, traditional and religious leadership organ on multilevel and across all sectors to mobilize, sensitize and unify the call to members of the community to collective community action to contain and mitigate the virus.This is critical, especially given that cultural values, living circumstances, spiritual inclinations, and multi- dimensional poverty, may contradict and disrupt compliance.
States are signing Executive orders for the compulsory use of masks in public places. The intention is to contain transmission of
infections. Some countries where the use of masks have been found effective in reducing the spread of coronavirus, are known to have , deployed national strategies to promote, educate and in some cases ensure the supply of the proper masks to its citizens. The rate of literacy and engagement of the citizens in such countries have been confirmed to be among the determinants of the safety dividend. Information on the types of masks, the proper treatment of the mask when worn; keeping ones' hands from adjusting the mask and probably picking up infections, should be the content of public enlightenment discours. Also the hygiene of taking off and disposing of the masks and the hygiene of maintenance where the mask in use, is not disposable.
Public enlightenment is required to inform about the protocol of physical distancing, hand washing & respiratory hygiene to be combined with the facial masks and environmental cleaning. Persons living in remote and isolated communities should be reached.
This is the time to SENSITIZE and EDUCATE every community in order to ENHANCE understanding of the USE of the facial mask in all local languages.
Otherwise- the wrong use of the Masks might be a source of Community Transmission.
It is unfortunate that older persons & others with underlying medical conditions, as we are also beginning to see in Nigeria shall bear the brunt of Delayed or Failed measures