COVID 19 Prevention, Elimination, and Eradication: The Status Quo

-- Dr Raju Adhikari / प्रकाशित मिति : आइतवार, साउन २५, २०७७

After almost 8 months, the world is still struggling to contain COVID 19 which has infected over 19.4 million and caused over 722,000 deaths. The scientific community now hold the view that Coronavirus COVID19 is the deadliest virus compared to the previous corona species (SARS, MERS). It is mutating fast like the Influenza virus and its effects are far more dangerous and unknown compared to influenza.

Of the three main strategies, prevention was successful due to lock down and social distancing measures if you ignore recent flare-up attributed to human errors and loopholes. On the other hand, eradication (zero infection in specific areas) is possible with the vaccine while elimination (zero infection worldwide) is impossible even after vaccination, experts say. The virus is now affecting people of all ages and causing many side effects from hypoxia, blood clot and may cause long term effects not experienced earlier with previous viruses. Data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection and 5% are critical infections, requiring ventilation.

There are debates on some of the options considered for virus treatments. Approval of few drugs not reported effective against previous coronaviruses and known to have serious side effects such as lopinavir/ritonavir; dexamethasone; hydroxychloroquine; azithromycin; tocilizumab is likely causing more harm in susceptible old people with low immunity. Another concern about the effectiveness of mask preventing coronavirus particles of 120 nm size while the pore sizes of the N95 mask are 100 to 300 nm.

The only way forward is tracing, tracking, and rapid detection of the virus in a large population and maintaining social distancing and hygiene measures for prevention until the vaccine is available. Most countries trying to increase the test numbers. India has tested 1.66% (aiming 5%) of the population while USA 18.8%, Brazil 6.3%, Russia 20%, South Africa 5%, UK 25% are doing better. Australia 14% is good, but Victoria stage 4 lock lock-down suggest more test and trace is needed

Nepal Strategy

The PCR test on 1.5% of the population close to 435,000 is a good number but due to increasing confirmed cases  over 22500  and daily reported cases close to 400,   expert believe that Nepal needs an aggressive approach to be on the safe side due to poor health infrastructure and open border.

PM KP Oli had called an emergency meeting of experts a week ago to discuss COVID situation and seeking their input on the modality of lockdown, testing scope, hospital-based preparations, making mask mandatory, operation of public transport and business, international border checkpoints and valley entry points. The unanimous feedback from the experts were to opt for smart lockdown instead of full lockdown, expand the scope of testing, adopt a strict system of operation in business and transport, tightening of international border checkpoints and valley entry points.

Nepali diaspora death is reported to have reached to 161 while the total death in Nepal stands only 73 and one may wonder how reliable Nepal’s reported data is?

Author is a Biomaterials scientist and is associated with SK&TT Department, Nepal Science Foundation Trust (NSFT), NRNA