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COMMENTARY
Year : 2020  |  Volume : 64  |  Issue : 6  |  Page : 90  

A science-based response to COVID-19


Former Principal and Head, Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India

Date of Submission15-May-2020
Date of Decision15-May-2020
Date of Acceptance15-May-2020
Date of Web Publication2-Jun-2020

Correspondence Address:
J P Muliyil
Department of Community Health, Christian Medical College, Vellore, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.IJPH_530_20

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   Abstract 


The COVID-19 pandemic behaves like many other viruses spread through respiratory routes. This is generally a mild disease for those aged less than 50 years. A complete and prolonged lockdown will reduce COVID-19 mortality but simultaneously lead to a graver public health, social, and economic disaster. The focus has to be based on the reality that exists in an area.

Keywords: COVID-19, science-based response, reducing mortality


How to cite this article:
Muliyil J P. A science-based response to COVID-19. Indian J Public Health 2020;64, Suppl S2:90

How to cite this URL:
Muliyil J P. A science-based response to COVID-19. Indian J Public Health [serial online] 2020 [cited 2020 Sep 29];64, Suppl S2:90. Available from: http://www.ijph.in/text.asp?2020/64/6/90/285632



COVID-19 became a worldwide pandemic almost in a flash, reinforcing the notion that humankind exists in a global village. International borders or local lifestyles presented no barricades for the spread of the virus. Even though the evidence so far suggests that this contagion also behaves like many other viruses spread through respiratory routes, the scientific community has been ambiguous enough to spread anxiety and fear. One should never allow fear to be the dominant frame of mind in formulating a response to these sort of adverse situations.

COVID-19 is by and large a mild disease for those aged less than 50 years. In the vast majority of instances, it presents as a sub-clinical infection or mild illness. Most infections occur through droplets, and infectivity lasts for less than 10 days after clinical onset. The infectiousness in preclinical and subclinical periods makes containment difficult, but in all instances, the body is able to clear the virus with good IgG response. The public health importance of the disease lies in the very high mortality that it causes among those above 60 years of age. This too appears to be not due to the poor immune response but as an overt response that damages a host's tissues. Like many other viral infections mainly transmitted from person to person through droplets, this illness too shall follow the general rules of herd immunity and become an endemic agent with repeated recurrence when there is a gradual increase in the susceptible population. The immunogenicity of the virus suggests that there should be no problems in creating a safe vaccine that should be available in the foreseeable future.

At present, there seems to be a serious effort going on in our country to contain and eliminate the disease. In many parts of India, including major cities, this will be futile, and we need to expect the epidemic to run its course. A complete and prolonged lockdown will reduce COVID-19 mortality but simultaneously lead to a graver public health, social, and economic disaster. The focus will now have to be in reducing the mortality. Self-imposed physical isolation of the elderly can theoretically reduce the overall mortality to a great extent. This will have to continue for 3 months or so till the herd immunity in the locality reaches the threshold level. A mismatch between what is possible and what one is trying to achieve causes a lot of suffering to everybody concerned.

I think our focus has to be based on the reality that exists in the area. Hence, where there is an established community transmission, we have to focus on supporting the health-care institutions that look after these patients so that we can reduce mortality. Moreover, we have to commit most of our resources for this to be effective. There are areas in the country that have succeeded in eliminating the disease locally; their challenge will be to maintain this status. However, at present, we are facing a crisis in many of our cities, and our approach has to be pragmatic and based on scientific credibility.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.






 

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