I've seen a lot of videos and talks on COVID-19 so far and, of course, I've read a lot on this subject. I think that while covering the COVID-19 pandemic, talking about the statistics, the virus in general and other things, I have created my own model of understanding of this huge public health issue, and, accordingly, the way to resolve it. I believe that there are four important public health measures we can take to end this pandemic with minimal socioeconomic and humanitarian losses.
Before we progress, I will make a couple of my usual disclaimers:
- 1. I am not an infection control specialist, I'm just a psychiatrist and a researcher – I might be wrong on some aspects of my discourse. At the same time, I am presenting my honest and educated opinion on the problem and I do it in good faith.
- 2. I am a practising physician, but this is an educational blog – my opinions and thoughts are not medical advice and should not be treated as such. If you need medical attention, seek it using appropriate channels.
- 3. I belong to several governing bodies and my opinions and thoughts might not be shared by these organizations, they are solely mine and are made in good faith.
Now, when we are done with the disclaimer, let's talk about these four public health measures to end this pandemic and to return to normal living:
1. Protect the vulnerable
We all heard that the virus is "targeting" the elderly and other categories of people. Well, the virus doesn't actually target anyone per se, but it is obvious that people with pre-existing health issues, immunocompromised and elderly will have harder time with fighting it off, and, accordingly, they haver lower chances of survival, so the very first thing we must do is protecting them. I am talking about making sure that the virus doesn't get into nursing homes and that we address the outbreaks there in the most effective way. We can also shield those who are at higher risk of complications by reducing their exposure to the virus – we must keep physical distancing, sanitizing equipment, use personal protective equipment.
2. Gradually, carefully, scientifically reopen the economy
This one might appear controversial and I would like to emphasize that I am not arguing for complete reopening of everything right away – I am talking about scientific analysis of existing data and progressive, incremental and cautious reopening of businesses, schools, institutions and services. There is a balance between the damages from the virus and the damages from isolation – younger and healthier people are very unlikely to have a complicated course of the virus and, at the same time, these individuals and the society in general suffer a lot from not being able to function. The current measures have already flattened the curve, but also they have affected many businesses and the whole economy very negatively, which will translate into lots of health issues and deaths in the nearest future. Even for those of you who don't care about economy, we see that the health care utilization went down significantly and lots of elective medical procedures were not performed – cancer screening, elective surgeries… people are not coming to emergency rooms even if they are sick, so there is an emerging issue of undertreatment of multiple medical problems which will affect the health and well-being of the population and will result in premature mortality, possibly at a much higher level than the COVID-19. Finally, we need to work on herd immunity, and it can be achieved only when the majority of the population acquires the virus. By lifting the measures and exposing those who are at a low risk of having health issues due to this virus we can create herd immunity with minimal exposure of the vulnerable people. It will protect them, and all of us in the end of the day.
3. Increase the capacity and preparedness of the health care system
The main premise of flattening the curve was not to prevent the virus from spreading, but to slow it down in order to avoid overwhelming of the health care system. We had some time already, the curve has been flattened, but we still can and should work on increasing preparedness via acquiring proper equipment, increasing capacity of hospitals and specialized units, training staff, developing more effective treatment protocols etc. All these things will help with handling the future cases of the virus and might turn out to be especially needed in case we have a second wave.
4. Improving our general health
There is a good chance that most of us will eventually contract the virus and we know that certain health issues are making us more vulnerable. While there are things we cannot change, like our age for example, there are quite a few things that we can address – we know that obesity is one of the major risk factors for COVID-19 deaths1, so we can use this time to lose weight. We can work on our lifestyle in general – improve our nutrition and make sure that we get all the micronutrients we need to have a strong immune system, we can engage in exercise activities to increase our resilience, we can work on stress inoculation. Also, we can still keep distancing, use personal protective equipment, sanitize our environment to reduce our personal risk of infection.
These were my thoughts and I genuinely believe that if we implement all four of these measures, we will be able to mitigate the harms of this pandemic. Some of us will even end up being healthier than they were before, both physically, mentally, and financially. Again, these are just my thoughts and if you have different opinions, please share. There are many other things we can talk about and I will definitely discuss it in my next blogs and on my YouTube channel, so if you don't want to miss a thing, check it out and subscribe. I hope you'll like it and, as always, you are welcome to leave comments and make suggestions.
Stay safe, strong, and healthy!
1. Garg S, Kim L, Whitaker M, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:458–464. DOI: http://dx.doi.org/10.15585/mmwr.mm6915e3