COVID19 and the changing concept of Public Health | Mansingh Aidee

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The recent outbreak of COVID19 has left the world shocked.The pandemic has hit the world hard in terms of healthcare, economic and development.As Public Health that is meant to be acting upon mass population, the article themes to describe relationship betweenCOVID19 and Public Health

Adapted from CEA Winslow definition of Public Health”]Public health is a science and art of promoting and protecting health of healthy people, preventing health risk factors, injuries and disease, controlling epidemics and encouraging people of disease domain for early detection, treatment and compliance through educational, policy regulatory, empowerment, infrastructural and managerial interventions to help people achieve optimum level of physical, mental and social well-being

We believe that prevention is better than cure. In other words, public health interventions are important in keeping us healthy. Having said this, a very little public health interventions are being carried out in the world and in Nepal, where hospitals and doctors (medical personnel) are termed as health. Thus we can understand that our health system is more focused on clinical health services rather than public health initiations.

People used to see public health field as something where public health practitioners teach people how to wash hands, how to use condoms, ensure immunization of children and so on before this global pandemic occurs. However, people and government have realized the significance of public health more now.

As public health practitioners focus on promoting health, preventing health risk factors, injuries and diseases, protecting health (biological and chemical factors), controlling epidemics and outbreaks and finally encouraging for early detection, treatment and compliance so, health system without public health concepts will be of baseless to practice and aim to create a healthy community.

COVID19 and Public health

Corona virus disease 2019 (COVID19) is a respiratory illness that spread from person to person caused by newly discovered novel corona-virus. This COVID-19 pandemic situation has forced the lock-down of the people, business, goods, and services worldwide. The COVID19 pandemic threatens to beat the health care system of the world and the globe is struggling to respond to pandemic COVID19, Wuhan of Hubei Province of China being the epicenter with the first case of COVID-19 reported on 31 December 2019. Public Health Emergency of International Concern (PHEIC) has been declared on 30 January 2020.

The World Health Organization (WHO) declared COVID19 a pandemic on March 11 after over 118,000 cases of corona virus were detected in over 110 countries (Gautam, 2020). Nepal, one of the landlocked countries, fails to remain untouched from this pandemic and the first case of COVID19 was reported on 23^rd January, 2020. Poor urbanization management with densely populated cities, inadequate health equipment and infrastructure and very little public health initiatives from concerned stakeholders are some of the excuses existed in the health system of the nation. As Nepal undergone federalism with new constitution being promulgated in 2015, there is significant change in health system of the country. Still, the three government’s coordination and collaboration part is seen huge gap to response and initiate public health led initiatives in the country. Since Nepal does not have adequate health technology to combat the virus, it is creating huge panic and stigmatization among COVID19 patients.

This virus probably emerged from an animal source, but is now spreading from person to person. People who are in close contact with one another (within about 6 feet) through respiratory droplets produced when an infected person coughs or sneezes are high chance of getting virus. A person can also get infected with virus by touching a surface or an object that has the virus on it and then touching their own mouth, nose or their eyes.

Patients with COVID-19 have had mild to severe respiratory illness with symptoms of:

• High fever
• Dry cough
• Shortness of breath and exhausted

The serious symptoms includes difficulty in breathing or shortness of breaths, chest pain or pressure, loss of speech or movement.

However, the Government of Nepal took action to prevent, control and early detection and treatment of COVID19 by the cease of the border, cancellation of internal and international flight, travel restriction, lock down of the country, increase laboratories and incentives to health workers, establishing quarantine camps in different local levels of the country, rescuing and providing relief emergency materials to the people in need through local government and community based organizations, lobbying policy and adapting technologies for the detection of corona virus and make sure dedicated hospitals to treat the COVID19 cases.

This lock down has been able to prove as preventive measures of spreading corona virus in a mass with exponential growth.

There is currently no vaccine discovered to protect against COVID19. The best way to prevent infection is to take everyday preventive actions, like avoiding close contact with people who are sick, staying at home, avoiding crowd, maintaining social distancing and washing our hands often with soap and water or with alcohol based hand sanitizer for at least 20 seconds. Similarly, there is no specific antiviral treatment for COVID-19 till date. People with COVID19 however can seek medical care to help relieve symptoms or kept isolation till they recovered. (CDC, 2020)

Current status of COVID 19 and Public Health

Taking prevention and control of this pandemic into considerations, many countries in the world are practicing lock down, shutting down schools and academic institutions, offices and every businesses which is followed in Nepal as well.

Even the world’s developed countries in health system fails to face this global pandemic, which evidenced that health is beyond than that of medical systems and treatment, hospital and infrastructure that we believed as health system. So, this is the utmost time that we can exercise public health initiatives, lobbying public health policies and advocating about our area of our work. With this pandemic, we can clearly visualize that we all are practicing social distancing, hand-washing with soap and water or with alcohol based hand sanitizer, avoiding crowd, staying at home and self-quarantine, early detection, etc. These all are the areas of public health.

 

Way forward:

This despair is uncertain. Thus, public health initiatives should be launched on time. There is no evidence that epidemic is controlled without a sustained public health education campaign. Therefore, following public health measures should be implemented before it will be too late:

• Review and revise national health policy
• Investment in public health
• Recruit public health workforce for contact tracing in each local government
• Increase PCR testing (100%)
• Change quarantine policy (Child friendly, gender friendly)
• Improve quality of our quarantine facilities (Pathetic quarantine centers are multiplying transmission of the COVID19 in Nepal)
• Declare public health emergency
• Minimize social stigma relating to corona virus
• Establish a universal helpline number for any COVID19 related crisis from health emergency, mental health. Counseling, transportation, social stigmatization.
• Regular and honest communication between all level of the governments
• Develop policy and guidelines with the ease of lock down and new normal

Therefore, it is baseless to imagine about creating healthy community without public health interventions and initiatives and this is a very factual period to study and revise our national health system in different levels of the government. COVID19 realized the importance of public health to every one of us. Thus, with joint and multi-sector collaborations, we can envision COVID19 free Nepal and world.

References:

1. (2020). CDC. Retrieved from www,cdc.gov: https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html.
2. Gautam, S. (2020). Combating misinformation. MyRepublica.

• ✍️ Mr. Mansingh Aidee  Bachelor in Public Health , NHIS/Stupa Recommended Citation :Aidee, M., 2020. COVID19 and the changing concept of Public Health [online] Nepal Health Magazine. Available at: <https://nepalhealthmag.com/covid19-and-the-changing-concept-of-public-health/> [Accessed July 03 2020]