Claire A Davies
March 30, 2020
Just 21 cases of coronavirus have been confirmed in Ethiopia as of today, however with other countries seeing a pattern of infection that doubles in case number every few days, there has never been a more urgent time to protect yourself and your community. This deadly form of coronavirus (known as COVID 19) poses the biggest global health emergency of our times. COVID 19 is weeping across the globe, threatening the collapse of health systems in state-of-the-art health facilities in Italy’s Lombardy province and New York. This Coronavirus poses a particular threat to countries with limited capacity to cope, both in terms of hospital and intensive care beds and the huge threat to the economy posed by governments restrictions on movements and ‘lockdowns’.
It’s never been more crucial to take seriously the public and personal measures you can take to contain the spread of infection. There are still many unknowns about this lethal strain of coronavirus but it appears to be highly contagious. Most people will experience cough and fever, however some may experience rapid deterioration of respiratory symptoms around day 7. People may also have coronavirus but not have any symptoms – but still be infectious.
People with compromised immune systems (including HIV) and elderly persons are particularly at risk of becoming severely unwell.
If control measures are adopted strictly and in a widespread manner then it may not be too late. Here’s what you can do to protect yourself and your country:
Wash your hands
Coronavirus is spread by respiratory droplets which can enter the eyes, nose and mouth of another person causing infection. The droplets are often carried on your hands after picking them up from the air, physical contact with an infected person or contaminated surfaces.
When it comes to coronavirus, there’s no such thing as a quick handwash. A thorough handwash needs to take about twenty seconds. See the photo for the correct technique. It’s essential to use soap which destroys the outer lipid layer of the virus particles.
Avoid touching your face
Virus particles on hands can easily enter the mucous membranes of the eyes, nose and mouth, causing illness.
We all naturally tend to fiddle with our faces. Learning to leave your face alone is tricky but the habit can be broken. Use a tissue if your face is itchy or try 5 strong blinks instead of rubbing your eyes if they are irritated.
Cough and sneezes spread diseases
Always use a tissue to cough and sneeze, otherwise you risk showering people with viral particles. Dirty tissues should go in a bag and straight in the bin.
If you are unwell, stay at home.
Keep your distance from others
Early adoption of social distancing measures has been part of the Ethiopian government’s strategy to contain the virus. The WHO recommends keeping your distance from other persons by at least 2 metres.
Mass gatherings are banned. Schools and universities have also been closed, however there have been concerns including those cited by President Sahle-Work Zewde that social distancing measures are not being observed.
With a quarter of the world on lockdown to try and contain the virus, it’s essential to keep away from others. The infographic below demonstrates the effect of social distancing on the number of cases – a dramatic difference.
There is a raging global argument about facemasks at the moment. If you are sick, wearing a mask is likely to give some protection for your loved ones from the infection. For healthy people walking around in facemasks, it’s debatable as to how long these masks provide any protection. Masks do not provide any protection once damp and many people are unaware of the correct technique to remove them.
With a global shortage of protective equipment for health care workers, I urge to you to conserve the protective equipment for Ethiopia’s doctors and nurses on the front line of the fight against coronavirus.
See the WHO’s advice on when to wear a mask. I myself as a physician do not wear a mask on the rare occasions I am on the street in London during the lockdown.
Keep surfaces clean
Coronavirus has unfortunately adapted well to survive for long periods of time on surfaces. While it is impossible to keep every surface completely virus-free, you should consider the following:
Wipe down your desk, phone and computer with an antibacterial wipe if you share with others.
Wipe down door handles.
Try not to touch taps with your hands. Use a tissue or else some large lever taps can be pushed closed with your elbow.
There’s some evidence that your mobile phone surface carries more microbes than a toilet seat. Phones can be wiped with an alcohol wipe once or twice daily or carefully with soap and water on a cloth. The BBC has produced a video you can watch. Check your phone manufacturer’s guidelines for more details.
Consider cultural matters
Very sadly, certain behaviours at the heart of Ethiopian culture are prime routes for viral spreading. I know this is going to be unpopular but shaking hands, “shoulder bumps”, kissing of other persons and church walls/floors can all spread the virus. Sharing of foodplates with other persons will also spread infections from contaminated hands. Even rigorous handwashing will not prevent this as people will be touching mouths during the meals and there may be persons harbouring asymptomatic infection. I don’t have the answer to the meals – perhaps each person can mark out their own ‘territory’ on the plate. Ethiopians should choose the solution that works for them.
A final message
Many people, particularly the younger groups, are complacent about coronavirus until it arrives in droves and takes our loved ones. Coronavirus, unchecked, continues to take country after country by surprise, overwhelming health systems with large numbers of severe respiratory infections. The mortality rate is currently under debate, of anywhere between 1 and 4%, however with estimates that the virus can infect 80% of a population if left unchecked can mean a massive number of deaths as well as shattered economies. Writing this to Ethiopia from my base in one of the most affluent countries in the world, the UK, I can tell you I and my colleagues have never been more frightened at what is happening to both our patients and colleagues as the health care workers also succumb to infection.
As yet, it is uncertain how the virus is going to play out on the African continent. I hope that Ethiopia’s early adoption of social distancing measures pays off. I also sincerely believe that Ethiopia, with its history of adversity, does at least have some measure of ‘resilience testing’ and strong communities to overcome hard times – something we lack in more developed societies. In the meantime, it is down to you to take the measures seriously and avert disaster for your country.
Dr Claire A Davies is a family physician in London
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