A FIN public health message for the Corona Virus Crisis: What are your social responsibilities? What is their rationale?

There are two primary ones:
(i) observe hygiene behaviour; and
(ii) try to QUARANTINE yourself and your entourage to the maximum extent possible IN YOUR HOME.

First, take all precautions not to get infected. So practice hygiene behaviour – especially washing hands and coughing into a handkerchief or into your elbow.

Second, take all precautions not to infect others. The mantra advocated for this is social distancing. According to many Western sources this is 6 feet and according to the World Health Organization this is 3 feet . Since in many communities such social distancing is impossible to observe, quarantine within homes has been called for. And to nudge this behavioural change – schools, educational institutions, places of worships, event halls, malls, cinema houses are being shut in India as well as in many other countries.

However, the political heads of some countries have not been responsible enough to insist on quarantine. Further, even in regions where quarantine has been called for, there are still many people who are not complying. This is terrible. Let us explain why.

Suppose we make the simplifying assumption that the proportion of vulnerable people (i.e. with an existing persistent health condition) in all populations is the same. This is not true – the proportions are much higher in developing countries. But let us assume this for simplicity.

 

Then, the parameters that determine the degree of risk are basically two.

First, the number of hospital beds with ventilators available as a ratio of the population is crucial. This represents the healthcare capabilities.

– Greater the healthcare capabilities, lower is the risk. However, in developing countries healthcare capabilities are generally lower.

– Greater the population in relation to the health care capabilities, the greater is the risk of not being able to access medical attention. In developing countries the risk is generally higher.

For instance, the WHO recommends 5 fully equipped hospital beds per 1000 people in a community. On the assumption that a person infected by covid-19 is likely to infect at least two more people, a 2% mortality rate has been forecast (note that different epidemiological models for transmission exist). That means to reanimate 2% of serious cases, 20 beds per 1000 people is required. This is why even in a high income country like Italy, which has about 10 equipped beds per 1000 people, there is a shortage of equipment and hospital beds to treat corona virus cases. Contrast this with a study by WHO in 2018 on Delhi, which found only 2.7 beds per 1000 people, which makes the covid-19 even more of a crisis there. How are countries, especially developing countries like India to cope? There is only one way and we turn to this now.

 

Second, the “socializing” within the community, or how many people, a person in the community is likely to closely interact with and transmit the germ to – determines the spread and the eventual disease burden of corona virus. This is country specific. THIS IS THE ONLY PARAMETER THAT CITIZENS IN EVERY COUNTRY CAN INFLUENCE IN THE SHORT RUN – whatever has been recommended by the local authorities. The lower the socializing or the higher the effective quarantine, the lower is the risk.

This argument is further illustrated in Figures 1 and 2.

 

Under the above context, we congratulate the Indian government and public agencies, and those of all other countries, which have pushed for strict quarantine to minimize the transmission of corona virus.

Now, we call upon all citizens of all countries to:
1. practice hygiene behaviour;
2. And quarantine themselves in their homes to the maximum extent possible
– as the socially responsible response to this crisis.

With best wishes to all and especially sending our good vibes and prayers to all medical personnel all over the world dealing with the corona virus crisis,

 

The FIN team

 

(Cover Image: The Economic Times)