Prevention is better than cure in fighting the pandemic

By Dinesh Bhugra

IN MY entire medical career, I have never seen anything like it.

As a medical student in India, I remember seeing cases of infec­tious diseases and looked after them with careful protection. I re­call seeing cases of smallpox and typhoid and other life-threaten­ing diseases, but the current situation is truly unparalleled.

We have had previ­ous epidemics – SARS, MERS, swine flu and others – but there has been nothing quite like it. If a year ago, some­one had predicted that major parts of the world would be in partial or complete lockdown with over half a million diagnosed with a virus, nobody would have be­lieved them. Covid-19 fears no borders and it is not a social class con­fined infection. Princes, prime ministers and politicians have got it, and the daily death toll is rising.

Having said all that, it is important to recog­nise that a vast majority of individuals will get very mild symptoms, may not even notice that they have got it and will fully recover.

We are not entirely clear about the mode of transmission – whether it is droplet infection, touching infected sur­faces or actual physical contact with those who have sub-clinical infec­tions. In spite of the UK government’s best ef­forts and public health messages, there are re­ports of people not fol­lowing social distancing procedures and collect­ing in significant num­bers in public places.

South Asian families have pressures and needs that must be tak­en into account by the population, community leaders, service plan­ners and those who de­liver services. Many families will have two or three generations of in­dividuals living togeth­er. They may have a common kitchen, even when they are living next door to each other. Under these circum­stances, what is needed to protect the vulnera­ble older adults, who may have pre-existing medical conditions, as well as others?

The first step is to keep up to date with the most recent reliable in­formation from trusted sources. These could be the NHS, World Health Organisation (WHO) and various reputable charities through public service announcements and accessing their websites whenever pos­sible. In addition, rele­vant information in oth­er languages can be ac­cessed. Social media can provide good quali­ty information, but be careful in that they may also act as sources of misinformation.

Unless you are work­ing in essential services and cannot work from home, keep your travel and contact with others to a minimum. Official advice does not advo­cate using masks, but having it on can reduce the chances of touching your face to a mini­mum. If you are travel­ling on public transport keep your distance and if that means moving to another part of the bus or the Tube, do so.

Try to work from home as far as possible and keep going out of the house to an abso­lute minimum, perhaps no more than once a day to exercise, or shop for essentials and medi­cation. When you are out and about, try and use a mask even though its protection may be short-lived. Keep a small bottle of hand sanitiser in your pocket, try not to shake hands, and even with friends and neighbours keep your distance. If you are having things delivered, collect these, wash your hands in a careful 20-second manner.

If anyone in the household develops symptoms of a new cough lasting longer than four hours and gets a temperature try and isolate them to a separate room with no or minimal direct con­tact with others, making sure that they have plenty of fluids. One person, suitably masked, can get food and fluids to them. If the fever is high, par­acetamol can be used as instructed. Do en­sure that if anyone else in the household devel­ops symptoms, similar isolation is made availa­ble. Where two or three generations are living together it may not al­ways be possible but, in this period, adjust­ments are not only nec­essary but essential to combat the spread of the coronavirus.

There have been sug­gestions, specially on various WhatsApp groups that turmeric, garlic, Chinese herbs, homeo­pathic drugs or Ayurve­dic medication works. There have been stories in the press that chloro­quine (an anti-malarial drug) and various anti-viral drugs have been used successfully. At times of distress, it is human nature to explore all possible options but there is no clear clinical evidence. It is a virus which, when it causes pneumonia, will not re­spond to antibiotics. Hospital treatment will be required in a number of cases, but the best treatment is prevention.

When self-isolating or working from home, try and create a struc­ture as if you are going to work – take short breaks, concentrate on work but have time for yourself. You can try yo­ga, meditation, listening to music, exercise, listening to religious hymns if you are so inclined or watching your favourite TV programmes on catch-up services in or­der to relax and manage stress. Keep in regular contact with friends, colleagues, peers, neighbours and ensure that those who are alone do not feel lonely.

We are all in this to­gether and will get through it. This too shall pass.

 Dinesh Bhugra is emeritus professor of mental health and cul­tural diversity at the In­stitute of Psychiatry, Psychology and Neuro­science at King’s Col­lege London.