AS defined by the World Health Organization (WHO) and the Centre for Disease Control (CDC), a disease is classified as a pandemic when it has an exponential global spread, which is usually rapid and uncontrollable and has a great impact across borders, due to economic loss, social disruption and severe suffering.
On the other hand, endemic diseases are described as regular, with a constant spread within prevalent regions, to which we have to adjust our lifestyle to accommodate because they cannot be eradicated. Examples of such are malaria, yellow fever, chicken pox, tuberculosis, Hepatitis B and soon COVID-19.
Yet another classification is an epidemic category, which is a sudden rise of a condition with characteristic of a contained spread over a restricted geographical area and may not necessarily be contagious, for example Zika virus, Ebola virus, small pox, obesity and opioids addiction.
However, it must be cautioned that there is the possibility of moving from epidemic back to pandemic, depending on the rate of spread, if frequently quick assessments and enforcement measures are not instituted.
Just two years and two weeks after the first COVID-19 death in Guyana, our country has reopened with a record vaccination achievement of eighty five percent of the adolescent, adult and elderly population vaccinated with one dose and sixty five percent fully vaccinated.
Additionally, there is just over fifty four thousand persons who would have received a booster shot. When compared to some other countries, which are yet to get universal access to vaccines, compliance to COVID-19 restrictions and quarantine measures, Guyana stood tall. We have achieved the goals set out by the lead health organisations, without a viral video of barbaric and violent enforcement, even though we had political, economic and climatic challenges.
Looking back, three weeks after the first COVID-19 death, the Pan American Health Organization (PAHO) had predicted that twenty thousand persons would have contracted the disease within a month if lock down and restriction methods were not immediately implemented, since there were no approved vaccines at that time. After two years the total confirmed cases approximated to 63,350 and deaths to 1,227.
The SARS –CoV-2 virus predominantly found in bats, was suggested to have crossed over via a wild domesticated animal to man and has since changed into variant forms; a few highlighted VOC (variant for concern) are alpha, beta, delta, omicron (BA.1, BA.2, BA.3, BA.4 and BA.5).
One of the lessons learnt is that this infection has peaks and troughs, graphically referred to as “waves”, which, according to John’s Hopkins Medicine, is now in the fifth wave due to the highly transmissible BA.2 sub-variant in Shanghai, the most populous area in China and in Europe (Italy, France Austria and Germany) and United Kingdom.
Some of these countries had relaxed the COVID-19 restrictions such as not wearing mask on public transportation systems, not requiring vaccinations for entry (just a negative COVID-19 test and a sworn statement of not experiencing symptoms), not mandating self-isolation enforcement measures when infected even when there are multigenerational relatives under one roof. Two weeks ago, 39 out of 188 countries were reporting new cases, where seven countries reported twice as many new cases.
The dynamics of the situation has changed with convenient home self-test kits and approved anti-viral medications now becoming available. This phase now requires adjustment in the protocols for diagnosis, treatment and monitoring. Innovative surveillance systems to capture accurate data for positive and exposed persons need to be proactively addressed.
The characteristic effects of the current variants of concern were measured by increase transmissibility, increase severity of disease, decreased neutralization of antibody effectiveness, failure to detect and reduced effectiveness of the treatment or vaccines.
According to the CDC Deputy Director, just over two weeks ago, we are moving to the endemic stage but cautioned that COVID-19 is not gone. It was further elaborated that we must be careful in highly populated areas or large gatherings since we have to live with this virus and make the necessary adjustments so as not to disrupt our lives and livelihood.
Similar sentiments were echoed earlier in February of this year when the WHO Head of the African continent indicated a transition out from the pandemic to endemic, which was the contrasted warning by the Director General of WHO, since eighty-five percent in Africa were not vaccinated due to unequitable access to vaccines.
However, a repeated reason for the spike in the global trends was attributed to human behaviour. According to the Washington University School of Medicine, we cannot be the same exiting the pandemic.
We need to mentally process the situation and the uncertainties and have open conversation, respecting our individual decisions or hesitancy on our “newly found freedom”. Hence, it is advisable to find common grounds and also set boundaries according to your comfort level of operating, especially for the vulnerable or high risk population.
Establishing routines and mode of operation, especially when back out to school, work and social gatherings will help you to plan ahead and prepare instead of being caught in an eventuality. A psychologist from Birbeck, University of London, endorsed a new hybrid way to work, where human reconnection in a safe manner is recommended. The American Psychological Association highlighted “Mask Free” anxiety in certain sections of the population.
Wearing of masks at this time may not be universally mandatory but this learnt habit may give some level of comfort to those who are mentally not prepared to increase their exposure. So is washing or sanitising of hands, not greeting by extending for hand shake or sometimes not being within close proximity, mentally maintaining the five feet distance.
These have been replayed in our heads so many times over, especially if you are a healthcare worker, that to unlearn this behaviour will take great effort. So behaviour adjustment will be at an individualised pace and everyone should be respected for their choices. At the same time we are witnessing glimpses of outbreaks so we must be in a flexible mindset to transition to either ends of the spectrum if need be.
For further pharmacological guidance and physician referral, contact the pharmacist of Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.