COVID-19: SPREAD THE HOPE NOT MISCONCEPTION

Introduction

Over the past week, the Coronavirus outbreak in Ghana and other African Countries has moved from the 1^St Stage of Imported cases to the 2^nd Stage of Local Transmission (i.e. direct spread from the index cases) to the 3^rd Stage of Community Transmission where sometimes the source of transmission is untraceable. It becomes even murkier since some infected persons are able to transmit the COVID-19 disease without showing symptoms of the disease.

The situation has necessitated some drastic and bold Containment and Mitigation measures by the Government of Ghana and other Governments with the objective of delaying high surges of reported infections which can overwhelm our Health Systems. Key among the measures are Restrictions on Public Gatherings and Travel both in and out of the country. Other important measures are:

1. Contact Tracing (Over 400 Persons in Ghana) and Testing of symptomatic Contacts.
2. Regular Hand washing with Soap and water and the use of Alcohol-based hand sanitizers.
3. Respiratory etiquette
4. Self-Isolation
5. Social Distancing
6. Preparation of Health Facilities and Strengthening of the Health System to Manage the Epidemic.

In the midst of all these there are a host of Myths and Misconceptions around especially on social media which could cause fear and panic and also affect the efforts to manage the unprecedented situation. The best advice therefore is for everyone to:

1. Remain Calm and avoid Panic, practice all professional recommended advice on Personal Hygiene and Social Distancing,
2. Avoid Myths and Misconceptions and
3. Conduct oneself as if one has the disease in order to remain safe and protect others.

Some Myths/Misconceptions of COVID-19

1. The Youth Are Safe from COVID-19 infection

Although Current data from severely affected countries point to the elderly (above 60years) especially those with serious medical conditions having worse outcomes, the youth are not immune to the disease. In fact in the US, 20% of infected persons are between 20-40 years and some have suffered mortality.

• Blacks have better Immunity and do not die from COVID-19 infection

Again the evidence so far does not support this notion. The issue of blacks having less amounts of ACE2 receptors, on cells which facilitate the entry of the virus into cells to cause havoc (thus giving protection) is not backed by clinical data so far. In Africa, we do not have enough data to make any inferences on Covid-19 disease outcomes in the black population.

• Our Hot and Humid Weather is not Conducive to Viral Spread

The exponential number of cases being reported in Sub-Saharan Africa so far does not support this assumption. Whilst it may be true that the virus may not survive as long in the external environment here as compared to colder climates, it has been demonstrated that person to person transmission is much more significant than transmission through fomites (nosocomial e.g. doorknobs, rails, counter tops etc).

• Diagnosis by Withholding Breath

It has been erroneously reported in some social media that if one is unable to hold the breath for at least 10 seconds after taking in a deep breath on waking up in the morning, it is a confirmation of a diagnosis of COVID-19 infection. This has no scientific basis and cannot be true.

• Drinking of Liquor (Akpeteshie) or Copious amount of Water Prevents infection

Another misinformation involves the belief that drinking Liquor including Akpeteshie kills the COVID-19. It is also said that intake of copious amount of water washes the Virus into the Stomach for the Gastric Juice to kill or digest it. Again there is no scientific data to confirm this.

• Use of PPE (Personal Protective Equipment) in Public Areas e.g. Markets, Shopping Malls, Lorry Parks, Schools

I was personally surprised last week when I saw several individuals of the public wearing Surgical Masks and hand gloves in the streets ostensibly for protection against COVID-19 infection. Some of them were even touching their faces with their gloved hands and frequently adjusting the masks with their hands. Improper use of PPEs can be even more dangerous with this contagious virus. It should be noted that PPEs are to be worn by Health workers and other Caregivers. Individuals can wear the face mask if they have respiratory symptoms. The misuse of PPEs can contribute to shortages which could be detrimental for the management of this pandemic.

7. The use of Hydroxy-Chloroquine for the Prevention/Treatment of COVID-19

There has been reported use of good old Chloroquine in combination with other antimicrobial agents in a limited number of patients with COVID-19 in China with some significant improvement in their condition. It should be noted however that this is a limited trial and in a different population. In the US the FDA has approved it for clinical trial and not for general prescription. The effect of the drug in COVID-19 infection could be very different. Already there are unconfirmed reports of Chloroquine poisoning in Nigeria following the US President’s statement that it has been approved by the FDA for use and it is going to be a game changer. In Ghana there are reports of the sudden shortage of the drug after individuals rushed to buy it without prescription. It is completely out of order for anyone to take it either for prevention or treatment now without proper prescription.

8. The use of Serum or Blood of Recovered COVID-19 Patients for Treatment.

The use of Serum of Recovered or Convalescent Patients of Viral Illnesses is useful and well documented. In deed in the fight against Ebola the technology was used. However, in the case of COVID -19, even though the potential is there, it is early days yet.

9. There is Vaccine for Covid-19

Again there is a good chance that a Vaccine would be found for the disease. This holds a very good potential for fighting this pandemic. Several countries are working on it. It may however take some months, possibly 18 months or more to develop and test it for safe use.

Conclusion

We need to stay safe and healthy under the present limitations on our Social Gatherings by

1. Limiting or Avoiding over crowded areas (Pubs, shopping malls, buses) unless it is necessary
2. Following advice on Personal hygiene and avoid handshakes
3. Having healthy diets
4. Undertaking regular Physical Exercise and have fresh Air
5. Keeping our social contacts active with the use of ICT
6.  And above all Meditating and Praying Unceasingly in this period of Social Distancing.

W/BRO. DR PAUL KWAW NTODI, SPH, RGK