WHO press release March 9th, 2020. Is it a pandemic yet?

WHO press release on March 9th 2020. Video (1 hr ish). Press release by Dr Tedros Adhanom Ghebreyesus.

Note: I’ve picked and chosen information that may not have been either discussed previously or that needed verification. This is not an opinion piece.

WHO has consolidated guidelines for the following four categories of coronavirus cases.

  1. Countries with no cases: Find more cases, test, isolate patients.
  2. With sporadic cases: Find more cases, test, isolate patients.
  3. With clusters of cases: Find more cases, test, isolate patients.
  4. With community transmission: Test every suspect’s contacts. Act to reduce epidemic to manageable clusters. Consider closing schools, mass gatherings, and other similar measures to reduce exposure.

In all types, the main aim is to stop transmission and prevent spread.

Other updates

  • WHO has shipped personal protection equipment (PPE) to 57 countries, and lab supplies to 120 countries.
  • Since Friday, South Korea, China, Azerbaijan, and Saudi-Arabia have contributed $300 million toward WHO’s efforts in reduction of coronavirus.

Dr. Tedros presented the following

  1. Never give up
  2. Let hope be the antidote to fear
  3. Let solidarity be the antidote to blame
  4. Let shared humanity be the antidote to shared threat

Pandemic criteria:

The world is closer to experiencing a pandemic. Currently over 100 countries and over 100,000 people have been affected. Technically, this is not the ‘definition’ of pandemic which includes uncontrolled transmission of contagion. However, a few weeks ago total cases were only 30,000 and fewer than ten countries were affected. Thus, it is reasonable to state that the world is closer to a coronavirus pandemic. Dr. Tedros, emphasized, “But, this would be the first pandemic in history that could be controlled.”

The wording is important. The term pandemic can cause people to become upset and give up, and simply mitigate the losses instead of attempting to control the transmission. Whereas, WHO wants to emphasize that countries use controlled measures to decrease the virus transmission, and not give up.

What does full recovery mean?

It is important to note that 70 % of the people infected in China recovered from the virus. Please realize the following

  • Communal spread is possible for 2 weeks (14 days)
  • Full recovery from virus takes 6 weeks
  • Full recovery (dependent on individual’s medical history, other health conditions, and age), can take up to months.

If 80 % of the cases from China had “Mild to Moderate” symptoms, what does that actually mean?

  • Mild: Fever, respiratory symptoms, dry cough.
  • Moderate: Includes the above + mild pneumonia
  • Severe: Includes the above + moderate to severe pneumonia, Oxygen masks, ventilators, ECMO systems (this is a treatment that helps oxygenate the blood externally (artificial lung), and death.

Being Calm yet Cautious

The current Trump administration’s ineptitude in dealing with the coronavirus outbreak is more alarming than the virus itself. While the CDC has traditionally acted with reasonable efficiency and actions against the H1N1 and Zika and this time around, it has failed miserably.

If the government and the CDC are unable to instill trust and assurance resulting in the public nervousness, then what does one do?

The net is filled with people stating ridiculous cures and profiting from people’s need to feel in control. Please click here for articles relating to myths and rumors. The latest news really upset me published by NPR /OPB Oregon about a hospital leader in Burns, OR. A hospital leader has touted her own test kit costing $200 to $500 (not validated by anyone) as a possible solution to the virus. She proceeds to suggest herbal supplements sold by her, as a solution. Alarmingly, she’s claimed that the flu vaccine will make you more susceptible to the coronavirus. She thinks all vaccines for measles etc. might hurt the population. This is outright conning the public and taking advantage of their fear.

Some people tout ‘mind over matter’, and there’s nothing to be afraid of, or ‘fear is the virus itself’. This is particularly dismissive if it comes from people are not in the risk category.

Sure, if you are not afraid, don’t be. No one is asking you to engage or read more information. But read the research and understand the reality of the situation. If you want to know who is at risk, click here

Others argue that most of the people getting the virus have the mild version. Whether one gets a mild case or severe case, the risk and probability of communal spreading is the same. That person unless quarantined will transfer and pass the virus onto other individuals who might be more susceptible.

For some people, being calm means ignoring and avoiding all information. For others, part of being calm to have access to the right information to deal with emergencies, being rational, understanding reality and probability. I will assume that you are in the latter group, or you wouldn’t be browsing the net looking for information. Below are *some* suggestions.

Things to do

  1. Have good hygiene practices
  2. Practice social distancing. Do not shake hands, Namaste, Spock’s Star Trek salute, a casual Hi (waving hand). Fist bumping and elbow shakes still involve touching. When you can completely avoid touching another person, do so.
  3. Respiratory etiquette. Know how to cough and sneeze (use the inside of your arm, not your palms). Do not openly cough into the air.
  4. Read this for understanding the realities of people at risk.
  5. Do take some time to relax and appreciate your life and family.
  6. Do talk about death without panicking or having a fatalistic attitude: This is the only part of life that is inevitable and has a probability of 100 %. But do remember, if the disease doesn’t affect you, something else will, if not, old age will. If you have loved ones who are in the risk category, do talk about preparedness and the reality of death as well as their wishes. Communication and keeping a realistic, reasonable response to the crisis is part of keeping yourself well. Stress is not good for the immune system.

If you want to take action beyond the immediate techniques to protect yourself and your family, consider donating to charities that have the infrastructure to help neglected populations at risk. Do not be a vigilante and contact others directly, you might be spreading the virus unknowingly.

Charities to support others impacted because of the outbreak.

There are multiple organizations that work with the elderly and people who need external support systems to survive life. Some of the help they provide include delivering groceries, medications, ready-to-eat food, and other essentials.

Below are some links to the local Portland, Oregon charities and organizations that are already in place and have the required infrastructure and set up to work with the government and health officials to read the neglected populations.

  1. Meals on Wheels:
  2. Store to Door
  3. Homeless populations
  4. Home care for people with Alzheimer’s etc.

If you are aware of more such organizations, please add them in the comment section (Note, all comments are moderated, spam/nonsense links will be deleted).

Who is at risk? A discussion on WHO guidelines and neglected populations.

WHO and CDC have defined very clear categories of people who are at risk based on their age, and pre-existing upper-respiratory health issues, chronic health issues. They’ve also specified those with immunocompromised systems to be more wary. Below is a discussion on each category and some forgotten populations/categories.

  1. Age and Gender
  2. Chronic Illnesses & People with compromised Immune systems
    • The CDC and WHO has outlined people with certain chronic illnesses to be in the higher risk category. The chronic illnesses specified are upper-respiratory illnesses, heart disease, blood pressure, diabetes.
    • What does ‘compromised immune system’ mean?
      • If your body is fighting one disease, it has a slightly lowered ability to fight another at the same time.
      • Cancer & other significant ‘assaults’ on the body: When undergoing chemotherapy while fighting cancer, the body is compromised and cannot adequately protect against a flu or anything that is seemingly benign. So instead of remaining a flu, it becomes more complicated and causes infections such as pneumonia.
      • Post-surgery (for anything major or minor): Infections are common because the body’s immune system is compromised during the ‘recuperation’ period.
      • Pregnancies: Pregnant people need to be cautious in not exposing themselves due to a particularly stressful time for their immune system.
  3. Various professionals that have a higher risk
    • Sanitation workers, housekeepers, janitorial and custodian services: Doctors and nurses might understand the complete risk and are possibly on the priority list for getting PPE. However, sanitation workers in public buildings and areas do not have the same priority. Workers have to work with dirty bathrooms, rooms, body fluids, and dirty laundry, are not necessarily given adequate information and protection. They are at risk. If you need information on laundry cleaning solutions that are needed to protect from coronavirus, please click here.
    • Teachers: Though children are not at risk, they are carriers of many diseases and can carry the coronavirus. They are hotbeds for communal spread due to a lack of understanding of hygiene. This affects the teachers and school workers who cannot possibly be isolated from random children hugging and touching them.

People who will be affected indirectly, due to lack of information, testing, supplies, or circumstances.

  1. Disabilities and other chronic illnesses: This category of people and their risk has not been discussed as much.
    • People with disabilities (sight, hearing, mental health issues) may not be getting the whole message due to decreased information access to them. Others who have to have significant reliance on surfaces to move their bodies (wheelchairs) etc. are in a very fragile state as one cannot constantly keep cleaning the streets. If inside places, many are forced to lean or prop themselves against railings, and other furniture as support. Many have to physically move themselves from their chairs to the toilet bowl by physically propping themselves on the public bathroom railings.
    • https://news.wttw.com/2020/03/06/cps-teachers-assistant-marks-6th-coronavirus-case-illinois
  2. Nursing homes and institutions: People with chronic illnesses either have an immune compromised system, or physical issue that forces them to have public support systems such as “Meals on Wheels” or “Store to Door” or are confined to nursing homes. They are at danger in not getting regular food, or groceries.
  3. Homeless populations: Due to limited or zero access to resources, the homeless population can be affected directly or indirectly. Lack of clean clothes, soap, water, sanitizers, will significantly affect communal spread.
  4. Army, Marines, Navy soldiers and officers: There is literally no information on what is happening with bases in other countries including the ones in countries worst hit.
  5. Prison populations: Newly jailed inmates and prisoners are not getting any testing completed. They live with other people in close quarters in unhygienic conditions, shared bathrooms, and rationed soap and water. This is a disaster waiting to happen. Recently, Iran released about 54,000 of its prisoners (who were jailed for small issues), back in the public, specifically due to an outbreak in their prisons.  
    1. https://www.cnn.com/2020/03/04/middleeast/iran-coronavirus-response-intl/index.html

Tackling a contagious disease outbreak isn’t as simple as ‘washing one’s hands’. Careful consideration must be given to who is at risk, and who can be impacted indirectly and thus contribute to communal spread.

UPDATES: March 9th 2020 9:40 AM PST

  1. Italian prisoners riot against coronavirus measures that don’t protect them.
  2. United States Prisons: Gov. Andrew Cuomo announced that NYS (prisoners in NY) will be making 100,000 gallons of sanitizer. This will be used for public schools and prisons only.
  3. Children are getting affected in the United States. There were plenty of children affected in China, which is why they cancelled schools and implemented online training.
  4. Military Bases: Coronavirus affected cruise travelers are now being quarantined at military bases.
  5. Marine in Virginia tests positive