Ulfat Amin
Diseases like the COVID 19 pandemic have brought public health practice into eminence as an integral aspect of health care. Such diseases pose threat to populations, and mere administration of health care is insufficient to control the spread of such communicable diseases. Over the past century, public health has developed a series of strategies to apply at population level to control the spread of communicable diseases. There are circumstances when communicable diseases threaten populations, and a broader public health strategy may be required. Quarantine is but one component of communicable disease control. On its own, it is unlikely to be effective, and it is by no means the sole method of controlling an outbreak. It is also important to make a clear distinction between quarantine and isolation. Quarantine refers to the separation of those exposed individuals who are not yet symptomatic for a period of time (usually the known as incubation period) to determine whether they will develop symptoms. Quarantine achieves 2 goals. First, it stops the chain of transmission because it is less possible to infect others if one is not in social circulation. Second, it allows the individuals under surveillance to be identified and directed toward appropriate care if they become symptomatic. This is more important in diseases where there is pre-symptomatic shedding of virus. Isolation, on the other hand, is the separation of people who have been diagnosed with a contagious disease. Quarantine is a blunt instrument to use in the control of infectious diseases. Quarantine is simply a period when a person cannot carry her/his daily routine due to restriction in movement. So do not fear it, go for it and save yourself and your community. However, in some circumstances it is one of the only possible means of responding to an infectious disease threat. Likewise, early in the SARS outbreak in Toronto, when the disease showed rapid transmission to health care workers, the causative organism was unknown, as was the duration of communicability, mode of transmission, and incubation period. Many questions were unanswered. In this context of uncertainty, a prudent precautionary approach and the use of quarantine were likely justified. To help people quarantine themselves voluntarily we need to make some interventions:
Awareness: provide awareness to people about what quarantine is, why it is important for families and communities via social, print and electronic media. It is responsibility of every member of society to voluntarily report their friends, family members, collages for the safety of community.
Psychological support: The fear of contracting is real and can be scary. This can be overcome if there is strong psychological support from family members, friends, colleagues, health workers and others.
Accurate information: Providing access to correct information and preventing exposure to misinformation is the best help that we can provide to a person in quarantine or isolation. This makes the person aware of the situation, its seriousness and enables people to understand that it is in their interest and the interest of other that they are put under quarantine and observed. Access to correct, current and credible information keeps the quarantined person socially aware.
Keep them connected: Being separated from loved ones and unable to carry on daily routine can result in anxiety, stress and restlessness. It should be ensured that people in quarantine or put in isolation have regular communication with the outside world (especially with family and friends) through telephonic calls, video chats etc. This would help the person feel less lonely.
Hold their attention: If you are put in quarantine, one of the best ways to put your fears to rest is to keep your brain busy. It can be helpful of those in quarantine are provided with fun activities and forms of entertainment (music, games, books etc) that can divert attention from their disease status.
Financial support: The fear of not being able to earn and support their family during the quarantine period is genuine and must not be ignored by the government. People, especially those who are dependent on daily wages and are their family’s primary breadwinners, are the most vulnerable to this form of stress. Fear of loss of income for 14 days can result in joblessness in some cases.
For the unorganized sector, the government must announce emergency measures to win people’s confidence that their daily wages during the quarantine period will be taken care of by it. Such measures would diminish the chances of people from socially and economically weaker sections hiding their illness.
Quarantine is simply a period when a person cannot carry her/his daily routine due to restriction in movement. So do not fear it, go for it and save yourself and your community.
Encourage people for voluntary quarantine: The government, family and society in general can contribute significantly by encouraging suspected coronavirus patients to put themselves in voluntary quarantine rather than being forced to be put under quarantine. Voluntary quarantine carried out with noble motives is likely to have fewer mental health issues than ones associated with people who are forcibly made to be in quarantines. COVID 19 like public health emergencies are stressful times for people and communities. Fear and anxiety about the disease can lead to social stigma, towards people, places and things. For example stigma can occur when people associate disease with a population or nationality like COVID 19 with chines. It can occur after a person has been released from quarantine even though he/she is not a risk now. We must remember that stigma affects emotional and mental health of stigmatized groups. Stigmatized groups may be subjected to: Social avoidance or rejection, Denials of healthcare, education, housing or employment and sometimes Physical violence. Stopping stigma is important to make communities and groups resilient. The fight against the coronavirus outbreak is a collective fight. We need to ensure that coronavirus patients or the suspected cases are not stigmatised in society. Every responsible member of society can stop stigma related to COVID 19 by knowing the facts and sharing them with others. Some points by which we can control stigma:
• Communicators and public health officials can help counter stigma during the COVID-19 response by maintaining privacy and confidentiality of those who are suspected, isolated or quarantined.
• For medical professionals follow medical ethics, do not disclose identity of COVID 19 suspects on social media.
• Quickly communicate the risk or lack of risk from associations with products, people and places.
• Raise awareness about COVID-19 without increasing fear.
• Share accurate information about how the virus spreads.
• Speak out against negative behaviors, including negative statements on social media about groups of people, or exclusion of people who pose no risk from regular activities.
• Be cautious about the images that are shared. Make sure they do not reinforce stereotypes.
• Engage with stigmatized groups through media channels including news media and social media.
• Do not stigmatize health care workers, they are working for us. Do not make situation difficult for them.
• Adhere to guideline provided by WHO for mental health and psychological considerations during COVID 19 outbreak.
• Do not pay heed to rumours.
( Author is a freelancer. Views are author’s own, [email protected])