key: cord-0827521-q66xifmu
authors: Oyeniran, Oluwatosin I.; Chia, Terkuma
title: Lutte contre la pandémie de maladie à coronavirus (Covid-19): tirer les leçons de la réponse à la maladie du virus Ebola
date: 2020-07-03
journal: Ethics Med Public Health
DOI: 10.1016/j.jemep.2020.100558
sha: 9dc3d87a80b8163db1496bfc46dd0c2db1eacd7d
doc_id: 827521
cord_uid: q66xifmu

Abstract Coronavirus disease (COVID-19) is caused by a beta-coronavirus (SARS-CoV-2) that affects the lower respiratory tract and appears as pneumonia in humans. COVID-19 became apparent in December 2019 in Wuhan City of China, and has propagated profusely globally. Despite stringent global quarantine and containment drives, the incidence of COVID-19 keeps soaring high. Measures to minimize human-to-human transmission have been implemented to control the pandemic. However, special efforts to reduce transmission via efficient public health communications and dissemination of risks should be applied in susceptible populations including children, health care providers, and the elderly. In response to this global pandemic, this article summarizes proven strategies that could be employed to combat the COVID-19 disease outbreak, taking a cue from lessons learned from the Ebola virus disease response. Résumé La maladie à coronavirus (COVID-19) est causée par un bêta-coronavirus (SARS-CoV-2) qui affecte les voies respiratoires inférieures et se présente sous forme de pneumonie chez l'homme. La COVID-19 est apparue en décembre 2019 dans la ville chinoise de Wuhan, et s'est propagée à grande échelle dans le monde entier. Malgré des mesures de quarantaine et de confinement rigoureuses, l'incidence de COVID-19 continue de grimper en flèche. Des mesures visant à minimiser la transmission interhumaine ont été mises en œuvre pour contrôler la pandémie. Toutefois, des efforts particuliers pour réduire la transmission par le biais de communications efficaces en matière de santé publique et de diffusion des risques doivent être déployés dans les populations sensibles, notamment les enfants, les prestataires de soins de santé et les personnes âgées. En réponse à cette pandémie mondiale, cet article résume les stratégies éprouvées qui pourraient être employées pour combattre l'épidémie de maladie COVID-19, en s'inspirant des leçons tirées de la réponse à la maladie du virus Ebola.

The outbreak of coronavirus disease 2019 caused by the 2019 novel coronavirus (SARS-CoV-2) was first reported on 30 th December 2019 in the Chinese city of Wuhan in Hubei Province [1] . The disease is a respiratory infection caused by a new strain of coronavirus belonging to the same family as SARS-CoV and MERS-CoV [2] . The virus is widely known to be transmitted through person-toperson, symptomatic, and asymptomatic individuals. The common symptoms of an infected individual include coughing, sneezing, fever, difficulty in breathing amongst others [3] .

The disease has spread widely and rapidly from China to almost all the continents of the world, such that many countries have closed their territorial borders or/and banned travels to or from countries with reported cases. The World Health Organization (WHO) first declared it a public health emergency on 30 th January 2020 and asked all countries to prepare adequately for it. As of 19 th June 2020, reports from affected countries show that there is a total of 8,519,543 confirmed cases and 454,582 deaths from the coronavirus disease [4] . The first reported case of the disease in Africa was on 14 th February 2020 in Egypt [5] , and as of 19 th June 2020, all the 54 African countries have reported a total of 275,327 confirmed cases and 7,395 deaths [6] . A study modeling the spread of the disease put African countries between moderate to high risk [7] . Regrettably, most African nations are known to have weak healthcare infrastructures [8] [9] [10] , which makes the findings of that study fearful. This is evidenced by the dearth of capacity to diagnose the coronavirus and availability of suitable quarantine facilities [11, 12] .

At the initial outbreak of the disease, only two laboratories in Africa (one in Senegal and one in South Africa) could test for the virus [13, 14] , however, presently, the majority of the countries are reported to have testing capacities. Even with this remarkable development, these testing facilities are grossly insufficient to cater to the large populations [8, 11] , as these facilities are located distances away and not within easy reach of a greater percentage of the populace. This situation has created fears about the capacity of developing nations to adequately and efficiently respond to this outbreak [8] [9] [10] [11] [12] . However, during the last Ebola outbreak in West Africa in December 2013 which originated from Guinea, many countries in the region could not deal with Page 4 of 10 J o u r n a l P r e -p r o o f 4 the emergency [15, 16] . With the experience from the Ebola response, lessons from it could be valuable in combating the current coronavirus disease outbreak which is spreading rapidly globally.

The first line of action from the Ebola disease was risk communication. With no specific treatment for the coronavirus disease, prevention is the most immediate and valuable action and has proven to help contain the spread of the disease [8, 11, 17] .

Citizens must be well informed and sensitized on all aspects of the disease, particularly its prevention [8, 9, 11] . This would help in tackling myths and misinformation as well as improve health-seeking behavior [18] [19] [20] . This measure will in no small way slow down the infection rates; and where individuals show any symptoms, such individuals will quickly seek healthcare or would be promptly reported to health officials for quarantine and subsequent treatment. Additionally, individuals who have contact with a suspected case will avail themselves of testing and monitoring. Contact tracing will be greatly enhanced as people would volunteer information instead of hiding and further increasing the spread.

Intensive training of healthcare workers at primary, secondary and tertiary health facilities as was the case during the Ebola outbreak could be a very useful means of curtailing the spread of COVID-19 [8, 9, 11, 12] . This is important and necessary, as caregivers themselves are not exempted from misinformation during disease outbreaks [21] . A study suggests that the ill preparation of healthcare workers reduces their willingness to attend to suspected cases of infections during such outbreaks [22] . For example, if the healthcare workers at the primary healthcare centers are adequately trained, it will enhance the referral system and curtail spread within their communities. Since these centers are nearest to the people, they are more likely to report any observed symptoms seen in their workplace. Furthermore, this would prevent the spread of the disease within health facilities as was the case at Daenam Hospital in Cheongdo in South Korea. Healthcare workers will be able to protect themselves against contracting the virus as they are a critical resource and play a pivotal role in combating its spread [11, 12] . This is more so important to the overall response processes as infections of healthcare workers will greatly reduce manpower [23] .

Provision of infrastructure and safety equipment such as quarantine facilities and kits will go a long way in supporting the fight against this disease. A study highlighted the critical role played by the polio program infrastructure during the Ebola virus outbreak [24] . As noted earlier, many of the developing countries lack adequate health infrastructure [8] [9] [10] [11] [12] . Patients with infections from the virus cannot be hospitalized in the same healthcare facility with patients admitted for other ailments;

hence, the need for separate facilities for isolation and treatment. At the height of the outbreak, the Chinese healthcare facilities in the affected regions were overwhelmed by the large numbers of infected persons, which occasioned the rapid construction of the 1,000-bed capacity Wuhan Huoshenshan Hospital within ten days. The provision of safety equipment such as hazmat suits is necessary for combating the spread.

The community-based strategy of social mobilization and community engagement was highly effective in case detection of the Ebola virus, thereby reducing the extent of transmission in a country with a weak health system [25] . The experience gained from community mobilization in reducing the Ebola transmission in low resource settings has the potential of being helpful for the global community in the fight against the COVID-19 [25] . Overall, effective communication, community, and social engagement must be formally placed at the core of the response in public health emergencies and given a good budget [11, 26] . OIO and TC conceptualized and designed the study. TC drafted the first manuscript.

OIO reviewed the final manuscript for intellectual content. All authors are responsible for the integrity of the work.

Update: Public Health Response to the Coronavirus Disease 2019 Outbreak-United States

A new coronavirus associated with human respiratory disease in China

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

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Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study

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