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 Table of Contents  
LETTER TO EDITOR
Year : 2020  |  Volume : 6  |  Issue : 1  |  Page : 63-64

Coronavirus disease 2019 pandemic: Upscaling the preparedness and public health emergency response at the point of entry


1 Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission19-Mar-2020
Date of Decision29-May-2020
Date of Acceptance30-May-2020
Date of Web Publication20-Jul-2020

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpaet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrsm.jcrsm_18_20

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How to cite this article:
Shrivastava SR, Shrivastava PS. Coronavirus disease 2019 pandemic: Upscaling the preparedness and public health emergency response at the point of entry. J Curr Res Sci Med 2020;6:63-4

How to cite this URL:
Shrivastava SR, Shrivastava PS. Coronavirus disease 2019 pandemic: Upscaling the preparedness and public health emergency response at the point of entry. J Curr Res Sci Med [serial online] 2020 [cited 2020 Oct 31];6:63-4. Available from: https://www.jcrsmed.org/text.asp?2020/6/1/63/290243



Dear Sir,

Coronavirus disease 2019 (COVID 19) pandemic has taken the world by storm and has made the public health authorities to introspect about their preparedness and response action plan.[1],[2] The global situation looks quite challenging with various nations imposing travel restrictions amid the sudden rise in the number of cases predominantly in the European region.[1] The global estimates suggest that a total of 5,593,631 cases and 353,334 deaths have been attributed to the infection.[1] The novel infection has a global case fatality rate of 6.3%, while the American and the European regions together have accounted for the maximum percentage of the global caseload.[1] All these estimates are very much alarming and clearly justify the need for an urgent public health emergency response on the global scale as no nation or individual is immune to the disease.[1],[2]

It is quite clear that the most predominant way of the disease transmission is through close contact with the positive case of the disease. The probability of getting infected significantly enhances once a passenger is coming from a nation where the cases of the disease have been reported.[3] This directly emphasizes the need to strictly implement the International Health Regulations at the various points of entries, which include formulation of an emergency response plan and the development of a strategy to screen passengers and provide appropriate care to the suspect cases to minimize the exposure to other contacts.[3],[4]

COVID-19 and Point of entry

The objectives of the public health response at the point of entry are to detect ill travelers and elicit details about their history of exposure, report suspect cases to health authorities and to perform isolation, and offer initial management and follow it up with a referral to earmarked healthcare facilities.[3],[4] However, it is obvious that none of the intended objectives could be satisfactorily accomplished unless it is supported with better planning and logistical support.[3] The detection of ill travelers will essentially require a trained team of personnel, who are well supported with the necessary equipment (viz., thermal imaging camera, personal protective equipment, and hand washing facilities). Further, the process of detection can be done either through self reporting (travelers reporting their symptoms) or visual observation or through temperature measurements, and once any such passenger is identified, the other co passengers should be instructed to maintain distance, while the ill traveler should be moved to an earlier identified physical structure.[3 5] Moreover, specific attention and planning are also required for interviewing these ill suspects. Ideally, interviews should be conducted in a well defined place near point of entry with adequate space for the isolation of the passengers and should be done by a trained staff.[3 5]

The place of the interview should be different from the quarantine facility, which is expected to keep the healthy contacts for a period of 14 days.[3] In addition, specific attention should be given in the place of interview for the arrangement of personal protective equipment, disposal of contaminated medical masks/tissues, transport facilities for individuals who are referred for further clinical evaluation, and sensitization of ill travelers about hand and respiratory hygiene practices.[1],[3] The entire process of interview and further actions (such as isolation of COVID 19 suspects and referral to predefined health facility through contacting the driver) should be conducted as per the already defined protocol. However, before the referral, the suspect case should be isolated in a well ventilated room, and if the number of such cases exceeds more than one, the suspects should be instructed to maintain a distance of 1 m between them.[3],[5]

The personnel employed should also orient these suspect cases about the need to wear a medical mask, practice respiratory hygiene, and avoid touching the front of the mask (if touched, must do hand washing) and the need to change the mask, if it gets wet or dirty with secretions. Further, maintaining the safety of the team of personnel is of utmost importance, and they should also strictly adhere to the practice of social distancing, respiratory hygiene, and hand hygiene. Moreover, the place of interview, isolation facility, and ambulances used for referral of suspect cases, all should be periodically cleaned and disinfected, and all standard infection prevention and control measures should be strictly implemented and adhered.[3]

In conclusion, strengthening the procedure of early case detection and supporting it with strict adherence to the infection prevention and control measures at the point of entry are crucial dimensions. The gains made in these domains will eventually determine the caseload and deaths in any nation and thus should be given utmost attention.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report – 129; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200528-covid-19-sitrep-129.pdf?sfvrsn=5b154880_2. [Last accessed on 2020 May 29].  Back to cited text no. 1
    
2.
Lee A. Wuhan novel coronavirus (COVID-19): Why global control is challenging? Public Health 2020;179:A1-2.  Back to cited text no. 2
    
3.
World Health Organization. Management of Ill Travellers at Points of Entry – International Airports, Ports and Ground Crossings – In the Context of the COVID-19 Outbreak – Interim Guidance. Geneva: World Health Organization Press; 2020. p. 1-7.  Back to cited text no. 3
    
4.
Sriwijitalai W, Wiwanitkit V. Positive screening for Wuhan novel coronavirus infection at international airport: What's the final diagnosis for positive cases. Int J Prev Med 2020;11:30.  Back to cited text no. 4
  [Full text]  
5.
World Health Organization. 2019 Novel Coronavirus (2019nCoV): Strategic Preparedness and Response Plan. Geneva: World Health Organization Press; 2020. p. 1-3.  Back to cited text no. 5
    




 

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