The virus is a new kind of Coronavirus known as COVID-19. The first cases were diagnosed in Wuhan China towards the end of 2019. The virus has since spread to other parts of the world.

While we expect new evidence to emerge from ongoing studies, below are what is currently known about COVID-19:

It is transmitted from animals to humans.
It infects the upper airways and lungs.
It is thought that human to human transmission may occur through cough droplets that can contaminate the immediate environment from where it is contacted. Because it is still new, we are still understanding fully the way(s) in which it is transmitted.
Like other infections that infect the upper airways and lungs, people who have COVID-19 would generally have a watery nose, sneezing, itchy and painful throat, cough and fever.
In some people, the infection may progress into severe difficulty in breathing as in pneumonia.
Sadly, in some cases, the disease progresses in further severity and it has already caused the preventable death of many people.
The people most affected based on currently available data are those above 60 years and with pre-existing conditions.
Basic prevention includes regular hand washing with soap and [warm] water, keeping hands from the face and social distancing.
The advice is that if you suspect that you may have COVID-19, you should isolate yourself at home and call those responsible for fighting coronavirus in your community or country.
There is currently no scientifically proven definitive treatment of COVID-19.
There is currently no vaccine approved by the World Health Organisation or relevant national authority to protect against COVID-19.
At the individual level, in addition to hand washing, keeping the hands from the face and social distancing, it might be good to stock up on household supplies including some paracetamol in case you may need to self-isolate.
The World Health Organisation has now declared COVID-19 as a pandemic, which means that it is now widespread all over the world.

The most up to date data from the World Health Organisation as of March 15, 2020, suggested that the number of confirmed cases worldwide is 162,687. The number of confirmed deaths is 6,065. This is an ongoing pandemic and the evidence suggests that the number of cases and deaths worldwide would increase.

Countries are implementing various strategies to contain and delay the spread of the infection. The response depends on previous experience, data and the tools that are available and at the disposal of a society, country and the world.

The potential effects of COVID-19

The ease of spread and its ability to cause death in those who contact it (in especially the most vulnerable – at this time the elderly and people with pre-existing health conditions) make COVID-19 such a scary virus. It is because it is new and poorly understood, can cause serious illness, have no proven cure and prevention and that it can cause death, that the virus spreads fear in communities and the world. What the United Nations Secretary-General referred to as “fear going viral”. The primary instincts of humans to survive kicks in and there is general panic and pandemonium.

This really is a public health emergency of global proportions caused by a virus that we don't yet fully understand. It has the potential to seriously disrupt the very systems that support modern society. How we respond (which would depend on whether we have the tools and are willing to use them), would determine whether we can modify the effects of COVID-19 on individuals, communities, society and the world. The potential effects can be classified into first, second and third-order effects that are dynamic and interrelated. These effects can be the biggest challenge that some countries and the world have faced for a generation. COVID-19 could fundamentally change the world as we know it. What that change might be we do not know, but with every challenge comes the opportunity to respond appropriately.

First-order effects

COVID-19 has the potential to overwhelm our health systems. This is because it is spreading fast from persons (who are infected) to other people who become infected and then spread on and on because COVID-19 spreads easily. It is also because many people who contact it quickly fall it and require medical attention. Because COVID-19 is new, the population has very little or no immunity and thus would easily infect many people within a short period of time if the right sets of interventions are not implemented to stop the disease or at least reduce the speed or rate at which the spread of COVID-19 is occurring in the population.

The result of rapid spread of COVID-19 may concentrate attention and effort on fighting it and may consume most of the healthcare resources. Other healthcare needs may suffer. Healthcare workers may be infected, and their morale affected, reducing capacity and the ability of healthcare facilities to provide services to COVID-19 patients and patients with complex and other needs. The demand for the inputs in the production of health may far outstrip supply in a short period of time, giving very little opportunity to respond. The latter may especially be true for countries that depend heavily on imports for major inputs into the production of health. This may lead to increased disease burden and deaths directly from COVID-19 and other healthcare conditions that are preventable. This may on its own have negative economic consequences.

To effectively manage COVID-19 outbreaks, countries should respond relative to where they are in the outbreak, their relative circumstance (stage of development) and the tools available to them. This is mindful of the potential health and economic impact. There are three key drivers that are important to national response (containment and mitigation continuity) in an epidemic, which would apply to COVID-19.

The first is case prevention, recognition, and definition. Information, education, and testing are important to this response.

The second is to prevent spread. Self-isolation of individuals with suspected symptoms which should lead to testing, quarantine of confirmed cases and management by trained healthcare professionals with full protection, and contact tracing for isolation and testing which may lead to quarantine.

The above is generally the containment part of the intervention continuity. In many epidemics as with COVID-19, intervention is dynamic requiring ongoing and flexible response with the clear objective of preventing, reducing and halting the spread, and the goal of reducing the impact.

The third is to reduce or delay the rate of spread. This is the mitigation intervention continuity. It requires implementing strategies to do with social distancing by keeping people apart and thus reducing the opportunity for human to human contacts and, therefore, making transmission less likely. The latter would include reduction in the movement of people such as restrictions on travel between targeted (at early stage of the outbreak in which cases are increasing rapidly) countries and within country. It can also include closing schools, stopping large public gatherings such as sports stadiums, etc. and encourage working from home. It would also include arranging special care for the most vulnerable.

When the containment – mitigation continuity response is effectively executed, it could result in flattening the coronavirus epidemic curve. Flattening of the epidemic curve results from disrupting the natural progression and the spread of the disease outbreak to achieve fewer cases spread over a longer period or the same number of cases over a longer period. The idea behind the flattening of the curve is that there should be fewer cases in a country (circumstances) within a period which allows the frontline responders to emergencies such as healthcare workers and healthcare facilities to cope and for industry to respond in increasing capacity and supplies of the inputs required to fight the epidemic. This includes research that would lead to improved understanding of the infection and the development of treatment and preventive vaccines. This is the objective of the right interventive measures. To disrupt the natural progression of the virus not to infect a large population within a short period of time.

The outbreaks of a new infections such as the COVID-19 would naturally (without the right intervention measures) evolve through rapid spread to peak. This happens because there is little or no immunity in the population. Therefore, the virus has the opportunity to spread. But as it spreads (even without the right intervention measures) many people in the population who become infected recover and have some immunity to a level that can be described as herd immunity.

The problem without the right intervention measures is that the number of cases dramatically rises beyond the capacity of the healthcare system. Healthcare workers in this circumstance become vulnerable and some of them may be infected leading to increased morbidity and mortality among healthcare workers. If this were to happen, it would further reduce the capacity and ability of the healthcare system to respond and could cause health system collapse.

Flattening the Coronavirus Curve

Second-order effects

As a result of “fear going viral”, people start to panic-buy. This disrupts supply chains. Widen spread scarcity may ensue as the economy is unable to respond. Some of the scarce commodities may be vital necessities, the lack of which, may impact health needing healthcare services that are already overwhelmed.

The real and imagined potential negative effects of a pandemic such as COVID-19 which is new (with less clarity and uncertainty) can increase speculations and hysteria. This can be worsened by the response of relevant authorities at national and global levels. The impact on markets can be dramatic triggering losses and the massive erosion of the value of financial markets around the world.

Social distancing which includes school closures would have a potential impact on the future of children and the economy. When children stay home and there is no help, their parents cannot go to work and earn (except they can work from home). Family income may reduce.

Social distancing which includes travel restrictions adds to the fear of travelling. This impacts travel, tourism, hotel and hospitality businesses. This can lead to loss of revenue, business and jobs.

Social distancing which includes closures of sports arenas, cafes, restaurants and other places that may increase human contact, would lead to loss of businesses, loss of jobs and loss of individual and household income.

When social distancing includes shut-down of a city or country as may be necessary if the virus is spread wide and wild uncontrollably, people whose physical presence is required at work and factories to produce the goods that we need, may not be able to get to work, as the transportation system shuts down. Production capacity may reduce and there may be shortages of vital supplies. This can hurt the economy of individuals, households, countries and the world.

Third-order effects

The overall effects of a pandemic such as COVID-19 would affect health, cause death, weaken health systems, disrupt national economies and disrupt (even destroy) global supply chains. While some businesses producing inputs for health intervention may profit in the short term, disruptions in the global value and supply chains (that these businesses depend on) means that they cannot scale or increase or surge capacity. In the medium to long term even these businesses would suffer losses from inefficiency, relatively low demand in the market and depressed financial markets. Generally, most businesses would suffer. The national and global economy could be seriously affected leading to recession.

Conclusion

COVID-19 pandemic poses grave risk well beyond national borders. We are socially, financially and economically globally connected more than ever before. While nations are responding individually, the tools to respond effectively to limit the potential effects of COVID-19, may be limited to different degrees. This constraint may in part be historical and related to existing global trade, financial and monetary systems that might impact their capacity and ability to respond appropriately.

Obviously, COVID-19 requires a multidimensional and multidisciplinary response across and the whole of government. It requires a health response. It requires a fiscal and monetary policy response. Because many developing countries may be limited by the tools required for in these multidimensional and multidisciplinary response, there should be a global response to COVID-19 and future pandemics. Together, the world has the resources to act against global threats.

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