COVID-19 and its impact on behaviour

-By Dr Minhaj A Qidwai

Freedom of living in a country is an opportunity, and we should be fortunate to have Pakistan to live in freedom. However, freedom brings responsibility on all of us. For our living with space, the responsibility lies on Triple S Model-‘State, Society and Self.'

The State plays its role in securing the boundaries and ensures internal security. However, in the case of COVID, it has managed the pandemic by smart lockdowns. While society came forward in helping the government and individuals in the form of generous donations, providing ration to the needy and supplying food to the people in isolation. Society is formed of individuals. Therefore, the role of the self is essential.

Each individual goes through a life cycle. Most of us want to grow and do something for ourselves, family and society. To do so, we need to focus on self-improvement. To do so, we need to make ourselves aware of our strengths, weaknesses, the opportunities around us and the threats. Once we are aware, we need to regulate ourselves for becoming a role model to have an impact on our family, society and State. However, Self-awareness is critical.

In our lives, all of us develop their own beliefs and values for moving forward. The idea comes from:

• Faith


• Increase in Knowledge, its application and skills.


• Verification of Knowledge


• Education


• Experience from others


• Respect of Family-Powerful family


• Environment


• Peer Pressure


• Culture


• Mentor

These influencers on our belief form the basis of our values. The belief and the values are the inputs in our lives processed over a period giving the output in the form of our attitude resulting into behaviour as the outcome; which will determine our impact on the others. Thus, to affect others, we need to have the right beliefs and values.

As we proceed in our lives, we want to feel secure. If we consider security as our end value for living in society, and prosperity as the personal end value; the mean value to achieve security acceptable to society will be honesty, and the mean unique value will be logical, professional growth. It is important to note that the end values of security and prosperity could also have been achieved by dishonesty or corruption and bypassing the system. Thus, it is upon us, how we develop ourselves as a role model for our family, Society and State. For doing so, we must focus on self- awareness and regulations.

COVID also demands that we be aware of it and at the same time, be ready to counter the threats posed on us. Therefore, to be healthy for ourselves and family; Self-awareness is essential in dealing with COVID. The following brief on COVID will assist us:

About COVID:

• SARS (severe acute respiratory distress syndrome) is the virus that causes coronavirus disease 2019 (COVID-19).


• SARS = Spreads easily person-to-person


• Little if any immunity in humans


• Treatment under research.


• The incubation period ranges from 1-14 days, most commonly around five days.


• People are most contagious when they are most symptomatic (the sickest).


• Some spread might be possible before people show symptoms.


• COVID poses a greater risk for severe illness for people with underlying health conditions:
  
  
  
  • Heart disease
  
  
  • Lung disease such as asthma
  
  
  • Diabetes
  
  
  • Suppressed immune systems
  
  
  
  

Transmission:

COVID-19 is spread from person to person mainly through coughing, sneeze, and possibly talking and breathing.

• Droplet - respiratory secretions from coughing or sneezing landing on mucosal surfaces (nose, mouth, and eyes)


• Aerosol - a solid particle or liquid droplet suspended in the air


• Contact -Touching something with the virus on it and then touching mouth, nose or eyes


• Other possible routes: Through faecal matter

Symptoms:

Most common symptoms	Other symptoms may include
Fever	Runny or stuffy nose
Cough	Body aches
Shortness of breath	Headache
	Sore throat
	Chills
	Fatigue
	Gastrointestinal: diarrhoea/nausea
	Loss of smell and taste

The person under investigation:

1. People who have the Clinical criteria, which includes:

• cough, fever, and shortness of breath

1. Risk factors within the past 14 days before the onset of symptoms, such as:

• contact patient is known to or suspected to have COVID-19; residence in—or travel to—an area where COVID-19 transmission is active; or


• direct handling of bats or others non-human primates from disease areas.

Testing:

• The test kit is called the "Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panel."


• A confirmed case is a suspect case with positive PCR Test.


• Once PCR is strict positive isolation should be undertaken.


• After completion of isolation of 11-21 days, PCR repeated to confirm.

Progress:

1. Most people will have mild symptoms and should recover at home and NOT go to the hospital or emergency room.


2. Get medical attention immediately if you have:

• Difficulty breathing or shortness of breath.


• Persistent pain or pressure in the chest.


• New confusion or inability to arouse.


• Bluish lips or face.

Managing COVID:

1. No treatment available


2. How we are behaving:

• The Sceptics


• The Specials


• The Unawares


• The Worriers


• The Fearful


• The Confused


• The Panic Button


• The Decision Delays

3. 5 Decision Delays in COVID:

• Pre-Onset-No precautions


• Onset-Testing-Isolation


• Complications-Hospitalization-Choice of Hospital


• Delay in Decision at the Hospital


• Death-Body handover and burial.

Way Forward:

All have to play their role including State, Society and Self:

1. Role of State:

• Confidence in the Leadership.


• Right and Timely messages for the public.


• Public-EEE-educated engaged and empowered to deal with COVID.


• Behaviour Change through Communication.


• Disease Transmission to be under control.


• Health systems can "detect, test, isolate, treat every case & trace contact".


• Accessible and equipped Quarantine and Isolation Centres.


• Hot spot risks are minimized in vulnerable places.


• Workplaces have established preventive measures.


• Risk of importing new cases can be managed.


• Telehealth to be promoted.

2. Role of Society:

• Identification of Source


• Removal of source


• Assist in raising awareness about precautions


• Organization to play its role in terms of:
  
  
  
  1. Rostering personnel to prevent exhaustion and maintaining efficiency;
  
  
  2. Policies that enable employees to work remotely;
  
  
  3. Effective Communications with employees and customers;
  
  
  4. Stockpiling supplies or developing multiple suppliers in the event of a supply chain disruption.
  
  
  5. Consider the impact on workers.
  
  
  6. Stress Management.
  
  
  
  

3. Self-Change in behaviour

• Raise our awareness


• Take necessary Precautions for self, family and friends


• Timely decisions


• Remove Anxiety and FEAR


• Adequate rest and sleep


• Physical Distancing- Staying at least 6 feet apart


• Stay home when sick


• Appropriate diet to improve immunity


• Live in today


• Be a role model

Summary for dealing with COVID

1. Role of everyone


2. Value today


3. Situation analysis


4. Listen-attention-patience-understanding-process-feedback


5. Authenticity-verification


6. Transparency


7. Empathy


8. Optimism


9. Focus on behaviour change


10. Timely decision making

To conclude, COVID has become a paradigm shift in our daily lives. We need to understand that it is there to stay for an unspecified time. Life needs to be continued, and we need to live with COVID, considering it as a threat for ourselves, family, Society and State. The mainstay is changing in our behaviour.

-The writer is Faculty Member of American Institute of Healthcare Quality and President of Karachi Bridge Association, Pakistan and can be reached at minhajqidwai59@gmail.com