Control of the Covid-19 (Coronavirus) and Economy

The control of the Covid-19 (Coronavirus) pandemic may be very long. There are many persons who have no signs but can transmit the disease. How to fight the Covid-19 (Coronavirus) pandemic at the same time allow all economic activities to run. Public health experts should be able to find measures to prevent epidemics without requiring total confinement or the cessation of certain economic activities. In this case, the control of the Covid-19 (Coronavirus) pandemic should be done without stopping major economic activities which are among others, the transport of people, sport, conferences & meetings, tourism, cinema, music concerts & cultural events and schools.

What are the possible measures to combat Covid-19 (Coronavirus) without stopping the economic activities mentioned above?

 Mandatory screening

The screening with rapid tests that detect early the Coronaviruses with 100% sensitivity already exists on the market. They can be done compulsorily for the crew, passengers, hotel staff, before entering sports stadiums, conference rooms & meetings, parks and museums, cinemas, music concerts & cultural events. It is expensive but it’s better economically than stopping these vital activities for both the national and international economies.

Isolation mandatory if Covid-19 (Coronavirus) test is positive

Anyone with a positive test should be isolated until he/she is negative before continuing the trip. Consent should be obtained when purchasing the travel ticket or check-in. 

Spray disinfection with products with high virus-killing power and non-harmful

Spray disinfection of surfaces and orifices with products with the high virus-killing power and non-harmful, should be done on a regular basis and be part of routine hygiene at airports, bus and train stations, planes, trains, buses, sports stadiums, conference & meeting rooms, parks & museums, and schools. Public authorities should ensure effective inspection of these measures.

Mandatory wearing of masks

Anyone working at the airport, bus and train stations, crew and passengers, teachers and students, anyone working in the tourism and leisure industries should wear masks. Camera surveillance and other technological means should remind everyone who doesn't.

Compulsory Social Distension (the distance of at least one meter)

Airports, bus and train stations, parks, and museums should organize a distance of at least one meter. Planes, buses, trains, conference & meeting rooms, and schools should inform and insist that people do not touch each other.

Mandatory hand disinfection with certified products

Hand disinfection with certified products should be mandatory for anyone working at the airport, bus and train stations, crew and passengers, teachers and students, and anyone working in the tourism and tourism & leisure industries. Camera surveillance and other technological means should remind everyone who doesn't.

Dr. Claude Sekabaraga, MD, MPH

Covid-19 (Coronavirus) Control and Deconfinement for National and International Economic Activities

Introduction

Many Covid-19 cases have no clinical manifestations but are contaminating. Thus, the complete end of the Covid-19 pandemic may take a long time. The number of unemployed is already very high, poverty and hunger are increasing. It is imperative to find effective means of Covid-19 prevention and national and international economic activities. Without international economic exchanges, national economies will be weak for most countries. There is a need to find measures to fight the Covid-19 pandemic and national and international economic activities. Some recommendations:

Mandatory Wear of Mask

The compulsory wear of masks by those providing services to the public and those who use public services (airport, transport, including buses, taxis, etc., hotels and other accommodation, shops, etc.). Even though cloth masks do not protect at the same level as surgical masks, they may be more accessible by most of the population. Very high-risk personnel (health, tellers, etc.) should use the professional mask with a high level of protection. The taxi drivers and the passengers should wear a professional mask until the total end of the Covid-19 pandemic.

Compulsory Social Distension (the distance of at least one meter)

The distance of at least one meter should be strictly mandatory until the full end of the Covid-19 pandemic. For public transport by bus, metro, etc., it is essential to have one passenger per chair.

Mandatory hand washing or disinfection

Hand washing or disinfection should be mandatory, especially those who provide services to the public and those who use public services (airport, transportation, including buses, taxis, etc., hotels and others) accommodation, shops, etc.). The sink with water, soap, and disposable paper for drying hands should be at every entrance to public buildings. Hand disinfection before and after serving a customer. Hand disinfection before and after being served.

Compulsory Disinfection of Common Areas (Public & Domestic)

In addition to extensive spray disinfection of public spaces with appropriate equipment mandatory for public and private companies, the production of small containers of spray disinfectants is necessary. In addition to hand sanitizer outlets, it is essential to have also hand spray disinfectants for small common areas.

Mandatory Screening of High-Risk People

Accessibility to screening tests with high sensitivity and specificity is urgent. Persons providing services to the public (hospitals, airports, transport, including buses, taxis, etc., hotels and other accommodation, shops, etc.) should have access to rapid screening tests with the possibility of confirmation in case of positivity.

Mandatory Quarantine if Positive Test

People who are tested positive should remain under quarantine under supervision until the negativity ends.

Dr. Claude Sekabaraga, MD, MPH

Covid-19 (Coronavirus)- Universal Testing for Breaking Community Transmission

Introduction

The Covid-19 (Coronavirus) is spreading in communities both urban and rural in many countries in the world. The confinement is not a sustainable option. It can help in the short-term, but it is not affordable economically and socially.
Currently, three options are the ones that can contribute effectively to break the Covid-19 transmission:
(i) Universal vaccination: It may take a minimum of 5 years for the world.
(ii) Universal testing: It may take one year if included in the global health systems.
(iii) Universal barrier methods (mask, hand washing, and social distancing): It may take one month if there is political and community engagement.

Universal Screening
The PCR test with high sensitivity and specificity is the one largely utilized by the global health systems. The PCR is not technically accessible, and it is expensive. When the Covid-19 was with travelers and few contacts, it was the preferable test. Currently, Covid-19 is spreading globally in the communities.

Moving forward to the rapid tests and serology tests may increase the access technically and financially. There are rapid and serology combo tests (antigen and antibody) tests that can detect early and chronic infection or asymptomatic carrier. The positive cases should be confirmed by the PCR. There are rapid tests that can be used by the health professionals and the ones can be used at home (community health workers or self-testing).

Universal screening both by the health professionals, community testing, and self-testing for the detection of early and chronic or asymptomatic infections have high potential (high impact) to breaking the community transmission when the universal vaccination is not yet possible.

Access to the testing
The regulatory bodies of the health laboratories (Ministries of Health, Food and Drugs Authorities, etc.) should accredit the Covid-19 tests, the official representatives of the manufacturers (storage, transport, etc.), as well as the services providers (hospitals, clinics, pharmacies, etc.). This is to ensure the quality is maintained at all levels.

As much as many tests, many distributors, and many services will be accredited, the accessibility will increase towards universal access to testing. The access to the community and self-tests will make a big move towards the breaking of the transmission.

Incentives to the testing
There is an opportunity to establish a direct linkage between the economy and social activities to the prevention. All activities should be authorized on the conditions to have all the persons concerned to be tested and use the barrier methods (mask, hand washing or sanitizing, and social distance). The risky places like the dancing clubs, cinemas, etc. should need PCR tests. For others like the open markets, etc. should need the rapid and serology tests especially the combo tests that include the antigen and antibody testing. The regulatory bodies should provide the details of how each test should be used (what, why, and how).

With the decentralization of the Covid-19 tests at the community and households’ levels and linkages between the testing and the economic and social activities, universal testing can be reached and contribute highly to breaking the transmission.

Financing the testing
By moving towards universal testing, the economy of scale should be considered for the pricing. Regulatory bodies should assess the market and standardize the prices across the tests with the same nature and costs. The insurances (travel and health especially) should include the Covid-19 tests in the benefit packages. The subsidies to low-income populations should be planned for ensuring the test will not be a catastrophic health expenditure factor.

Conclusion
The Covid-19 universal testing can allow global businesses to resume as per the past normal conditions before the universal vaccination will be possible.

Dr. Claude Sekabaraga

Covid-19 (Coronavirus): International Authority for Epidemics of the United Nations Security Council (UN-AIE)

 Introduction

The Covid-19 pandemic shows us that epidemics constitute a major threat to global security (the world is really a village). Scientific and medical advice from international organizations such as the World Health Organization is accepted or not according to national politics. Mandatory joint action against a common risk is essential. It is the Security Council of the United Nations that has the mandate to compel states to take action towards global security.

Why?

Political and health leaders have assessments based on political ideologies, economic interests, and even culture. The last epidemics of SARS, Ebola, and now Covid-19 show us how the world can be seriously threatened at a very high level and even see entire populations seriously affected directly (disease) and indirectly (economy). When Covid-19 started in late 2019, no one knew that we are facing a pandemic that will paralyze the world (confinement of populations at home with important consequences like a rapid increase in unemployment and poverty). The world needs authority in addition to scientific and medical advice from organizations like the World Health Organization. These organizations will continue their role as advisers for evidence-based decision making.

How?

The United Nations Security Council creates an Agency of the International Authority for Epidemics (UN-IEA) with the mission of deciding what joint actions States must take to protect the world from the threat of an epidemic that is beginning. The UN-IEA will establish offices where it deems necessary (national or subnational level) to collect information with a view to making decisions for action to control an epidemic that is beginning. Action to control the epidemic to be implemented by a subnational, national, or international entity (Provinces, Regions, Federated States, Countries, Transport Companies, Airports, International Air Transport Agency, etc.).

Conclusion

As it is difficult to know whether an epidemic will remain local or will reach the whole world as Covid-19 has done, countries will have to lose their autonomy in the control of the epidemics.

The Security Council should meet urgently by teleconference to take joint actions to control Covid-19. Countries and States actions are not coordinated enough to be effective at the international level.

Dr. Claude Sekabaraga, MD, MPH

Covid-19(Coronavirus): Test, Travel & Stay Safe

Introduction

It is crucial to find effective means of Covid-19 prevention to allow national and international travel imperative for global economic activities. Without international economic exchanges, national economies will be weak for most countries. There is a need to find preventive measures to control the Covid-19 pandemic and allowing safe travels. Some suggestions:

Mandatory testing before any travel between cities and countries

The testing with high sensitivity and specificity with early detection is urgent. Persons providing the transport services (airports, taxis, hotels, and other accommodation, etc.) should have access to the tests as much as needed.

Mandatory Quarantine if Positive Test

People who are tested positive should remain under quarantine under supervision until the negativity ends.

Mandatory Wear of Mask

The compulsory wear of masks by those providing the transport services (airports, stations, taxis, hotels and other accommodations, etc.). They should use the professional mask with a high level of protection.

Compulsory Social Distension (the distance of at least one meter)

The distance of at least one meter should be strictly mandatory. For public transport by flight, bus, metro, etc., it is essential to have one passenger per chair.

Mandatory hand washing or disinfection

Hand washing or disinfection should be mandatory. The sink with water, soap, and disposable paper for drying hands should be at every entrance of airports, stations, hotels, and tourism sites.

Compulsory Disinfection of Common Areas (Airports, flights, hotels and tourism sites)

The disinfection with appropriate equipment and products should be mandatory for airports, stations, flights, hotels, and tourism sites).

Dr. Claude Sekabaraga, MD, MPH

Covid-19 Control: Transition from Home Confinement, Ban on International Travels and the Complete End of the Pandemic.

Introduction

Many Covid-19 cases have no clinical signs but are contaminating. Thus, the complete end of the Covid-19 pandemic may take a long time. Already some countries are starting to reduce confinement for economic reasons. But without international economic exchanges, national economies will be weak for most countries. Global Health needs to study measures for the transition from confinement, restarting of the economic activities, and the control of the Covid-19 pandemic. Some recommendations for this essential transition:

Mandatory Wear of Mask

The compulsory wear of masks by those providing services to the public and those who use public services (airport, transport, including buses, taxis, etc., hotels and other accommodation, shops, etc.). Even though cloth masks do not protect at the same level as surgical masks, they are more accessible for large-scale protection. Very high-risk personnel (health, tellers, etc.) should use the professional mask at a high level of protection. For motorcycle taxis, the driver and the passenger must wear a professional mask until the total end of the Covid-19 pandemic.

Compulsory Social Distension (distance of at least one meter)

The distance of at least one meter should be strictly mandatory until the full end of the Covid-19 pandemic. For public transport by bus, metro, etc., it is essential to have one passenger per chair.

Mandatory hand washing or disinfection

Hand washing or disinfection should be mandatory especially those who provide services to the public and those who use public services (airport, transportation, including buses, taxis, etc., hotels and others) accommodation, shops, etc.). The sink with water, soap and disposable paper for drying hands should be at every entrance to public buildings. Hand disinfection before and after serving a customer. Hand disinfection before and after being served.

Compulsory Disinfection of Common Areas (Public & Domestic)

In addition to large spray disinfection of public spaces with appropriate equipment mandatory for public and private companies, the production of small containers of spray disinfectants is necessary. Hand sanitizer outlets should also have spray disinfectants for common areas.

Mandatory Screening of High-Risk People

Accessibility to screening tests with high sensitivity and specificity is urgent. Persons providing services to the public (hospitals, airports, transport, including buses, taxis, etc., hotels and other accommodation, shops, etc.) should have access to rapid screening tests with the possibility of confirmation by the case of positivity.

Mandatory Quarantine if Positive Test

People who are tested positive should remain under quarantine under supervision until the negativity ends.

Dr. Claude Sekabaraga, MD, MPH

Ending Covid-19 (Coronavirus): The Management of Public Market Cluster for Breaking the Community Transmission (Contamination) in Developing Worlds

Introduction

The developing worlds within the low- and middle-income countries, and even some areas of high-income countries, may represent more than 75% of the world population. The developing worlds don’t usually use the private markets (malls), but they use the public markets with different levels from a village market to a large city market. The low-income populations don’t usually have the fridges and freezers to store food for many days. They don’t even have money to buy food for many days. The population goes to the market daily in cities and once or twice a week in villages where the markets complement the family production. Meaning the market connects daily the cities populations and once or twice a week the village families. During the confinement, it is not possible to close the public markets for the reasons mentioned above. To end the Covid-19 pandemic the public market contamination or transmission cluster needs strategic, practical options and customized ways to prevent the contamination or transmission.

Engaging and Capacity Building of the Public Market Management

Having the public market management engaged to put in place the preventive measures is key. The entry door should be to build their capacity and confidence as well as their leadership. The capacity building should be customized to the specificity of the market including the users (sales and buyers). Many public markets are open spaces, without clear entrances and exits. Very few may have cameras to monitor the respect of the barrier’s preventive measures. Supervisors don’t have in their terms of reference and capacity to monitor the disease’s transmission. In fact, the Covid-19 programs should build it for Covid-19 but also for potential other epidemics or pandemics. 

Handwashing or Disinfection

Many public markets, especially the ones of the small cities and rural areas may not have the capacity to organize the public markets to have official entrances and exits as well as handwashing and disinfection stations. Even the public markets in bigger cities may be in that situation. For the disease’s prevention, in occurrence for ending the Covid-19 pandemic, the support should ensure the persons using the public markets can wash and sanitize the hands at the entrance and exits, and as necessary. It is an important contribution that may have a global impact considering the big number of people using the public markets and who connects more than 75% of the families around the world. In normal situations, hand washing prevents an average of 40% of diarrheas, especially of children.

Wear of Mask and Social Distancing

Having the public market’s users wear properly the mask and social distancing is necessary to end Covid-19 because to have the vaccination coverage level that can break the transmission (at least 60%) may take many years. Establishing a monitoring system of the proper port of mask and social distancing in each public market is important. The management of the public market should be supported in terms of skills, systems, and technologies to be able to sensibilize and monitor wearing the mask and social distancing.

Testing of Covid-19

The public market is a cluster that embraces communities, families, and individuals from different local, neighbor countries, regional and global areas. It is a composite cluster. Testing the users in all of them including confirming the variants may be an important factor in ending the Covid-19. 

Vaccination of Covid-19

The public market is a potential site that may bring the Covid-19 vaccination to the communities. The public market is central in terms of community life. To end the Covid-19, the vaccination should be part of this community life for acceptability and access.

Conclusion

The public markets in developing worlds within the low-middle and high-income countries have potential high impact to implement almost all the diseases prevention strategies and interventions, including handwashing and sanitizing, wearing the mask and social distancing, and vaccination for Covid-19.  

Dr. Claude Sekabaraga

Equitable and Sustainable Financing of Covid-19 Vaccination of Developing Countries

I. Introduction

The vaccination, including the vaccine, logistics, and healthcare administration, may cost an average of US$75 per person. The government tax to gross domestic products (GDP) per capita is 10-15% as the economy is 70-90% informal sector (not filing and paying the government tax). Before Covid-19, the GDPs per capita of most developing countries were US$500-US$1,000. With Covid-19, the GDP may be mostly below US$500 per capita. The tax to GDP (regular government budget source) is then US$50-75. Meaning the government of the developing countries should need to use almost 100% of the budget to finance Covid-19 vaccination. How to ensure vaccine availability and avoid financial barriers to Covid-19 vaccination?

II. Financing options

1. Covid-19 Vaccines Global Access (Covax) led by GAVI, WHO, UNICEF and CEPI

It is a great initiative but currently mobilizes less than 10% of the budget. The sources of financing are governments essentially, foundations and companies. With the global economic health crisis, it may be impossible to have the Covax mechanism cover more than 50% of the three-year needs. Which options to increase and sustain the financial capacity of the Covax mechanism? A small percentage added to the international flight tickets may provide sustainable contributions.  Covax should engage as possible the international travel organizations like International Air Transport Association (IATA) and similar and regulators.

The countries should use the purchasing power of the Covax mechanism to acquire cost-effective vaccines. It requires Covax to establish grants and paid vaccines for developing countries.

 2. National Covid-19 Vaccination Financing by Developing Countries

The fiscal space to accommodate the cost of the vaccines and related services doesn't almost exist. A small percentage of the telecommunication fee (used by more than 80% of the population, with easy payment collection) should contribute to financing the vaccination in a realistic, sustainable, and socially acceptable manner).

The persons with more than US$15,000 income a year (5-25%) may contribute using voluntarily paid vaccination facilities. It can be an opportunity of having cross-social economic categories indirect solidarity. It may help the businesspersons benefit with less waiting time, and some comforts already are paying for other services (accommodation, leisure, etc.).

III. Conclusion

The universal Covid-19 vaccination may be reached if both the Covax and developing countries' governments design sustainable financing mechanisms beyond the current funding grant-based. As GAVI slogan: "No one is safe until everyone is safe."  

Dr. Claude Sekabaraga, MD, MPH

Quality & Equity Healthcare

Financement Equitable et Pérenne de la Vaccination de la Covid-19 des Pays en Voie de Développement

I. Introduction

La vaccination, y compris le vaccin, la logistique et l'administration des soins de santé, peut coûter en moyenne 75 $ US par personne. L'impôt gouvernemental sur les produits intérieurs bruts (PIB) par habitant est de 10 à 15%, car l'économie est à 70 à 90% du secteur informel (ne déclarant pas et ne payant pas la taxe gouvernementale). Avant Covid-19, le PIB par habitant de la plupart des pays en développement était de 500 à 1 000 dollars. Avec Covid-19, le PIB peut être pour la plupart inférieur à 500 dollars par habitant. L'impôt sur le PIB (source du budget ordinaire du gouvernement) est alors de 50 à 75 dollars. Cela signifie que le gouvernement des pays en développement devrait utiliser près de 100% du budget pour financer la vaccination contre le Covid-19. Comment garantir la disponibilité des vaccins et éviter les obstacles financiers à la vaccination contre Covid-19 ?

II. Options de financement

1. Accès mondial aux vaccins Covid-19 (Covax) dirigé par GAVI, l'OMS, l'UNICEF et le CEPI :

C'est une belle initiative mais qui mobilise actuellement moins de 10% du budget. Les sources de financement sont essentiellement les gouvernements, les fondations et les entreprises. Avec la crise mondiale de la santé économique, il est presque impossible que le mécanisme Covax couvre plus de 50% des besoins sur trois ans. Quelles options pour augmenter et maintenir la capacité financière du mécanisme Covax ? Un petit pourcentage ajouté aux billets d'avion internationaux peut fournir des contributions durables. Covax devrait engager autant que possible les organisations de voyage internationales telles que l'Association Internationale de Transport Aérien (IATA) et les organismes de réglementation.

Les pays devraient utiliser le pouvoir d'achat du mécanisme Covax pour acquérir des vaccins à bon prix. Ceci demande que Covax puisse établir une option avec des subventions et une option pour vendre les vaccins aux pays en développement.

2. Le financement national de la vaccination contre le Covid-19 par les pays en développement :

L'espace fiscal pour l’achat des vaccins et des services connexes n'existe presque pas. Un petit pourcentage des frais de télécommunication (utilisé par plus de 80% de la population, avec un recouvrement des paiements plus facile) devrait contribuer au financement de la vaccination de manière réaliste, durable et socialement acceptable.

Les personnes dont le revenu annuel est supérieur à 15, 000 dollars (5 à 25%) peuvent contribuer en utilisant des centres de vaccination payés de manière volontaire. Cela peut être l'occasion d'avoir la solidarité transversale indirecte entre les catégories socio-économiques. Cela peut aider les personnes dans les businesses à bénéficier de moins de temps d'attente, et certains conforts déjà payés pour d'autres services (hébergement, loisirs, etc.).

III. Conclusion

La couverture vaccinale universelle contre la Covid-19 peut être atteinte si Covax et les gouvernements des pays en développement conçoivent des mécanismes de financement durables au-delà du financement actuel basé sur des subventions. Comme le slogan de GAVI : "Personne n'est en sécurité tant que tout le monde n'est pas en sécurité".

Dr. Claude Sekabaraga, MD, MPH

Quality & Equity Healthcare

Mettre fin à la Covid-19 (Coronavirus) : La gestion du cluster de marché public pour briser la transmission communautaire (contamination) dans les communautés en développement

Introduction

Les communautés en développement au sein des pays à revenu faible et intermédiaire, et même certains endroits des pays à revenu élevé, peuvent représenter plus de 75 % de la population mondiale. Les communautés en développement n'utilisent généralement pas les supermarchés, mais ils utilisent les marchés publics de différents niveaux (marchés de village et ceux de grandes villes). Les populations à faible revenu n'ont généralement pas les réfrigérateurs et les congélateurs pour stocker de la nourriture pendant plusieurs jours. Ils n'ont même pas d'argent pour acheter de la nourriture pendant plusieurs jours. La population se rend quotidiennement au marché dans les villes ou une à deux fois par semaine dans les villages où les marchés complètent la production familiale. Le marché relie quotidiennement les populations des villes ou une à deux fois par semaine les familles des villages. Pendant le confinement, il n'est pas possible de fermer les marchés publics pour les raisons évoquées ci-dessus. Pour mettre fin à la pandémie de Covid-19, le marché public comme cluster de contamination ou de transmission des maladies a besoin d'options stratégiques et pratiques et des options personnalisés.

Engagement et renforcement de capacité des gestionnaires de marchés publics

L'engagement des gestionnaires des marchés publics pour mettre en place les mesures préventives est essentiel. La porte d'entrée devrait être de renforcer leurs capacités et leur confiance ainsi que leur leadership. Le renforcement des capacités doit être adapté à la spécificité du marché, y compris les utilisateurs (vendeurs et acheteurs). De nombreux marchés publics sont des espaces ouverts, sans entrées et sorties claires. Très peu peuvent disposer de caméras pour surveiller le respect des mesures préventives. Les superviseurs n'ont pas dans leur mandat et leur capacité de surveiller la transmission des maladies. En effet, les programmes Covid-19 devraient développer cette capacité aussi bien pour la Covid-19 mais aussi pour d'éventuelles autres épidémies ou pandémies.

Lavage ou désinfection des mains

De nombreux marchés publics, en particulier ceux des petites villes et des zones rurales, peuvent ne pas avoir la capacité d'organiser les marchés publics pour avoir des entrées et des sorties officielles ainsi que des stations de lavage et de désinfection des mains. Même les marchés publics des grandes villes peuvent être dans cette situation. Pour la prévention de la maladie, pour mettre fin à la pandémie de Covid-19, l'accompagnement doit veiller à ce que les personnes fréquentant les marchés publics puissent se laver et se désinfecter les mains à l'entrée et à la sortie, et en cas de besoin. C'est une contribution importante qui peut avoir un impact global compte tenu du grand nombre de personnes utilisant les marchés publics et qui connecte plus de 75% des familles. En situation normale, le lavage des mains prévient en moyenne 40 % des diarrhées, notamment chez les enfants.

Port du masque et distanciation sociale

Faire en sorte que les utilisateurs du marché public portent correctement le masque et la distanciation sociale est nécessaire pour mettre fin au Covid-19.  Avoir le niveau de couverture vaccinale pouvant rompre la transmission (au moins 60%) pourrait prendre de nombreuses années. La mise en place d'un système de surveillance du port du masque de manière appropriée et de la distanciation sociale dans chaque marché public est importante. La gestion du marché public doit être soutenue en termes de compétences, de dispositifs et de technologies pour pouvoir sensibiliser et surveiller le port du masque et la distanciation sociale.

Tester la Covid-19

Le marché public est un cluster qui englobe des communautés, des familles et des individus de différents lieux et régionaux et pays. C'est un cluster composite. Faire le test de la Covid-19 aux utilisateurs, y compris la confirmation des variantes, peut être un facteur important pour mettre fin au Covid-19, en complément aux autres interventions. 

Vaccination de la Covid-19

Le marché public est un site potentiel qui peut apporter la vaccination Covid-19 aux communautés. Le marché public est central en termes de vie communautaire. Pour en finir avec la Covid-19, la vaccination devrait faire partie de cette vie communautaire pour l'acceptabilité et d'accès. 

Conclusion

Les marchés publics des communautés en développement dans les pays à revenu faible, intermédiaire et élevé ont un impact potentiel élevé pour mettre en œuvre presque toutes les stratégies et interventions de prévention des maladies, y compris le lavage des mains et la désinfection, le port du masque et la distanciation sociale et la vaccination contre Covid-19.

Dr Claude Sekabaraga

Please support the establishment of "International Authority for Epidemics of the United Nations Security Council (UN-AIE)" to prevent future pandemics, by signing the petition: http://chng.it/WkJs768k

The Covid-19 (Coronavirus) pandemic is a world threat of both medical, economic, social, etc. It is necessary for the port of mask and other control measures are implemented at the global level. Please support the establishment of "International Authority for Epidemics of the United Nations Security Council (UN-AIE)" to prevent future pandemics, by signing the petition: http://chng.it/WkJs768k

Rapid Study of the Prevalence and Incidence to Adjust the Measures to Control Covid-19.

Introduction

Many Covid-19 cases have no clinical signs but are contaminating. But the contaminated persons can be sick and die. As general confinement has a negative impact on the subsistence income of the populations and the economy of countries, it is urgent to know the prevalence and incidence of Covid-19. Rapid studies in different regions and cities are necessary. Control measures may be specifically adjusted to the prevalence and incidence of Covid-19 according to regions and cities. The possible options:

Option 1: Absence of Covid-19 cases in a region or city

If certain regions and cities do not yet have a case, the control measures can be a ban on entry and exit, reinforce physical distension, hand washing and the port of masks compulsory for the persons who provide services to the public (airport, transport, including buses, taxis, etc., hotels and other accommodation, shops, etc.). But economic activities within the region or city can continue while implementing other preventive measures. This will allow having reduced internal economic activities. Goods entering and leaving can be disinfected as possible.

Option 2: Presence of cases (without new cases) of Covid-19 in a region or city

For the regions and cities that do not yet have new cases, control measures should include isolation of cases, isolation of entrances and prohibiting exits, reinforcing physical distensions, hand washing and port of masks compulsory for the persons who provide services to the public (airport, transport, including buses, taxis, etc., hotels and other accommodation, shops, etc.). This will allow having reduced internal economic activities. Goods entering and leaving can be disinfected as far as possible.

Option 3: Presence of new Covid-19 cases in a region or city

For the regions and cities with new cases, control measures should always include confining the population, prohibiting entry and exit of the population, reinforcing physical distension, hand washing and the mandatory of the port of masks for the persons who provide services to the public (airport, transport, including buses, taxis, etc., hotels and other accommodation, shops, etc.).

Dr. Claude Sekabaraga

The World Will Live More and More with Pandemics: How to Control Pandemics Without Confining the World?

Introduction

The Covid-19 (Coronavirus) pandemic shows us that the world is a village. At a very short time, an epidemic (high number of contagious diseases in a locality or a country) can become a pandemic (transmission of contagious disease on a continental or global level). As the world is currently like a village due to rapid means of transport (planes, high-speed trains, etc.), epidemics will very often become pandemics.

Closing the conference centers, sports stadiums, places of tourism is to confine the world with all the businesses. We are facing World confinement that does not say its name.

Viruses, bacteria, etc. that create epidemics and pandemics are vulnerable to disinfectants that can be sprayed on surfaces, holes, air, hands, etc. There are also barrier methods to prevent transmission. How can we control the epidemics and pandemics without confining ourselves and confining the economic and social activities essential to the survival of humanity, ultimately confining the world?

Isolation and Quarantine

When there is a rapid increase in cases of illness in a locality, this requires time to identify the contagious agent responsible and the measures and means of prevention. The time is short to avoid the risk of a pandemic like the case of Covid-19. Two urgent actions:

1. Isolation of the locality: All the unknown epidemics should be considered as a global risk and imply a neutral international body that would take measures of isolation. It would mobilize the financial means to support the affected population. The conflict of interest limits the decisions of local and national authorities.
2. Quarantine of people at risk: People who have left the locality within a maximum of three weeks and their contacts should be quarantined and tested if possible. If the test is positive, they should remain under controlled quarantine until the negativity ends. If the test is not yet available, they should return to the community (home and work) after three weeks of observation.

Physical or Social distension

For any beginning of an epidemic for which the transmission methods are not yet known, the distance of at least one meter should be strictly compulsory. For public transport by bus, taxi, etc., it is essential to have one passenger per chair.

Disinfection

Disinfection by spraying common areas (surfaces and holes) should be compulsory for public services, businesses, and any operator providing services to third parties. Households should be sensitized to disinfect common spaces and holes (toilets, sinks, etc.). Hand washing and disinfection should be mandatory, especially those who provide services to the public and those who use public services (airport, transportation, including buses, taxis, etc., hotels and other accommodation), shops, etc.). Hand disinfection before and after serving a customer. Hand disinfection before and after being served.

Port of Mask 

In the epidemic locality and the surrounding localities, it should be mandatory wearing of masks by those providing services to the public and those who use public services (airport, transport, including buses, taxis, etc., hotels and other accommodation, stores, etc.). Even though fabric masks do not protect at the same level as surgical masks, they are more accessible for large-scale protection. Very high-risk personnel (health, tellers, etc.) should use the professional mask with a high level of protection.

Conclusion

The world (like a village) needs a common mechanism (authority and actions) to control quickly and effectively the epidemics that may increasingly be pandemics. It will avoid the confinement of the populations and the cessation of economic and social activities essential for the survival of humanity, as is the case for Covid-19 (Coronavirus). 

Dr. Claude Sekabaraga, MD, MPH