Issues of Epidemiology and Public Health: Forecasts and Strategy

Issues of Epidemiology and Public Health: Forecasts and Strategy

Speech by Yergaliyev K.A., MD MPH DrPH at the meeting of Kazakh scientists with the Minister of Health of the Republic of Kazakhstan  Birtanov E.A.

“There is no doubt that the coronavirus pandemic has affected all aspects of our lives and all countries, regardless of where we live and what language we speak. The coronavirus pandemic is a global crisis that has yet to be resolved, and there is no active treatment or vaccine (it may take at least a year to develop an appropriate vaccine).  Starting this week, we are already seeing a number of countries diminishing the quarantine regime. Despite the fact that the state of emergency in Kazakhstan has been extended until May 11, we see that the state authorities have begun to diminish the quarantine regime.

In this regard, I would like to focus today on the main aspects of the post-quarantine period that should be given special attention. These theses are based on the recommendations of scientists and public health experts at Harvard University.

The first aspect is the epidemiological aspect. International experts say that a system for identifying patients and tracking contact people with further isolation should be formed and implemented. One of the key success factors in China has turned out to be that they have a fairly strong system for tracking people’s faces through phones, smartphones, the Internet and social networks, as well as cameras.  Of course, there is a question of possible violations of individual freedom of human rights.

Just recently, scientists from Nazarbayev University proposed 4 scenarios for solving this problem, where the most effective scenario was the one where a certain monitoring system would be formed through an application on a smartphone. This system will also allow collecting data necessary for modeling and forecasting different scenarios of the epidemic development. For example, in Kazakhstan, the regions are usually at different stages of development as part of the spread of coronavirus infection. If the cities of Almaty and Nur-Sultan are at the peak of morbidity among the population, then other regions are on completely different sections of the epidemiological curve. Therefore, it is necessary to carefully make decisions in terms of simultaneously relaxing quarantine measures, which can have a negative impact on the whole and lead to the second wave. 

The second aspect is the medical aspect. Basically, this is clear: it includes the resource capacity of the healthcare system, i.e. the availability of resources for testing the population, treating sick people, and the availability of the necessary medical personnel. Solving this aspect requires financial resources and time.

The third aspect is economic.  Of course, during the quarantine period, the population and businesses do not work, and therefore the economy stands still. This led to the formation of a certain pressure on the early opening of a business, and therefore the government decided to gradually put the enterprises into operation. However, this should take into account the preventive norms. 

Here I would like to focus on precautions in the workplace because tomorrow everyone will go to work and managers will need to know what to do. Thus, according to the recommendations of Professor Joseph Allen from Harvard, business should adhere to the following five simple strategies:: 

The first strategy is to work from home. If possible, the person (employee) must work from home;

The second strategy is to release only the key personnel necessary for the life of the enterprise to work;

The third strategy is engineering control, i.e. optimizing the ventilation of air in buildings, purification and filtration, by increasing the flow of outdoor air, using portable air purifiers, and replacing existing filters in air circulation systems with filters that can capture smaller particles.  

The fourth strategy is administrative control, i.e. reducing the crowding of employees in the enterprise if it is possible to make a sliding schedule or alternating shifts for employees or possible distribution of employees in the room so that they are not in the same place. Use of conference rooms and other common areas by setting restrictions or creating rules for staying in these places. 

The fifth strategy is the use of personal protective equipment, i.e. masks, gloves and regular temperature measurement and the use of disinfectants.

The fourth aspect is the most important one related to society because the pandemic and the crisis have led to the formation of new realities, new social norms that we will have to adhere to in order to protect ourselves and our loved ones. 

First, this is the norm of social distancing, which will require each of us to change our lifestyle, change our behavior, that is, we must reconsider our view and norms on the banal handshake, holding holidays, events, and I think this will not be so easy to do given our cultural context. Just the other day, there was a case in the news where a resident of the East Kazakhstan region invited 30 people to a memorial dinner and all 30 people were quarantined. Or in the city of Kokshetau was a case when employees of the Anti-Corruption Agency were in the bathhouse violating the quarantine regime. And this is an indicator of the overall level of awareness of the population, and I think there is still a lot of work to be done and a lot of effort to be made.

In conclusion, I will note the following points that will be important for the further successful implementation of post-quarantine measures to protect the health of the population in Kazakhstan:

The first point is the application of a multidisciplinary approach with the mobilization of the public. For example, this kind of discussion was held for the first time and we see the active participation of colleagues from different directions.  

The second point is communication, effective and as reliable as possible informing the public about what is happening, what we know and what we do not know yet. Open communication is very important, especially in conditions of low public confidence.  

The third point is the ability to learn from what has happened, through conducting scientific research and analyzing data, using it to make management decisions.

The last point is the awareness of the impact of globalization on the epidemic, the interconnectedness of countries and economies of countries. It follows that we are all interconnected and the decisions that other people make in another country can have a very strong impact on the results of our work. And this will need to be taken directly into account. 

Thank you.”


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