Categories
Health Communication World Diary

Can ‘Herd immunity’ Prevent It?

You probably heard the term ‘herd immunity’ (also called community immunity and herd or group protection) in relation to the coronavirus disease outbreak when some governments, including that of UK Prime Minister Boris Johnson, (are said to have) considered allowing herd immunity to develop on its own, without a vaccine, by letting the virus spread through their populations.

The argument was that though it might lead to a trail of deaths, the coronavirus would have left millions of recovered people with antibodies to fight it.

The chief science adviser to the UK government, Sir Patrick Vallance, said the country needed to “build up some kind of herd immunity — by having potentially 60% of the population (40 million people) contract COVID-19, as one of the “key things we need to do” — so more people are immune to this disease and we reduce the transmission”.

Later, however, Matt Hancock, the UK Secretary of State for Health, clarified that “creating so-called ‘herd immunity’ in the UK against coronavirus is not part of the Government’s plan for tackling the killer illness”.

Herd immunity happens when so many people in a community become immune to an infectious disease that it stops the disease from spreading.

The underlying scientific/medical argument is that

individuals could gain immunity to the new coronavirus if they develop antibodies; that can happen through vaccination, or after they get infected and recover

So, if enough people become immune, that can confer “herd immunity” to an entire population.

This protects even people who aren’t immune because so many others are immune that they prevent the virus from spreading within a community. Herd immunity would effectively end the coronavirus pandemic. Something like this:

Courtesy: Copyright National Foundation For Infectious Diseases (NFID), USA. Used only for illustration purposes.

It might not naturally occur to us that those who are infected with germs (e.g., viruses, bacteria) do not have the ability to infect infinite numbers of people. Individuals can remain contagious only for a limited time — before their own immune system clears the germ and they become non-contagious.

Equally, different germs require different doses of pathogen* to be transmitted in order to successfully infect another individual, and those that require higher doses may also require more prolonged contact to transmit infection.

[* A pathogen, broadly speaking, is anything that can produce disease. It can also be referred to as an infectious agent, or simply a germ.]

There has been past evidence for the emergence of herd immunity in other recent outbreaks.

In 2015, Zika virus, a mosquito-borne illness caused an epidemic panic. Two years later, in 2017, there was no longer nearly so much to worry about. A Brazilian study found by checking blood samples that 63% of the population in the northeastern beach city of Salvador had already had exposure to Zika; the researchers speculated that herd immunity had broken that outbreak.

In a radically different environ, Norway is said to have successfully developed at least partial herd immunity to the H1N1 virus (swine flu) through vaccinations and natural immunity. Similarly, in Norway, influenza was projected to cause fewer deaths in 2010 and 2011 because more of the population was immune to it.

But the thing about such data is that there is not just as much of it as one might want to decisively conclude in one direction or the other.

For a population to achieve herd immunity, a certain proportion has to be immune. That proportion depends on how infectious a virus is, a measure called R0 (pronounce ‘r-naught’) — the average number of people that a victim passes the virus on to.

The more contagious it is, or the higher the ‘Ro’ is, the more people need to be immune for the infection rate to start falling.

For some diseases, herd immunity can go into effect with as little as 40 per cent of the people in a population becoming immune to the disease, such as through vaccination. But generally, a much higher percentage of a population must be immune to the disease to stop its spread.

For example, it has been found that 19 out of every 20 people must have the measles vaccination for herd immunity to go into effect and stop the disease. This means that if a child gets measles, everyone else in the population around them will most likely have been vaccinated, already have formed antibodies, and be immune to the disease to prevent it from spreading further. If that is not the case, and if there are more unvaccinated people around the child with measles, the disease could spread more easily because there is no herd immunity.

And therein lies the problem with the option.

There is no vaccine currently available for COVID-19. We never know when it might arrive. So, the only hope currently is to develop herd immunity via contracting the Coronavirus.

Supporters of the method argue that about 493,000 people have recovered from the coronavirus already, and it’s likely they are now resistant.

The counter is: What is the degree of immunity?

The world has no idea how long the affected (and recovered) will stay immune. (With some coronaviruses, as well as with ordinary flu, the immunity lasts less than a year.) Also, even if they stay immune for long (like, until the vaccine arrives), the world has no idea how long it would take to reach herd immunity.

It is also unclear how much protection antibodies confer on people who have recovered from COVID-19.

Some early research suggests that not all recovered patients develop coronavirus-neutralizing antibodies to the same degree. According to a report (that has not yet been peer-reviewed) from Chinese scientists, about 10 of 175 participants studied did not develop neutralizing proteins. This suggests they could have a higher risk of reinfection! 

That report too does not give enough knowledge. Nothing so far has.

So, perhaps (since we are not medical researchers or doctors), herd immunity isn’t the answer to stopping the spread of COVID-19.

Once a vaccine is developed for this virus, establishing herd immunity could be one way in the future to help protect people in the community who are vulnerable or have low-functioning immune systems.

Categories
Health Communication Video

Let’s Show Compassion For Covid-19 Patients

#LeagueOfIndia requests all of us to show ‘COMPASSION’ towards persons who have tested positive for #COVID19. It is NOT their fault. It could have been us.

Categories
Health Communication Video

Thank You Health Workers!

#LeagueOfIndia says ‘THANK YOU’ to all the #health workers, the #CoronaFighters, the #CoronaWarriors.

Categories
Health Communication Video

Stay Home India

The government is doing all it can to help us. Now, it’s really up to us to make sure that it succeeds. Do follow the instructions of a 21-day lock-down. Stay home, save lives. Including yours.

 

Categories
Health Communication People

Don’t Be A ‘Covidiot’

The title of this editorial comes from this particular tweet on the official Twitter page of the League of India:

The prime minister, in a televised address to the nation, announced a ‘Janata Curfew’ from 7 am to 9 pm Sunday, 22 March, to stop the spread of coronavirus that has already claimed four lives in the country and infected at least 169 others.

“Under ‘Janata Curfew’ no one will go out of their houses. It will also prepare us for the forthcoming days,” said PM Modi, hinting that such isolation drives could be essential in future to stop the spread of COVID19.

The PM’s appeal to the nation follows a global trajectory wherein, to stop the spread of coronavirus, health officials have instructed the public to practice social distancing — staying home, avoiding crowds and refraining from touching one another.

Social distancing includes ways to stop or slow the spread of infectious diseases. It means less contact between you and other people.

Social distancing is deliberately increasing the physical space between people to avoid spreading illness.

Staying at least six feet away from other people lessens your chances of catching COVID-19.

Why? When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain the virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.

Social distancing is important because COVID-19 is most likely to spread from person to person through:

  • direct close contact with a person while they are infectious or in the 24 hours before their symptoms appeared
  • close contact with a person with a confirmed infection who coughs or sneezes, or
  • touching objects or surfaces (such as door handles or tables) contaminated from a cough or sneeze from a person with a confirmed infection, and then touching your mouth or face.

So, the more space between you and others, the harder it is for the virus to spread.

It is worth reminding ourselves again that COVID-19 is very contagious (an infected person will infect 2 to 2.5 others on average, versus about 1.3 others with the flu), and there is evidence that people who have only mild symptoms or no symptoms at all are helping spread the disease.

That makes it more difficult to contain and is partly why we are taking such aggressive social isolation tactics: We cannot always be sure who has the virus, and we don’t want to risk it being passed along unwittingly to a more vulnerable person.

Since emerging from Wuhan, China, in late 2019, the coronavirus has spread to more than 150 countries.

To date, it has infected over 221,000 people globally, according to data compiled by Johns Hopkins University, with 8,966 deaths.

As there is no vaccine available for the coronavirus at present and testing remains relatively limited in many countries, the WHO has stressed the need for citizens to take collective action. Collective action includes ‘social distancing’.

At the base of those ‘collective actions’ lies the first target for health administrations globally viz., to ‘flatten the curve’ of the spread.

The ‘curve’ refers to the projected number of new cases over a period of time.

In contrast to a steep rise of coronavirus infections, a more gradual uptick of cases will see the same number of people get infected, but without overburdening the healthcare system at any one time.

The idea of flattening the curve is to stagger the number of new cases over a longer period, so that people have better access to care.

That is all that the government is asking from us. It is merely asking us to sit at home and be with our loved ones. Not too much, right? So, let’s not be ‘Covidiots’.

 

Categories
Change Communication Cinema Communication Health Communication

Toilet: Ek Development Communication Katha

Official Poster: Toilet: Ek Prem Katha

Akshay Kumar is fast emerging as a very unlikely bearer of varied and content-driven Hindi cinema. Derided by the reigning Hindi cinema establishment and its audience bank as ‘Bharat Kumar 2.0’ for his off-screen nationalistic messages and works, the prolific actor’s latest film – despite its shortcomings – could end up as a case study on development communication, or Communication for Development (C4D), in the Indian context.

Director Shree Narayan Singh’s Toilet: Ek Prem Katha (TEPK) is a social satire revolving around Prime Minister Narendra Modi’s Swachh Bharat Abhiyan.

Keshav (Akshay Kumar) and Jaya (Bhumi Pednekar) are natives of two adjoining rural neighbourhoods of Mathura district in Uttar Pradesh. After a brief period of wooing and cajoling by Keshav, Jaya gives in and the two get married.

But the marriage begins on a disastrous note when Jaya finds out that there is no toilet in the Keshav household – and, after many unsuccessful attempts to fit in, walks away from him.

Left with no other option, Keshav sets out to make things right – and, in the process, takes on the well-entrenched mindsets, social barriers, and the administrative mechanisms of our country.

Acknowledged in the end credits of the film, avid news readers are able to recollect that the genesis of the film lies in the real life story of a young girl Anita Bai Narre from Betul, Madhya Pradesh.

But there have been a few other similar instances too. For example, Kanpur girl Neha Shrivastav had walked away from marriage just four days prior to the date for the same reason. Neha told the media at the time that she had taken the step after getting inspired by a Vidya Balan advertisement about toilets at home.

The two examples are significant. The former has given birth to a C4D driven movie while the latter took inspiration from a C4D message to give birth to a social reaction (from an individual, to begin with).

Put together, the examples illustrate the symbiotic relationship between C4D and society. On the one hand, C4D is about understanding and giving a voice to the needs of the society, but on the other, it is also about drawing out a response from the society by means of that voice.

TEPK is a good example of being an agent of both ends of the cycle.

If a thoroughly utilitarian social communication featuring film star Vidya Balan – in an old DAVP packaging – could inspire a young woman in a conservative society like Kanpur to call off a monumental social milestone like marriage, then the ripple effects of the latest Akshay Kumar film can potentially be immense – especially in those sections of the society that are exposed to and influenced by Hindi cinema.

For, mind you, unlike, say the Vidya Balan communication, a film like TEPK intrinsically possess many elements that stay in the heads and minds of those exposed to it. For instance, Hans Mat Pagli song, a rare old-world melodious composition in the voice of Sonu Nigam, is a runaway hit. How can the person crooning the song not remember, every once in a while, the subject of the film?

Then there is the hilarious episode of the leading man getting married to a buffalo (not a spoiler, it was revealed in the film’s first trailer itself) to fight off the ‘Manglik Dosh’. The episode is played indirectly throughout the film – making it just as memorable as the basic premise of the film. Sometimes, it is imperative to illustrate how archaic some of the beliefs ‘look to the naked eye’ to force the believers to rethink them.

Again, which film had this scene? Ah, the film about building toilets at home, especially for the women of the family.

Then there is that rather strong view by the head of the family on the “impossibility of the Sacred Tulsi (Holy Basil) plant sharing the courtyard with a toilet”. It forms one of the milestone episodes of the film.

And we are not even talking about the very obvious subjects of not just humiliation but security hazards for women who are forced to answer nature’s call in the open. TEPK actually begins by highlighting (via the headlights of a tractor, if you will) the issue.

In other words, TEPK weaves together many such social issues into the singular premise of the film viz., building a toilet at home. And thereby talks about it in a complete socio-cultural context (of a sizeable section of the vast Indian society).

Using the story of the lead pair, their immediate families, and their surroundings, TEPK seems to stay true to the various United Nations (UN) organisations’ approach towards C4D via the following four interlinked goals:

  1. Behaviour Change Communication (in TEPK, it is primarily about the head of the house)
  2. Communication for Social Change (in TEPK, it relates to changing the thinking of both the panchayat and the villagers)
  3. Communication for Advocacy (in TEPK, the stress on overall sanitation is put through advocacy at local and regional government machinery)
  4. Strengthening an Enabling Media and Communications Environment (in TEPK, the lead pair not only makes use of an insider at a major Hindi daily but also media at large)

As per the United Nations Development Group (UNDG),

the greatest challenge the communicator faces is the preparation and distribution of development messages to millions of people in such a way that they are received and understood, accepted and applied. If they accept this challenge they will be able to get the people to identify themselves as part of a society and a nation. This identity will help in harnessing these human resources for the total welfare of the individual and community at large“.

This is where TEPK scores. It has made sure that the message is indeed received, understood and accepted by millions. It manages to do so by using an enchanting mix of humour, romance and the quintessentially Indian high pitch drama at places.

There is absolutely no doubt about the acceptance of the film by rural folks. But will they ‘apply’ the C4D message?

Well, “Mera Desh Badal Raha Hai“. And I am optimistic that the film would have a ripple effect – of whatever magnitude – in some geographies of the so-called Hindi belt. That is why I believe the film might end up becoming a case study on development communication in the decades to come.

All theories aside, however, TEPK is an enjoyable family watch. The author took his 67-year-old mother along and she loved it. “More such films should be made,” she said.

Not without its flaws, go watch the film for absolutely smashing performances by Akshay Kumar, Bhumi Pednekar and Divyendu Sharma. The direction is very good at most places. The editing, adroit at most places, could have been tighter in the second half.

Warning: You might end up humming ‘Hans Mat Pagli’ for the remainder of the day after watching the film.

3 stars for the cinema; 5 for being an agent of change.