We all hope the nCoV-2019 outbreak that has emerged in China in the last days of 2019 will be localized and will cause only a small number of casualties thanks to drastic measures. However, it should be noted that this virus surprised the experts with its long latency and widespread spread. Unfortunately, it is not impossible that the infection has already spread to through the planet, but due to its non-specific symptoms and the lack of screening options, this will only become apparent in the following weeks. In addition, it may easily happen, that the initially seemingly minor disease will develop into a fatal, mass-destroying epidemic, (e.g. due to poor mortality estimation or combination of the nCoV-2019 with SARS / MERS virus or by the mass infection of domestic or wild animals). Current communications from the relevant bodies do not make it clear whether the world 's decision - makers have any workable plans for this. In many cases, we can see that the epidemiological services focus almost exclusively on Chinese people with feverish symptoms, while it is now clear that non-feverish Europeans can carry and transmit the disease. In view of the mistakes made in the design of the Quarantine of Wuhan and the accidental or deliberate misinformation campaigns, there is a fear that the governments of the world are ill prepared for the escalation of the epidemic.
Our action plan presented here is meant for the situation that it becomes clear that the virus cannot be localized to China and will cause severe destruction. This is a suggestion, an example that will certainly not materialize in this form, but it may give decision-makers a basis for developing a quick and effective emergency plan. We hope you'll never need it - but if it does, it is crucial that more politicians and practitioners (and laypeople) think about our ideas. So, we ask you to distribute this proposal as a pamphlet! No problem if you do not agree with all points: Send it like this and add a comment!
It is not up to us to make decisions, but leaders need to know that we are listening and have an opinion. We do not want panic - on the contrary, we want to have an effective plan in case the worst, such as a European epidemic, occurs!
1.) Broad familiarization of Community hygiene rules (TV, Internet) with people:
Teaching the thorough hand washing (drawing / video). Familiarization with non-trivial routes of infection (mouth, eye, nose; safe use of community toilet, hair-shoe-jacket as routes of infection). Safe use of gloves, masks, scarves, coats. Special attention to workers at potential superspreader workplaces (cleaners, bar and restaurant workers, shop assistants, transporters). Informing and preparing vulnerable groups (elderly, refugees, homeless, prisoners). The importance of safe food preparation (even livestock animals and pets can become carriers). Public healthcare: the role of hospitals during epidemics, home care of patients, waiting for incubation time and the possibility of voluntary quarantine. Possibilities of vitamins and medicines. Importance of cooperation with relatives, the local community, and law enforcement in times of need.
2.) Enhancement of isolation
Call for the cessation of domestic and foreign transport, tourism, education and social transport. During the first week, only non-obligatory requests and roadside checks, later, compulsory use of a passport from municipalities, critical infrastructure companies or public health institutes. Enumerate and find the critical infrastructure companies (electric, water, gas, internet, police, military, clerical, press, food and commerce, logistics, service and cleaning companies, etc.), in order to set up a cooperation plan (e.g. that the outgoing workers could be replaced). Companies, organizations of non-critical infrastructure should gradually switch to a temporary "emergency" mode: reduce production and allow their employees to go on family protection leave or volunteer service.
3.) Transition to Emergency Economy
History has shown countless times that a capitalist economic structure based on individual interests is not efficient in an emergency. Maintaining countless organizations that support people's welfare needs, material growth, and entertainment requires the employment, movement, and payment of huge masses of people, while - naturally – these organizations are trying to influence legal, financial, and social decisions (ad absurdum: financial "vultures"). These activities can inadvertently increase the spread of the disease during an outbreak, obstruct the implementation of rapid and effective protection plans, and exhaust the workforce, while at the same time placing fair companies at a disadvantage. Moreover, the tangle of international relations and financial and legal interests can further increase chaos and test citizens' loyalty and morale in an already fierce situation. To prevent the collapse of the legal, financial and economic system, countries around the world should simultaneously freeze exchange, money and commodity prices, suspend or centralize control of corporate money flows and refuse to ratify legal treaties during the whole course of March, 2020. If the epidemic is curbed, markets will regain their former role as of 1st, April. However, as long as the epidemic persists, companies and organizations that are not involved in maintaining critical infrastructure in society, should join national antivirus programs or contribute to the leave of their employees, who may return to their relatives, or volunteer to join government protection programs.
4.) National antivirus holding:
The legal, financial and administrative systems of Western democracies, as well as individual financial interests, can hinder the social and industrial transformations needed for the success of virus protection measures. As the number of patients increases, the traditional bureaucracy can collapse, and some citizens may become distrustful or disobedient - for fear of being robbed due to the emergency measures. To prevent these problems, each state should set up an emergency trust holding company (National Antivirus Holding), which will be capitalized by central banks. This provides the financial basis for antivirus activities in all countries. All property over which patients or deceased persons cannot exercise their property rights is temporarily transferred to this holding (looting = a crime against the state). From there paid are the increased salaries of volunteers, critical infrastructure operators and the aids of retired families, and also the temporary and permanent compensations of stopped businesses. This is where companies finance the transition to hygiene tools, antivirus research and public health care. When the emergency ceases, the Holding accounts for assets, revenues and expenses (with the supervision of IMF), helping to rebuild the economy.
5.) Protection of Critical Infrastructure
Electric, water, gas, internet, police, army, clerical, press, food & trade, logistics, service & cleaning companies:
- mandatory use of masks and gloves
- avoidance of public spaces (public transport, nightclubs, events)
- sickness reporting obligation (also for close relatives)
- regular screening - as soon as enough rapid tests are available
These companies are required to work closely with the state and subject their operations to antivirus protection.
6.) Transforming the public health system
The public health system, general practitioners and hospitals are by no means fit for dealing with a severe and massive epidemic. In fact, it is often the case that they intensify it - in the absence of adequate protective equipment, virus positive patients can more easily infect other patients and even medical staff who are ill for other reasons, while the necessary equipment (such as a ventilator) and nurse are no longer available. In the event of a raging epidemic, patients are in the best hands of their relatives; especially if the essential medicines or equipment needed for their treatment can be safely transferred to their homes. Of course, in the event of an immediate danger to life, hospitalization may be necessary - provided that life-saving equipment is still available. In order to provide systematic medical supervision, it will be necessary to set up out-of-hospital study camps (eg tents) in each residential area (2-3000 people) where patients can meet doctors (eg in every second day I the same hour) from the competent hospital. From here, doctors can refer patients with severe conditions to hospital if the area still has free ventilation - and if the patient does not give up the opportunity for the benefit of others (such as a young patient in an adjacent area). As the public health system is powerless in the absence of adequate equipment, pharmaceuticals and hygiene equipment, it is vital that industrial plants capable of producing them are produced at maximum speed, and, moreover, the need for rapid conversion of companies of similar profiles. However, this requires the voluntary commitment of companies, the transfer of production technologies from other (even foreign) companies, and the rapid development of new emergency solutions. The organization, coordination, and funding of all these must be worked out by the state antivirus holding company and later reward participants (similarly to public health workers). Health research and development companies should, where rational and feasible, re-focus on anti-viral development: development of rapid tests and flock tests (procedures for samples of 10 to 100 people, even pooled), antivirals and vaccination in the event of a mass epidemic may be the last way of survival for the society.
7.) Family protection leave:
The most effective way to avoid the epidemic is to physically isolate it from potential patients, which can take up to a month for a long latency illness. It is also important that the care of patients (whether victims of a virus or other illness) should not burden the public health system as much as possible, and that minors and the elderly subject to care should not be placed in high-risk community settings. To this end, isolation of families and communities that are believed to be non-infected, should be encouraged, and patients and carers should be served in the best possible way, avoiding unnecessary transport (fever reduction, home ventilators, oxygenators, medication). However, it is also important to make it clear to everyone (for example, in the countryside) that complete isolation is not a long-term solution in itself: as the pathogen can return from infected animals even after years - developing a public health solution (vaccination) must be our main common goal.
8.) Voluntary virus protection system
To serve family protection, local governments, preferably based on the existing social system, must establish volunteer organizations. These volunteers will contact and communicate with each citizen (eg. by phone and internet) and family, collect their claims, maintain their living conditions (eg service, food, medicine, supplies) and essential medical examinations (visits, referrals). They help to maintain local order and relieve those who are operating critical infrastructures and public health systems - and in the event of labor shortages, the may join them too. Rewarding and recognition of volunteers will be the responsibility of the Antivirus Protection Holding.
9.) Sharing current knowledge about the virus with the general public:
- Virus behavior in humans: Clarification of infection routes (by touch or by air? Oral, nose, eye, genital, anal?). Description of symptoms. Infectiousness (without protection, among family members, in health care facilities, with protective equipment). Mortality (dead vs. healed). When do the specific symptoms appear, from the time of infection? When does virus spreading begin? Can the virus be detected after healing? Probability of re-infection?
- What is the viability of the virus in livestock and pet animals, migratory birds (can they become carriers? Can the virus be detected in their meat and products - incubation times, symptoms, pathways of infection)
- What is the viability of the virus on different surfaces (metal, plastic, wood, paper, painted surfaces, water and food), temperature and humidity.
- Effectiveness of conventional disinfectants on different surfaces (and body - involving patients), effectiveness of protective equipment.
- Track mutations in the pathogen and identify interactions with other human coronaviruses (SARS and MERS + rhinitis) (primarily these can lead to more virulent or more lethal variants). If livestock and migratory birds can become infected, the potential impact on humans of new variants
If the social order were to collapse over large areas, this information would be vital to the survival of the civilization in the absence of the Internet and well-informed physicians - and this knowledge should be disseminated as widely as possible (eg through major Internet sites, in printed form at authorities)
by: Andrella
