With cases rising, COVID19 scenario has taken an odd turn in Manipur. Because the state authorities are not responsive enough to soothe the anxiety of the pandemic amongst the public, clubs and leikai volunteers are resorting to sambal khaba (erecting barriers) and spray tunnels at their leikai entry, as a form of taking authority in their own hands. Unfortunately, this has become a conditioned behaviour of our society. The belief is that such efforts are ways of protecting the leikai from others who may bring the virus into their leikai if allowed unrestrained entry. Unscrupulous elements are meanwhile taking undue advantage of the panic amongst the public. They are pushing such measures, which have shown no effectiveness against the virus. The tragedy is, these irrational behaviours have come to be tipped with business interests by certain benefactors.
First let’s see what is fundamentally wrong with a sambal khaba?
From an epidemiological perspective, a containment at leikai level by volunteers may sound logical and even rational. They in fact often earn applauses from the gallery of innocent common public. Seeing the multiple containment zones declared by state authorities, a belief may have seeped in that such containment zones can limit the virus to the contained zone. However, this belief is incorrect. A simple containment by limiting traffic is not the whole purpose of a containment zone. This limitation has to be combined with active surveillance and testing for complete segregation and isolation of the infected so that the spread may become contained, thereby keeping the uninfected safe. This fundamental seems to be lost on the part of the volunteers. By following their own pseudoscientific efforts, they may in fact, harm their locality, though with the false belief that they are blocking the virus’s passage.
A ‘samble’ed leikai does not afford any protection from any of the volunteers who can be infected. They won’t know as they are most likely asymptomatic). Also those who are residents of the leikai, cannot remain confined – they have work, need to buy groceries and daily essentials, some go on recreational walks, some plays. So import will happen by the leikai residents themselves unknowingly eventually. Especially if the fundamental of breaking the transmission is not followed. (ie wear mask, maintain distance of three feet, wash hands frequently.
Next let’s see what is fundamentally wrong with a spray tunnel?
For this we have to revisit the nature of the virus and how it spreads. The virus predominantly prefers the respiratory path of our body. It attaches and lives in the cells lining this path. And also sheds from these cells. This means that when we breath in, the virus’s gateways are our nose, and mouth. This is in-fact the most common way we get infected. And once we are infected, the viruses are expelled out from our body every time we exhale air; through the same nose and mouth during activities of speech, cough, sneeze etc. The exposed eyes are also another route. But not so common as the nose and mouth.
An infected person does not carry the virus over his clothes. What he actually does is that he breathes out the virus from his respiratory path. So the virus is inside and not outside until he breathes them out.
What a spray tunnel does is that, and when done properly and with proper sanitisation solution, it can spray over the outside surface of the clothes that we wear, and disinfect them. But for the purpose that are being done at our leikai level, the gadget/and the solution cannot satisfactorily disinfect our clothes, simply due to the fact that the whole process is non-standardised.
Disinfectant tunnel, those that are done in institutions like virology labs, do sanitise and disinfect outer suits. However for them, there are stringent protocols and infrastructural standardisation, which makes them perform as intended. Those are at different biosafety levels.
For the current spray tunnels being executed at our leikai, the major issue is that it can cause exposure of passers to health hazards. As the people are not well formed, inhalation of the solutions used in sprays is hazardous, especially if hypochlorite solutions are used. Same is true of other agents like hydrogen peroxide, or spirit sanitisers. These tunnels can also cause chemical contamination of the areas where they are used. They, in addition to exposure hazards, can cause emergency conditions like bronchospasms. And can also have longer term side effects.
The Ministry of health and family welfare had already issued a health advisory against the use of any spray or spray tunnel for the purpose of disinfectant in relation with Covid19.
Why are volunteers and leikai people resorting to such gimmicks?
Herein lies the lacunae of governance vis-a-vis effective public awareness campaign for the pandemic. Such misinformation should have been removed by timely advisories and counsel from public health departments. The illegality of such ventures should have been elucidated and even punished for causing harm. But because there is lack of a strategy and direction towards how the public should responds from relevant authorities, such unscientific responses are abundant in all places of Manipur.
So what can be done? Our leikai cannot be left unprotected
If we all comprehend thoroughly the core aspects of the virus, and how it transmits, we can easily protect ourselves and our leikai from the pandemic. And we don’t need to search or look for answers anywhere else. The solutions have been already provided to us by the WHO, MOHFW, ICMR, State authorities. What we need to do is just three fundamental things – wear masks, maintain physical distance of three feet or more, and wash hands frequently. We could also avoid crowding, especially in confined spaces. This is how we can protect our individual selves, which then also means protecting our leikai, if we all follow this.
What more can be done?
We can do more, but after keeping these fundamentals at the back of our mind. The following is a list we can do instead of sambal khaba, or spray tunnel.
From the money we collect for spray tunnel, we can easily
- Buy masks, which can be washable ones, surgical ones or any other ready made ones; distribute to our residents.
- Buy sanitisers, soaps and distribute in the leikai, especially to those who cannot afford much.
- Make awareness posters, do’s and don’ts pamphlets
- Make dispensing easier for mask, soaps, sanitisers at specific location of our leikai
- Welcome our leikai visitors with mask and sanitisers, help them
- Maintain a register of visitors to our leikai. Just in case one of them gets reported positive in future, so that we can help in contact tracing.
How can the health department and state government help?
As much of these problems stem from lack of public awareness and clear instructions/guidelines from authorities, it is imperative that more aggressive and effective public awareness campaign be pushed by the State government for effective dissemination of reliable information to the public. Clear, lucid and simple advisories from the authorities are the need of the hour. Cryptic SOPs, or technical SOPs can lead to less compliant citizenry. And for this a concerted effort by all, to collaborate and act collectively is needed. The government, of course, must be aware that the onus of creating this common platform is on their shoulders.
What we all need to understand is that the virus is not going to go away soon. We are going to learn to live it. Other countries and societies have achieved some amount of success in this. Now it is our turn to do the same. How we can do so effectively, is left to our collective wisdom. Let us hope we don’t fail each other in this dire time, where cooperation from each quarter is needed. We have to have a collective responsibility by taking responsibility from our individual’s end.
So , please WEAR MASK, MAINTAIN MORE THAN THREE FEET DISTANCE, WASH HANDS FREQUENTLY, AND VERY IMPORTANTLY, DON’T CONGREGATE UNNECESSARILY. Be safe. Just focus on these fundamentals to break the transmission.
The writer is a plastic surgeon consultant