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Only the people can liberate themselves from COVID-19 – the new epidemic!

05-28    

——A four months collective journey through the unknown back to (nearly) normality


Author: Michael Hermann, Chief Representative


20 years ago Humana People to People (‘HPP’) developed a concept to prevent and control HIV and protect the health of the people – the ‘Total Control of the Epidemic’ or ‘TCE’ concept. It was and is based on the slogan “Only the people can liberate themselves from AIDS the Epidemic”. 

HIV prevention worker on village household visit

20 years later, this slogan still stands.TCE has reached over 20 million people in Africa and Asia since its introduction and is a well tested HIV and AIDS response program. TCE has over the years systematically engaged people in the communities in the fight against HIV and AIDS. It maintains a person-to-person approach, where information is provided on how to stay healthy, and people can make informed decisions on how to maintain a healthy lifestyle, infected or not.


This slogan though sadly needs to be applied to a new virus and disease 

‘Only the people can liberate themselves from COVID-19 – the new epidemic!’

Early January a novel corona virus that causes a disease called ‘Covid-19’ was discovered in China. On March 11, 2020, the World Health Organization (WHO) has declared the novel corona virus (COVID-19) outbreak a global pandemic.

The corona virus can attach itself to droplets of an infected person who coughs, sneezes or breathes heavily, and it can enter the body of another person through the mouth, the nose or the eyes. The virus can also spread to surfaces by the infected person coughing or touching and from there it can enter your body if you touch the surface and then your eyes, nose or mouth. On hard surfaces the virus can survive for 3 days. 

An infection with the SARS-CoV-2 virus is sometimes so mild that the infected do not know their status. Such asymptomatic carriers can unknowingly infect others. Even people who get ill with Covid-19 will be able to spread the disease for days before they realize they are infected. When people who are infected feel fine, they may continue normal life there by spreading the virus to other people. This is why Covid-19 can spread very fast.

There is currently no known cure for COVID-19, but scientists are working around the clock to try out different medicines and methods to treat the symptoms. 

When there is no treatment or vaccine the way to slow the spread of an infectious disease is to reduce the spread from person to person. A method when fighting HIV is to use condoms to reduce the spread, whereas strict hygiene practices can stop the spread of cholera. 

The corona virus, however, can be transmitted from droplets in the air and therefore stronger measures are needed to stop its spread. The recommended steps to limit the spread of Covid-19 include wash hands often, clean surfaces regularly, do not touch your face with your hands, keep a physical distance of 2 meters to others, wear a mask in public spaces with other people, do not gather many people together, be aware of any symptoms of Covid-19 and in particular fever; and follow the rules for physical distancing.

Home-based HIV testing

With more than 5 million reported infections and more than 300,000 reported deaths at the time of writing, it is crucial that we the people understand this new danger and disciplined do what is needed to prevent infection.

Luckily the communities in the projects in South West China and the people in HPP, as well as the rest of China, seem now to have surpassed the onslaught of the epidemic due to some extraordinary 4 months of action with an unprecedented strategic intervention of complete lockdown of normal life.

Training of HIV prevention workers

On 23.1.2020 Wuhan was locked down. At the same time Yunnan Province declared a First level health emergency. Kunming also went into lockdown. First the buses and taxis between Kunming’s 17 districts and counties stopped. Then the normal inner district public transport stopped. Then the metro stopped. Then the shops closed. I live about 4 km away from the office where I work, and there are about 120 shops on the roadside. They all shut down. Bicycling to the office was like being in a ghost town. 

Then we were all informed by SMS and public notices in every apartment block to stay home, and only go out with surgical masks. But all of our staff could not find any mask in any shop. Luckily I had just had taken my annual health check in the hospital and they gave me 10 masks as a present. Then for 7 days in the Spring Festival Holiday, I went daily to 4-7 pharmacies, but all the masks had sold out. 

So during the holidays we tried to source face masks in Germany, Denmark, Spain, India, Laos and Vietnam, through local NGO partners – but either they were already sold out or the government had just issued export prohibitions. I was surprised that even some medical doctor friends in Germany were not allowed to buy any masks for us here in China. Finally we heard from a contact in Shanghai, that a contact in Nepal had bought a large amount of masks, and we could send two people to Nepal to pick them up. Arriving all masks had gone, but luckily in 2 days by going from pharmacy to pharmacy they could bring back 5,000 masks, and convinced customs to let them through because they worked for an NGO despite Nepal just having stopped the export of masks on the departure date. From Zimbabwe we also could source 4,000 masks, so finally each employee and also project partners’ employees received 50 masks as a very appreciated gift and the excess was given to project village teachers and local cooperation partners. 

But of course, pre-epidemic China produced something like 10 million masks/day, and then suddenly 1.4 billion people are told to use masks, so it is easy to get the picture. Then the government under emergency rules similar to other countries did central procurement of masks, to avoid hoarding, price hikes and black market. Since April the masks are now readily available, as China ramped up production to something like 120 Million per day or more.

The first day in the office

The holiday ended February 3rd, but we were notified to extend it for one week. So we did. On February 10th we were told we could restart our office work with 1/2 of the usual staff – to increase the physical distancing (in the villages all and everything was still closed down), but we were recommended to let all people work from home. So then 1/2 of our office staff met up in the office on Monday the 10.2., we organized the work, and in the following 3 weeks, all people worked from home, with me being alone in the office and sending files and documents to people at home. Only on March 2nd did we resume work in the office, but again with only 1/2 of the team – it is practice here in China to be on the safe side, try things out and only scale up if it works out well. From 16.3. onwards we were finally back to full office work – but already from 10.02. onwards everybody in the office had to take temperature at arrival and at departure and this was reported daily to the local residence committee. And also in the residential area where our office is, all entrances had been blocked, except one, and it was mandatory to get taken temperature until middle of April. Coming home to my rented apartment, also here all entrances were closed, except one, and the guard took temperature. If one was found in public without face mask, people quickly approached and asked to follow the rules. No exception for foreigners. So we speak of full lockdown, full detection measure and full people mobilization. And full time for everybody. 

Strict daily control measures until end of April

The essential shops like pharmacies were open all the time, supermarkets opened very quick, but small shops opened in Kunming first middle of April. My usual small restaurant changed to take away only. Every time one was leaving the home, one had to scan a digital CR code, also taking the bus, entering and leaving a supermarket, entering and leaving the open wet market, buying a sandwich at the roadside restaurant – you had to scan the code, and leave the trail for possible contact tracing. With an invisible virus killing thousands of people, it makes common sense to put safety over privacy concerns. Of course not everyone followed the rules, especially from March on more and more people did not scan, but knowing that almost all new COVID-19 cases are imported from abroad, being a foreigner, I always did in order not to make people around me worried.

Online training of village preschool teachers in February

We as rural development organization could not hold meetings, trainings, gatherings – our field work in the villages needed to change to online work. (We run rural preschool programs, rural community development programs and rural HIV/AIDS prevention programs). Teacher training went online. And as preschools stay closed (they might open in batches from next week on), we supported parents via online methods to engage their children in these days of stay home orders. Luckily China’s infrastructure and digital infrastructure has been heavily invested in over the years – about 1 billion of 1.4 billion people have access to smart phones.

Self made class room decoration in March

All this lockdown happened while we in Kunming with its 6 million people only had 54 registered cases. And in the whole province of Yunnan until today we only ever registered 185 cases among 46 million people. 

Online encouragement of parent-child activities in April

Rules for reporting for epidemics vary from country to country and even with decades of Globalization, we do not have unified measurements in the world. Some countries report positive, if one tests positive. In the beginning China only report an infection, if one tested positive AND had symptoms. Some countries did speedy and large scale testing; some countries only allowed to test, if one had symptoms and a travel history to China. Some countries only register COVID deaths, if one dies in the hospital, not when one dies at home or in the care home. Some countries count you as COVID death, if you die WITH the virus, even you die of final stage cancer, and some countries count you only as COVID death, if you die DUE to the virus. Some countries require a coroner physical inspection; some countries have changed the death diagnosis to phone calls to your relatives. What is a ‘notifiable disease’ also varies between countries. Then due to this pandemic, the lack of Personal Protective Equipment, the scale and speed of the disaster, countries also changed their regulations and definitions. We as humanity might be better off, if countries use unified definitions so we do not compare apples to oranges. But of course the rules in each country have their history and reasoning – so to unify them has its own challenges. For Example China reported some 84,000 registered cases – but did until about 8 weeks ago NOT include positive but asymptomatic cases, even if they were also put into quarantine. As the Chinese media group ‘CAIXIN’ and many others reported, Wuhan had about 45,000 asymptomatic cases, so one could add the 45,000 to the 84,000 based on current definitions. Like some other countries - e.g. the UK changed some regulations during this epidemic  - so China also changed its regulations, based on the ever-evolving reality, and from April 1 on the Chinese National Health Commission started to report asymptomatic cases of which you naturally find some when you decide to do mass testing, while you will have almost none in countries where you only test people with symptoms. As global citizens we should be aware of that we potentially compare apples with oranges, as long it is not stated, what the basis of the numbers is and what the definitions are and at what date the COVID time line has started in that particular country. 

Why did China only report cases when they were both positive and show symptoms? I do not know, f.ex. there are hundreds of millions of Chinese who carry the TB bacillus and would test ‘positive’ when only testing for the bacillus, but the disease only breaks out in about 800,000 Chinese yearly. So should we categorically mention ‘positivity’ as being the gold standard for reporting? (this situation of TB is the same globally, despite the outbreak rates vary from country to country). By the way, China handled asymptomatic cases in the same way as symptomatic cases – all positives were put into quarantine. 

 

Teacher home visits in May, while the schools still were closed

As said, these were extraordinary 4 months. For the previous pandemic in 2009, it took 2 months from ‘observing a pneumonia of unknown causes’ in February until reporting a new virus later called ‘H1N1’ in Mexico/US to the WHO (18.04.), 1/2 more month to publishing the genome (24.04.) and another 1.5 months, total 4 months from observation to declaring a Pandemic (11.06.) .

Luckily it seems the world during the last 10 years has improved its capability in this regard. Observation of a ‘pneumonia of unknown causes’ by doctors in Wuhan started in middle of December, reporting to health authorities was done 27.12.2019, 4 days later WHO China office was informed of a new disease, and the virus genome sequencing was finished 7.1. and shared with the world on 11.1.2020. On 20.1.2020 China National Health Commission included COVID-19 into the Infectious Disease Law as class B disease, to be administrated as class A, which then set the stage for that all provincial health authorities went in emergency gear and closed down the country with Wuhan as the Epi-Centre and its 10 million people being locked down for 76 days. So the whole process from observing the emergence of a new disease of unknown causes and its related virus to sharing its genomes with the world seems to be approximately double the speed of the previous pandemic. 

There is still a lot that we do not know about the COVID-19 virus and what the future will bring, but we do know that we have to stay informed and continue to protect ourselves and our communities. 

We should not fear, but go for the facts, and we might need to prepare ourselves to live with this virus for quite some time. We cannot wait for a treatment or a vaccine to be found, so the best prevention is not to get infected, not to let the virus in where we are; and furthermore to take control of underlying conditions that cause some people to be at increased risk.

So each of us should decide and follow through on this commitment: ‘I will not get it! I will not spread it!’

And then based on WHO and national government guidance decide what I will do in my day to day life to protect myself from COVID-19, what I will do where people gather, what I will do if I suspect I have been infected with COVID-19 and what I will do if I test positive for COVID-19.

Our attitude, knowledge and practice can go a long way to protect ourselves, our loved ones and our communities.

“Only the people can liberate themselves from COVID-19 – the new epidemic!”

The day before class opening

Hubei is slowly recovering of the pain of the last 4 months. The province conducted 1.5 million nucleic acid tests between May 11 and 17, with 72 percent, or roughly 1.05 million, done in Wuhan, as the city carries out its plan for universal tests on all residents. The asymptomatic positive rate was 46 out of 1 million tested, a significant drop from 660 out of 1 million in April.

On May 18th, I finally could do my morning run without a face mask, as the Chinese Center for Disease Control and Prevention, on a news conference on Sunday advised, that it's not necessary any longer to wear masks at outdoor parks and streets as well as playgrounds that are not crowded.

Some universities have reopened for their graduation classes only, some for all students.

Most of primary and middle schools have opened during the last 8 weeks in a slowly staged batch strategy.

Finally the first batch of our preschools opened on Monday 25.05.

Maybe the rest of our preschools in the remaining counties can open in June (the local government acts based on the local conditions). 

PRESCHOOL RESUMED! FINALLY! MY FRIENDS – I AM BACK!

Two times daily temperature taking

The first compulsory lesson – deep hand washing 

 

Practice makes masters!

There is hope that we did manage this round of the virus outbreak!

But maybe the virus comes back! Maybe it takes 2 years until the global community has beaten this virus.

Maybe it mutates too much for a vaccine. Nobody knows when certainty returns.

Until an effective treatment or a vaccine is made available for all the 7 billion people on this planet, we need to stay focused on the central task of limiting the spread of the virus in the community and for each person to stay healthy and to manage the health conditions, which can put this person at special risk if contracting the virus. 


Michael Hermann

Chief Representative

Humana People to People is a network of 30 non-profit associations engaged in international solidarity,

co-operation and development.

 

Self-made outdoor playgrounds

Growing out of a progressive education movement in the 1970s, Humana People to People is committed to tackling some of the world’s major humanitarian, social and environmental challenges. The Federation for Associations connected to the International Humana People to People Movement was formally established in 1996. Its goal is to achieve increased positive impact on global development through strengthening co-operation among members.

Self made class refurbishment

The 30 independent member associations are located across Africa, Asia, Europe, North and South America. They share a set of common values to protect the planet, build communities and support people to join forces, unleashing their potential for positive change and action. The values reflect common concepts on how to create development and how to raise funds for it. This ethos is shared by the numerous partners, national and international, who have supported the work of Humana People to People over the years.

Distribution of rice seeds to start the eco-rice project

The activities of Humana People to People are aligned with the UN 2030 Agenda. Together with the people in the communities where we work and our numerous partners, we continue to stand by countries as they strive to meet the Sustainable Development Goals, creating lasting positive change in the process.

Farmers’ Clubs as adult learning platform

HPP members believe in the power of people working together to bring about lasting change, equipping people with the tools, knowledge and skills to build their own bright futures

 

Mountain kids need protein like everyone else

Projects build on the active participation of people, be it farmers and their families; children, parents and grandparents; health support groups and girls clubs; and teachers and students in schools. They are the reason why HPP members are there in the first place, and they are HPP’s strongest allies in fighting for a more just and equitable world.

 

We are the future!

Today, in the turmoil of the Covid-19 pandemic, FAIHPP member organizations are together with everyone in their countries containing the spread, keeping the people informed and mobilized to stay safe, and using their experience to assist the poor who are most affected in the best possible ways. 


[1] the new Corona virus Bill alters the Coroners and Justice Act 2009, to specifically exempt alleged Covid19 deaths from jury inquests, https://off-guardian.org/2020/04/05/covid19-death-figures-a-substantial-over-estimate/

[2] See WHO 3rd party report on ‘Report of the Review Committee on the Functioning of the International Health Regulations (2005) in relation to Pandemic (H1N1) 2009’ p.51, & https://www.cdc.gov/h1n1flu/cdcresponse.htm


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