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 Table of Contents  
MINI REVIEW
Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 367-371

Nosophobia of corona: A loss or gain for India?


Department of Community Medicine, All India Institute of Medical Science, Raebareli, Uttar Pradesh, India

Date of Submission14-Mar-2020
Date of Decision21-May-2020
Date of Acceptance09-Jul-2020
Date of Web Publication15-Oct-2020

Correspondence Address:
Dr. Sourabh Paul
Department of Community Medicine, All India Institute of Medical Science, Raebareli - 229 405, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_37_20

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  Abstract 


Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases. COVID-19 is the third novel coronavirus disease similar to severe acute respiratory syndrome-CoV in 2003 and Middle East respiratory syndrome-CoV (2015) during the past two decades. Nosophobia is the irrational fear of having a specific disease. India has reported nearly 0.8 million cases and morbidity is more than 20,000. However, the fear or phobia has infected all the possible sectors (health, finance, industry, economy, education, sports, etc.). The objective of the article is to show the impact of nosophobia and make people aware that India needs to be very vigilant and open about the spread and containment of the infection but should not panic.

Keywords: Coronavirus, COVID-19, nosophobia


How to cite this article:
Paul S. Nosophobia of corona: A loss or gain for India?. Int J Health Allied Sci 2020;9:367-71

How to cite this URL:
Paul S. Nosophobia of corona: A loss or gain for India?. Int J Health Allied Sci [serial online] 2020 [cited 2020 Oct 28];9:367-71. Available from: https://www.ijhas.in/text.asp?2020/9/4/367/298119




  Introduction Top


Optimists had once imagined that the world might have won the war against infectious disease, but newly emerging, re-emerging, and deliberately disseminated infectious diseases continue to appear one after another.[1] Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases.[2] On February 11, 2020, the World Health Organization (WHO) had coined the name of the disease COVID-19 which was first identified in Wuhan, China.[3] COVID-19 is the third novel coronavirus disease similar to severe acute respiratory syndrome (SARS)-CoV in 2003 and Middle East respiratory syndrome (MERS)-CoV (2015) during the past two decades. Scientists had tried to establish the fact that similar to other zoonotic corona viral disease COVID-19 also had origin from animal (bat) and used pangolin (used in China for meat and scales) as an intermediate species before inter species jump. However, later on, COVID-19 had established the capacity of human-to-human transmission.[4]

Nosophobia is the irrational fear of having a specific disease. The origins of the word nosophobia come from “nosos”and phobos which mean disease and fear in Greek. In recent years, nosophobia has also been referred to as cyberchondria.


  Risk Factors Top


  • Exposure to high levels of media coverage about disease and the risks of contracting diseases
  • Repeated exposure to people with serious illnesses.[5]


Nonscaring Facts About Novel Coronavirus

  1. According to the WHO, the total number of confirmed cases globally (July 1, 2020) is more than 10.5 million, but more than half of them had already recovered. The number of serious or critically ill patients is presently 57,840 (1%) among the total active cases. Similarly, in India also, the number of serious or critically ill patients is 8944 (3.5%) and total recovery rate is 63.8%. Daily, the number of cases has already started downward trend in many European courtiers as well as China. However, American courtiers are maintaining consistently high tends for months.[6] In India also, majority of the cases are distributed among major ten cities of the country.[7] Moreover, there are evidence in Europe as well as in India (Indore, Bhilwara, and Dharavi slum in Mumbai) also that strict contact tracing, aggressive testing, social distancing, and lockdown measures have reduced the number of cases in many places[8],[9],[10],[11]
  2. Out of 194 member states of the WHO, 86 countries had reported the “community transmission”of the disease and 77 countries had reported “cluster of the cases.”Other countries had “sporadic number of cases”and India along with most of the Southeast Asian countries comes under this “cluster of cases category”[12]
  3. Although it is too early to compare the case fatality rate (CFR) in the middle of outbreak, the CFR rate of COVID-19 (4.64%) is comparatively low with recent outbreaks of 21st century, e.g., SARS (9.6%) and MERS (34.3%) and Ebola (22%–80%).[13] However, studies had suggested that there are a large number of asymptomatic cases which are not considered so real CFR may be much low[14]
  4. The Ministry of Health and Family Welfare, Government of India data suggest that CFR is maximum among elderly (50.5%) and minimum (0.5%) among <15 years' age group, although caseload in India is maximum among economically productive age group (30–60 years).[15],[16] Maximum death has also occurred among those having comorbid condition also. However, if we consider age-specific death rate and concurrent cumulative CFR, the story might be different.[17] A study conducted by Hassan et al. had found that the mutation of ORF3a gene probability had reduced the virulence of the virus in India (Ahmedabad) which, in turn, has reduced the overall mortality[18]
  5. The reproductive rate of infection (Ro) of COVID-19 shows the infective capacity of spread of the disease, but report shows that there is variation among different countries (Ro1.45.5).[19] India at present scenario though absolute number of cases are increasing, Ro showing downward trend. So the complete trend of real Ro will be stabilized once the pandemic is over.[20] If we compare COVID-19 with SARS (Ro= 2–5) and MARS (Ro= 0.3–0.8), it is highly infectious compared to MARS (Ro= 2–5) but not as high as SARS. Furthermore, it is not as infectious as airborne infection of measles (Ro= 12–18) also.[19] Hence, the present data suggest that COVID-19 is low pathogenicity but moderate transmissibility
  6. Studies have found that globally, those who are infected by COVID-19 (40%–45%), of them are asymptomatic or presymptomatic and the WHO has not yet confirmed that asymptomatic cases are a source of major transmission.[21],[22] According to the Union Health Minister of India, 80% of the cases in India are mild or presymptomatic.[23] Hence, it can be a beneficial for a country like India having a huge population
  7. There has been concern on social media about reports of people getting infected, recovering, and then later developing symptoms again. As it has been seen in the past that most of the recovered patients of SARS (Severe acute respiratory syndrome) lose their neutralizing antibodies within a few years, but those with severe disease had antibodies 12 years after infection. So these might be true for present COVID 19 also. However still now there is no scientific documented evidence.[24]


Impact of Phobia on India

  1. The biggest impact of corona phobia had on the economy of the country. The SENSEX and NIFTY had seen the biggest crashes of 2020 and Indian share market is in complete dark stage. This is at a time when economy of India is in crisis.[25] According to the Reserve Bank of India, Governor, the Gross domestic product (GDP) growth rate of India will be negative in 2020–21. Even in the first 1-month period of unlock, the economic activity has moved only 30%–40% because of the fear and phobia. Import export business had been severely affected with the foreign countries because of corona phobia[26]
  2. The outbreak of coronavirus disease 2019 is a stressful time for people. Fear and anxiety about a disease can lead to social stigma. Stigma affects the emotional or mental health of the people. Because of these fear and phobia of stigma, people have hidden travel history or contact history with a suspected/confirmed case which has increased the possibility of a large outbreak[27]
  3. Although the government has issued guidelines for proper functioning of all the regular preventive and curative services for primary health-care center during COVID-19 pandemic, data show that it has been severely affected in the country (especially immunization and maternal health-related services)[28]
  4. India's poultry industry has lost 13 billion rupees ($182 million) in 3 weeks after speculation on social media that chickens are a cause of the spread of coronavirus, denting demand for chicken and nearly halving prices. Millions of small poultry farmers have been hit by a sudden drop in sales[29]
  5. Global as well as Indian COVID 19 age specific caseload shows that there are very less transmission of the disease among young age population in spite of that many states had done proactive closer of schools and colleges. However, proactive closer of school to prevent epidemic is highly controversial. Closer of school should be on the basis of epidemiologically relevance not on the basis of fear and phobia. Many children get school lunches; their health might suffer from closing the school A group of experts suggest that school and college should open in India with certain preventive norms to protect oneself from the virus and it might help in achieving herd immunity in future[25],[30]
  6. All the social media platform (Facebook, Twitter, WhatsApp, and Instagram) are flooded with the messages of coronavirus and it is a matter of great concern that most of the messages are spreading fear and deadliness of the disease rather than the factual information helpful for the community. A majority of the stories about corona are false and fake news, but it is spreading like wildfire. People are sharing rumors, fake stories, and half-truths about COVID-19 with each other directly across different social media sites as they struggle to understand how best to protect themselves and their families. Messages recommending yoga, inhaling cannabis, and consuming cow urine and dung for prevention have also been circulating wildly. To make matters worse, a government department actually released advisories recommending a homeopathy drug and local indigenous “medicine”for the prevention and management of the infection. Techno companies and policymakers are trying their best to screen the false campaigns, but they are facing a tough time to respond. According to a new Morning Consult survey conducted on March 10–12, 2020, a plurality of 38% said that social media companies are doing a “poor”job of preventing the spread of false information about coronavirus on their platforms[31]
  7. Rumors about coronavirus had made hand sanitizer and surgical masks/N95 masks very costly affairs for the common citizen of India. The price of hand sanitizer and masks had gone 4–5 times high in retail market and it has also created an atmosphere of shortage. The WHO has estimated globally 89 million masks and 2.9 million liters of hand sanitizers are required, but it is mainly recommended for those who are: health-care provider or visiting a health-care facility/a person having symptoms of cough and fever/close family members of a suspected/confirmed coronavirus case or caregivers.[32] However, the atmosphere of fear is so high that people are wearing it at market, street, airport, and school every possible place and most of them are wearing it without knowing how to wear it or how to dispose it.


Common Face Mask use Mistakes

  • A mask is worn upside down, only over the nose, not pulled under the chin, or worn only over the mouth, leaving the nose exposed. Even the best mask will not protect if worn incorrectly
  • A user constantly touching and fiddling with the mask's filter surface, which cross-contaminates fingers and subsequent surfaces. A contaminated finger will cross-contaminate the next seven surfaces it touches, e.g., phones, iPads, and keypads
  • Pulling a face mask under the chin for conversation or eating and then putting the mask back up again
  • Reusing or recycling masks. This has been the most common and dangerous practice
  • Wearing the same mask for too long
  • Used masks are not disposed of quickly and appropriately. Used masks have a buildup of potentially infectious particulates that could include coronavirus and other pathogens, and if left around, they can cross-contaminate previously clean areas
  • Using a counterfeit face mask
  • Relying on N95 masks. When worn properly, these respirator masks get very hot inside and are very difficult to breathe in due to the pressure change between the air inside and the outside atmosphere. Wearers may take it off for a break which would reduce its protection
  • An inferior mask made of fabric, paper, or plastic or a dust or allergy mask is chosen and worn when there is unavailability of masks in the market because of high demand.[33]



  Way Forward for India Top


The WHO had declared coronavirus outbreak as a “Public health emergency of International concern”and according to the WHO director general, the present pandemic has not reached its peak.[34] India as a country of vast diversity has resisted many communicable disease outbreaks in past and much theory has put forward (natural immunity, environmental factor, etc.) behind this without much scientific evidence. In this atmosphere of negative environment, India can take it as an opportunity to improve the surveillance system for viral disease in the country. Training of the health workforce, improving the number of facilities for viral testing (1119 laboratories), developing isolation ward, and mass media campaign, stockpiling of personal protective equipment show India's preparedness toward the disease. Despite a creaky and uneven public health-care system, India has a formidable record in a defeating polio and facing up to a swine flu pandemic in 2009 and handling a more recent outbreak of the deadly Nipah virus. According to the register general of the WHO, country should strike a balance between protecting health, preventing economic, social disruption, and respecting human rights. Being a vast country, actions and decisions will need to be decentralized, and well coordinated but there is no need for panic. Rumors, myths, and misconceptions spread through different media could hurt an effective response to the infection. Hence, India needs to be very vigilant and open about the spread and containment of the infection.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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