We need Covid studies

The second wave of Covid-19 has exerted unprecedented pressure on Malawi’s healthcare system and economy.

While the world thought the subsiding infection rates would lead to the end of the pandemic, the devastating resurgence, with numerous variants, has shocked the world both in numbers of cases and deaths.

Complicating the fight against Covid-19 is that it is a completely new disease which has already mutated into over three known strains: the UK, South African and Brazilian variants.

Much is still not known about the new coronavirus itself and even the disease it is causing.

For example, a local newspaper on January 28 reported that doctors have now observed that high temperature is not common in all cases.

This exerts pressure on all arms of medicine, especially how to manage people with the disease and to protect those most likely to get infected.

As a disease prevention professional, my interest is on the clear understanding of the local epidemiology of Covi-19 disease and deaths.

For starters, epidemiology  is the scientific, systematic and data-driven study of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related conditions and events—not just diseases—in specified populations.

The populations could be neighborhoods, schools, cities, States, countries or the whole world.

Currently, we have some crucial information on the transmission of the coronavirus disease which helps us develop preventive measures such as frequently washing hands with soap, hand sanitising, social distancing and masking up.

However, not much is currently known about the some determinants of Covid-19.

This has apparently brought some relaxation in some groups and lack of strict control measures among those at high risk of dying from Covid-19.

My worry emanates from the apparent thinking of some low-income groups from high-density areas, informal settlements in cities and rural villages that Covid-19 is not attacking them.

These groups seem to think that Covid-19 is only for well-to-do people from medium and high-income urban settlements.

This misconception is being strengthened by their assumption that there is a difference in distribution of Covid-19 cases between the two social groups. This could be true or just a myth.

However, it is worrying how these two groups are approaching their acceptance to Covid-19 preventive measures.

It is common to see medium- and high-income people observing preventive measures to a better extent than the low-income people.

Another known factor is on the general high risk of one dying from Covid-19 for those with underlying conditions like hypertension, cancer, asthma and diabetes.

However, an opinion is spreading that from observation, those with diabetes and cancer are at much higher comparative risk than the others.

It is high time our epidemiologists were given a central role and resources in the fight against Covid-19.

It is time they undertook detailed comparative analyses of the distribution of Covid-19 according to place of residence as related to economic levels of residents of those residential areas.

We also need to understand the distribution of Covid-19 deaths according to cases’ underlying condition and even comparisons of the risk among people with different underlying conditions.

This will help us determine whether one underlying conditions really exposes patients to higher risk of dying.

If we get a better local understanding of these epidemiological distributions, our awareness messages to specific groups at higher risk of the disease or its related deaths will be based on proven evidence.

Government should consider urgently providing funds for epidemiologists to undertake such studies. This general approach to Covid-19 messaging will not help us much.