COVID-19 Pandemic and the Perspective of Public Health Science, By Oluwatomi Ajayi

By Oluwatomi A. Ajayi/

COVID-19 virus belongs to the Coronavirus family and has been traced to Wuhan, China as a possible source of the virus. Originally believed to be a zoonosis (infectious diseases transmitted between people and animals), the disease continues to spread easily between people and has consequently turned into a pandemic

A pandemic is transboundary in nature because it is an outbreak of infectious disease or an epidemic which occurs in many simultaneously. The COVID-19 virus is a contagion which has not only claimed several thousands of lives but has also made us all vulnerable. In fact the virus is negatively impacting the entire biodiversity as well as the economy. No one is spared thus indicating that the world is presently undergoing a serious global health emergency and therefore a serious public health issue.

In simple terms, the dimension of public health is concerned with the health of the community at large and this is divided into three main categories. The first one is the primary preventive services focusing on health promotion and health protection at the individual or family level. Activities in this category include immunization, hand-washing, clearing of bushes, fumigation of contaminated premises and other services aimed at improving personal hygiene and environmental health.

The second category is the secondary preventive level which includes activities that focus on early diagnoses and prompt treatment of diseases such as screening, early interventions, medical intelligence surveillance, contact tracing, disease notification and control, all of which are known to reduce morbidity and mortality. Finally, the third category is the tertiary preventive level which is the intervention that focuses on disability limitation and rehabilitation.

Essentially, the discipline of public health is wide because it is both the art and science of preventing disease, prolonging life, and promoting health through the organized efforts of society. It further uses the tools of law to enforce laws and regulations that protect health and mobilize action to solve health issues in order to ensure safety for all. That explains why public health practitioners are of the view that diseases do not just appear from the cloud, rather they are caused by ‘something’ unlike in the medieval period when the cause of diseases was attributed to supernatural forces until the discovery of the ‘Germ Theory of Disease.’

The background of these ‘Disease Detectives’ is grounded in the sciences which enables them to classify diseases under communicable diseases and non-communicable diseases; investigate outbreaks and track or trace these diseases while for infectious ones, they try to distinguish between those that are dangerous to society from other infectious diseases.

Historically, the genesis of modern public health and infectious disease law derived its origin from the cholera epidemics (1830-1847) and in response to this, the first International Sanitary Conference was convened in 1859 to discuss the infectious disease governance. Thereafter in 1946, the World Health Organization (WHO) was established to regulate international health regulations and public health laws.

In relation to the COVID-19 outbreak, no doubt we all have a collective and huge role to play in advancing public health security and safety. In so doing, measures like:

• Minimizing our exposure to other people by adopting social distancing, shelter-in-place, stay-at-home, transport restrictions, partial or total lockdown, visitor restrictions, self-isolation or quarantine orders and border closures; (In India, these methods are generally called ‘People’s Curfew against Coronavirus’);
• Observing  state environmental laws or local environmental bye-laws on disease prevention and containment;
• Obligations  of government policies at all levels to respect, protect and fulfil their citizens’ human rights to health ensure health institutions are equipped with relevant tools needed to provide equitable emergency care;
• Adhering to the international medical practice guidelines for health monitoring and disease control, for example, countries must operate within the framework of the International Health Regulations 2005; and
• Ensuring disease prevention measures is based on scientific evidence and public health principles knowing fully well that the obligations to advance public health services are grounded in scientific methodologies.

Certainly, human beings are prone to illness and therefore it is just natural that we want to do what we can to stay healthy. It is also a fact that how a person addresses his health concerns must be his decisions but not when it is related to diseases that are infectious in nature such as the COVID-19 virus.

In the context of a pandemic and in the interest of public health safety, some are of the view that though the Nigerian government is protecting the health of its citizens yet it must not be done at the expense of limiting our constitutional right especially the right to movement as guaranteed under Section 41 of the 1999 Constitution. But then we know the government can sometimes interfere with our rights if it is in the interest of public health and public safety as provided under Section 45 of the Constitution.

Similarly, restriction of movement is also justified under the Public Health Laws as well as the Quarantine Law. Hence it follows that where there are COVID-19 cases especially in countries with weaker health systems like Nigeria, it is necessary to have a law in place to curb the spread or at best slow down the transmission of the virus otherwise it could spread uncontrollably and how to contain the disease then becomes a major problem.

Already in Nigeria for example, as the chief security officer of the country, the President recently signed the COVID-19 Regulations of 2020 into law in addition to setting up the Presidential Task Force on COVID-19 aimed at defeating this pandemic considering the fact that there are no recommended drugs for a cure yet.  Thus it needs to be stated that these are powers that lie with the President. He has a legitimate duty to stop the virus whatever lawful way he can because the restriction is for our own good until Nigeria is certified COVID-19 free. It is also important to note that law is one side of the coin in public health security and safety matters.

Moreover, the public health law is driven both by science and law. The art of preventing and containing diseases is a public health science which is an arm of the public health law.  Public health science deploys law as a tool to achieve public health safety and goals. In other words, one can set health and safety standards with law. Therefore, public health regulations can intrude on personal interests or liberty, because certain rights are not absolute in the first place. To protect against potential epidemics, the Court may want to forego individual liberty for public health. See Jacobson v. Massachusetts (1905).  

In conclusion, we should realize that we are dealing with a contagion which has claimed thousands of lives and still does.  Apart from those who have shown symptoms based on the fact that they have tested positive for the virus and are being isolated or quarantined, we should note the existence of potential spreaders such as the asymptomatic and post-symptomatic carriers of the virus. The former are persons who have not yet developed noticeable or mild symptoms of the virus but may still transmit the virus while the latter are persons who got sick, appear to have recovered but may still transmit the virus to others.

 Let us all therefore be vigilant and stay healthy.

Resources: Livescience.com; www.encyclopedia.com on Legislation, International Law & Infectious Diseases; www.healthcare-management.degree.net; UNILAG Inaugural Lecture on Community Health (2016).

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