Written by Dr. Daniel Dube, MD, FACP
Please follow Malawi government guidelines and your healthcare providers.
This information is not for Malawi Healthcare professionals. It is not an exhaustive analysis and it is not scholarly.
How Do You Protect your family?
The World Health Organization has stated that people who are actively involved in their own healthcare have better outcomes from interactions with healthcare providers than people who are passive recipients of medications and information. This makes it important that people should learn and try to understand their disease processes in order to make informed decisions. To do this, one needs high quality healthcare information. Unfortunately, in the Information Age, it is difficult to sift through facts from fiction. It is also difficult to have a high-quality consultation with providers due to time constraints.
I have oversimplified this essay for the interest of effective education.
We all know that COVID 19 is spread from human to human through small droplets spread through breath, cough, speech, singing etc. The virus is also spread through contact with contaminated surfaces such as doors, kitchen counter tops, contaminated plastics etc.
Let us take a small family unit in Malawi and try to think through how we can analyze the risks of getting a COVID infection. After this, let us assess how we can try to protect our families.
The first question is what is the risk of COVID Infection that each family member brings to the family unit? After thinking about this then we should find out a personalized family plan that can be used to reduce that risk.
A. Assess the risk that your family has of being infected with COVID-19?
(Essential Risk)
1. What are the occupational risks; what kind of jobs do the family members have? In Malawi, mostly it may be one or two family members who work. Do family members undertake any of the jobs that fall into the category of “essential jobs”? Essential jobs are jobs in the following categories: healthcare work, Law enforcement (police, immigration, prison wardens), military personnel, factory workers, grocery workers, market workers(vendors), jobs that involve contact with the public, public transport drivers etc.
2. Do your family members use public transport?
3. How often do members of your visit public markets?
Social Risks
-Are you visiting public bars?
-Are you part of a church congregation that is physically meeting?
– Are you a member of a public gym?
– Are you a member of a private social club?
– Are you a socialite (involved in social events, parties etc.)?
– Are you involved in events that involve gatherings such as weddings, birthday parties etc.?
B. Are members in the household at Risk of serious infections and death if they are infected with COVID?
C. Does any of your family members qualify as immunosuppressed
- HIV/AIDS
- Malnourished
- On Cancer Treatments
- Have Liver, kidney diseases
- Diabetes
- Chronic diseases such as heart disease
- Old age
D. Do you have workers who do not reside with you in your household?
E. Do we have children that interact with other children or people outside the home?
The preceding questions should allow everyone to assess the risks that they have. It is important to highlight that human to human interaction is the greatest risk for infection. In general, our existence calls for human to human interactions. IN SUMMARY WE ARE ALL AT RISK. In Malawi most coexisting conditions are undiagnosed. It is therefore not possible to know your additional risks of severe illness caused by preexisting conditions. House workers may bring undetermined risk though their own exposure. This is the same with children whom through interactions with other children may bring the risk of infection with COVID home.
What Can We do for our family?
1. Consider a stay at home plan for your family. Obviously, this will be determined by your family finances. Even with that understanding, you should consider limiting movements of family members outside the home unless it is for critically essential activities such as visiting a healthcare worker, or business.
2. Consider limiting contacts outside the immediate family. The biggest groups are: People who are familiar to you. These are the people whom you are likely to judge as being healthy. These groups include members of the extended family, neighbors, close friends, church friends, work mates, children’s friends etc. A strict rule should be to limit these contacts.
3. Treat yourself as potentially contaminated with COVID 19 when you enter your house after you have been out of the home. Personal hygiene and avoiding direct contact with the family until after washing yourself and separating your clothes into a space that is separate from everyone else’s.
4. All household workers should be given an opportunity to wash their hands with soap when they come to work. If possible, work uniform should be provided in addition to masks. They should also observe strict social distancing with the family.
5. Regularly decontaminate surfaces, tabletops, bathrooms, kitchen surfaces with methylated spirit. Do not drink decontaminants.
5. Maintain high levels of hygiene in the home.
7. There are no recommendations for social distancing among family members and it may be hard to socially distance with small children in the home. We should consider assessing our exposure and making appropriate social distancing and use barrier protections if possible and practical.
8. Isolate members of the family that are high risk to the extent possible.
9. Educate and provide protective resources for household workers to protect themselves and your family. (Do not terminate their employment)
Remember
- -social distancing
- -hand washing and hygiene
- – listen to your government or local authorities
- – eat well
- – stay hydrated
- – exercise
Keep discussions of COVID and general health issues current with your family. Do not portray a sense of fear or doom or hopelessness. Diversify social activities within the home and limit exposure to conflicting news especially from across the Atlantic. Keep in touch with family and friends through social media and other means of communication. Spiritual health is important whether you are a believer or not. This revolves around maintaining the psychic network of people whom you love, things you value, reading, connections with the past and future and maintaining a positive spirit.
Hope this provoked some thought and a modification of lifestyle. Remember that other ethnic groups have initiated stay at home orders for their community in Malawi.
Dr. Daniel Dube, MD, FACP
Pulmonary and Critical Care
Disclaimer: This message is for my Malawian friends. The situations that I discuss are unique to that community.
