ISLAMABAD – The transmission of coronavirus or COVID-19 other than respiratory means was observed in the latest researches through the faecal-oral route that demands the government at all levels to ensure proper water, sanitation and hygiene (WASH) facilities to contain the pandemic conduction through this potent source, says a latest research study.
Research Fellow at Sustainable Development Policy Institute (SDPI) Dr Imran Saqib Khalid in his policy brief titled “Managing Risks to Water and Sanitation amid COVID-19: Policy Options for Pakistan” had highlighted the risks of coronavirus communication through infected patients’ stool while quoting the research carried by Xiao et al. (2020) found that the Coronavirus, in China, was evident in the stool of just over 50 percent of patients.
The study observed: “In more than 20 percent of severe acute respiratory syndrome coronavirus (SARS CoV-2) patients, the viral RNA remained positive in faeces even after negative conversion of the viral RNA in respiratory tract indicating the viral gastrointestinal infection and potential faecal-oral transmission can last even after viral clearance in respiratory tract.”
Dr Saqib in his study had argued that these findings were supported by Gu et al. (2020), who quoting evidences from 2003 SARS epidemic, found the presence of SARS-CoV-2 in stools of the patients days after they had been discharged from the hospital. “This means that symptomatic as well as asymptomatic (having no symptoms) carriers of the virus may be shedding it and could transmit it to others,” it added.
Raising serious concerns over the deleterious state of water, sanitation and hygiene in the country, he recommended short and long term measures to mitigate the risk of the pandemic increase.
The Short term or immediate measures to be taken, firstly, called the frontline fighters hospitals and medical practitioners to be cognizant of the potential for faecal-oral route of transmission of Coronavirus. They should devise adequate plans and procedures to counter this risk.
Dr Imran in his study mentioned that the national rate of open defecation in Pakistan went from 29 percent in 2004-05 to 13 percent in 2014-15. “Despite a significant improvement, this still means that well over 25 million people in Pakistan remain without access to sanitation facilities,” it added. Keeping in view this level of WASH facilities and open defecation rate institutionalization of local governments was necessary to develop plans and actions to counter the risks posed by COVID-19, with special focus on provision of regular supply of water as well as improved mechanisms for sanitation and personal hygiene.
The study also recommended that such disasters increased gender and disability inequalities in the society and the strategies to improving WASH facilities should address this concern.
Dr Imran also suggested: “Better communication with communities across the country in local languages through video, audio messages through social media, highlighting the risk faecal-oral transmission poses alongwith respiratory transmission through uniform messaging.”
Moreover, it was necessary to set up handwashing facilities at public places such as markets, train and bus stations, hospitals. “The growing social enterprise sector in Pakistan can play an important role in this regard.”
The study observed that hospital and industrial waste in urban areas was thrown in water streams and channels which were mixed with household liquid waste. It had increased the risk of virus contact among the sanitary workers who were washing the drains without any personal protective equipment.
“Sanitary workers should be provided necessary tools and personal protection equipment. They need to be imparted training how to work safely on post-COVID-19 era.”
In order to conserve water, hand washing campaigns should not focus on using running water to explain proper hand-washing techniques. The focus should be on the use of soap and proper scrubbing of hands as opposed to running water.
For the long term, Dr Saqib recommended that municipalities should allocate funds for improved Water Supply and Waste Disposal Infrastructure, ensure regular monitoring of water supplies with no contamination. They should also ensure treatment and management of municipal wastewater as per the National and Provincial Environmental Regulations. A plan of action should be devised to manage faecal waste in rural areas to avoid contamination of water supplies alongwith promoting integrated and adaptable water and sanitation decision-making across the county at all levels.