Conversations on COVID-19 4th Webinar: Lessons learned from HIV, Ebola and other epidemics & how can behavioral research help us respond to COVID-19
WEBINAR SERIES: WEEK FOUR Lessons learned from HIV, Ebola and other epidemics & how can behavioral research help us respond to COVID-19
The fourth webinar was held on Friday 10/04/2020 at 12:00 pm GMT/1PM Irish Time.
A SUMMARY OF POINTS MADE
Kate Thomson, Head of the Community, Rights and Gender Department at Global Fund to Fight Aids, Tuberculosis and Malaria.
Kate described her experience with being diagnosed with HIV in 1987 and the feeling of now having to survive another plague. HIV was a new disease, with lots of questions – COVID-19 is reminiscent in many ways.
People were dying alone, there were huge issues involving PPE supply, and inappropriate distancing measures and misinformation being spread.
A large difference is the presence of the internet, which presents both a force for positive communication and information dissemination, and for spreading false news.
Stigma and discrimination were rife during the HIV epidemic of the 80s, with breaches of human rights, generally towards groups that were marginalised, criminalised and excluded from society. The power of communities was immense; creative solutions coming through the community itself; speaking about experiences; peer support.
Around 1996: HIV treatment became available – access to health in the global north vs south shifted – there is a possibility of this with COVID-19. Gains made in combating HIV and TB must be maintained, while being mindful of supporting the COVID-19 efforts. Lessons learned in gender and human rights issues in previous epidemics must be kept in mind, and rights developed from HIV crisis must be protected.
Margaret Fitzgerald, Public Health Lead for Social Inclusion/ Vulnerable Groups.
Margaret travelled to Liberia in 2014, just before the peak of the Ebola outbreak – the situation was chaotic. The President at the time had enforced a notice of quarantine in West Point (densely populated low-income area).
NGOs provided treatment centres to support the collapsed health services. Healthcare workers started to become infected and fearful; many mortalities; not enough support for healthcare workers. The coordination of the response was insufficient, with reduced communication and collaboration between government systems and NGOs.
An important lesson learned – strong message with clear instructions on actions to take when sick; this must be supported with comprehensive testing and availability in healthcare.
Healthcare in LMICs: Those with the most need, often have least access. How do the most vulnerable self-isolate? The COVID-19 outbreak is showing the weak links in Ireland’s healthcare system – working hard to connect these pieces – this is a huge challenge.
Pete Lunn, Associate Research Professor at Economic and Social Research Institute.
Pete explores human decision and behaviour – his expertise is relevant to the Coronavirus outbreak.
Simply providing information and education does not change behaviour. Changes to physical and social environment are required to assist people to make behavioral change eg. handwashing; grabbing people’s attention at the right time, with the right message is required. People’s willingness to self-isolate can be supported with planning – allowing the public to be better prepared.
Collective action is necessary – collectively make changes to others, not just oneself – clarity of the message is vital; building a degree of team spirit; degree of disapproval by those who are engaging well towards those who aren’t. Ireland is behaving well around the virus and has an advantage of being a small, cohesive country.
Sian White, Behavioural Change Scientist, Research Fellow – WASH and Global Health at London School of Hygiene and Tropical Medicine.
There are many factors that enable or prevent effective hand washing: cognitive and environmental factors; societal norms; etc.
What are the reasons why people don’t wash their hands, even when facilities are available? Condescension towards people who are unable to cope with high-intensity situations is unhelpful. – there is no link between knowledge about handwashing and behaviour.
Most powerful driver of good hand hygiene practices is having universally accessible, convenient access to soap and water. We are seeing renewed call to ensure that hand washing facilities are easily available in places where people gather.
This Webinar also featured a recorded address from Alam Alhuda abu Kalib, State Minister of Health, Sinnar State, Sudan:
The Minister stated that the current pandemic will be the defining global health challenge of our time.
South Sudan had (at the time of speaking) 15 cases, 2 deaths and 2 recoveries with more than 200 suspected cases. Policy makers are in the process of deciding on measures to control the virus, while simultaneously managing the fragile economy.
He is also mindful of other illnesses such as Cholera, which put pressure on the Sudanese healthcare system – a health system collapse is possible if COVID-19 is not contained. The population works hard, while healthcare facilities are far away or not functional with added problems such as a reduced employment rate, civil war and shortage of basic resources such as water and food.
An overview of an OpEd written by Prof. Father Michael Kelly on the potential effect of COVID-19 on Zambia was also provided.
Zambia (at time of recording): 39 confirmed cases, 1 death – virus has not yet moved into the local population. Fear is beginning to spread and protective measures are difficult to enforce.
Easter poses difficulties in social distancing as the Zambian population is very religious. There is also a low number of health personnel with 1 Doctor to 12, 000 people in Zambia, compared to the WHO recommendation of 1:1000. Zambia would not be able to respond with personnel, resources, infrastructure.
Zambia is already experiencing an adverse economic effect due to changes in demand of copper from China. Tourism, which is a large source of income is at a stand-still, with access to Victoria Falls closed.
HIV prevalence is at 11.3% with the majority being on treatment – however, if the country has to deal with a Coronavirus outbreak, they will not be able to provide universal access to healthcare.
Webinar Anchor: Ruairi Brugha, Professor Emeritus, Former Head of the Department of Public Health & Epidemiology at the Royal College of Surgeons in Ireland
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