The effects of coronavirus pandemic that invaded the world in 2020 will last a long time and forever in the history books. Not only because of the illness and death caused by the virus but because of the many collateral damage it caused, in the form of poverty, economic ruin or the increase in other diseases neglected during the epidemic.
However, the coronavirus has also brought with it an opportunity that can tip the balance, to a lesser or greater extent, on the side of health and help fight against other health wars which, although they seem to matter less now, also cause many deaths each year. The flu, other infectious diseases or those caused by bacteria resistant to antibiotics could lose their pulse if the weapons we are using against the coronavirus are taken advantage of.
One of the most prestigious virologists in Spain, Margarita del Val, recently said that masks They will remain with us for two more years; other experts even believe that perhaps they will not leave some places or that, at least, they should not leave. “For now, at least, they will stay. Many specialists in Preventive Medicine have spent years fighting for masks to be mandatory in health centers during times of flu and now that that kind of ‘social shame’ to use them has been lost, it may be very convenient to maintain the indication beyond the Covid ”, explains Alberto Torres, professor of Preventive Medicine and Public Health and member of the Spanish Society of Preventive Medicine, Public Health and Hygiene (SEMPSPH).
Use of masks as in eastern countries
This loss of “social shame” has brought Western societies closer to what was already a custom in the Eastern world and has achieved that in many of these countries the incidence of the virus has been lower. In Japan, for example, the first evidences in the use of masks date back many centuries, as the doctor in Japanese History, Jonathan López Gálvez, recalls: “There is a basis that relates covering the mouth with the Shinto religion, where dirt it is taboo, and during the seventeenth century there is evidence of its use among patients. With industrialization, some workers used them to protect themselves and their modern use spread with the flu epidemic of 1918. Their antecedents probably made it easier for them to stay since then and that their use has been maintained.
The historian explains that currently “it is thought that the Japanese use it to avoid contamination, although it is not their main motive. They use them when they are sick because they are very respectful, and in other cases because there are many allergies. One in five Japanese has an allergy, especially to trees with which they were reforested after the Second World War and for which the population was not prepared ”.
In Japan and, in general in eastern countries, “the experience with other pandemics such as SARS or MERS also helped to extend the use of masks and other behaviors to avoid transmission, such as their way of greeting”, adds Jonay Ojeda , spokesperson for the Spanish Society of Public Health and Health Administration (SESPAS). Measures that, regardless of the reasons, have shown their effectiveness and that can help Spain to fight against other challenges, starting with the next waves of seasonal flu or winter respiratory viruses.
That effect on flu reduction has already been demonstrated in the southern hemisphere and it is likely that it can be replicated in Spain. “The measures against Covid are effective in containing the flu and other respiratory viruses and containing them would be a good legacy to preserve for the future,” says family doctor and Patient Safety expert Jesús Palacio.
Against antibiotic resistant bacteria
Other infectious diseases could also decrease if protective measures such as the use of a mask or hand hygiene, through washing or hydroalcoholic gel are maintained. “Measles, which is on the rise in some European countries, or some viral or contact meningitis. In this way, multi-resistant bacteria are also spreading, which pose a serious health problem that has now been overshadowed by the coronavirus. These bacteria are spread especially in hospitals and through contact due to poor hand hygiene, ”says Ojeda. Its control can save lives. Only in 2019, the second hospital registry carried out in Spain on bacteria resistant to antibiotics estimated 220,000 infections and 26,000 deaths in just one year in our country.
“These bacteria have the ability to stay on the surface for a long time and the only way to protect themselves is hand washing. The pandemic has helped us to get used to it and it should be maintained, ”says Torres, who also observes the positive side of the change when greeting. “In a couple’s kiss, some 80 million bacteria are exchanged. In one on the face they will be less, but in any case the distance that the coronavirus has imposed will allow millions of bacteria to stop being exchanged daily and, consequently, much less burden of disease ”, adds the expert.
Ventilate, inheritance of tuberculosis with potential
“That grandmother’s custom of opening all the windows in the house in the morning is inherited from tuberculosis, which killed so many people in Spain,” says Torres, “when it was understood how it was transmitted, ventilation was promoted. The air makes us sick ”.
Despite the doubts that the scientific community still raises about the transmission of Covid through the air, ventilation has been reinforced in closed spaces to avoid contagion. Within the recommendations of the Ministry of Education for the ministries, it appears: «The facilities of the center will be ventilated frequently, at least for 10-15 minutes at the beginning and at the end of the day, during recess, and whenever possible between classes, keeping windows open as long as possible.
Adequate ventilation is essential to avoid the concentration of aerosols, which exceeded the allowed threshold for 85% of the time according to an experiment carried out by a chemist and institute professor as published To be.
Clean the air to avoid illnesses but also to improve academic performance, as reflected a study from the American Brown University in which the normal ventilation of one class was compared with another in which HEPA filters had been installed. Students improved, on average, 0.20 points in math and English.
Will the habits be maintained?
The specialist in Public Health Xavier Cercavins predicts that, after the epidemic, “it will not be strange if all the seats in the cinema wear the mask again, perhaps not all year but from October to March.” It will also endure, he considers, “the change at the time of greeting and the end of the rejection of the mask.”
Cercavins does not see its compulsory use as plausible, but “the need to introduce it through pedagogy and education from children does.” Beyond the mask, the specialist believes that “only if the hydroalcoholic gel dispensers were not removed from stores, transport and any crowded public space, many of the infections would already be avoided.”
For Palacio, who does not see «foreseeable in the short term to stop using a mask in health centers or outside them when we have to maintain close contact», believes that in the future «a debate will be necessary on what protection measures are the most appropriate according to the epidemiological situation, the available resources and the values and preferences of society ”. The expert emphasizes that resources are always limited and it is necessary to attend to prevention, care for other neglected diseases during the pandemic or basic health services such as primary care.
However, the patient safety expert believes that the measures now imposed will have to be kept tight at the moment. “Without a vaccine or with a vaccine of limited efficacy such as influenza, it is not foreseeable that containment measures will be dispensed with and for a coronavirus that mutates like SARS-CoV-2 it will be difficult, in the current study of the science, develop a vaccine that is so effective that it allows to eradicate Covid as was done with the smallpox«.
Torres hopes “that the maintenance of these habits is not left to chance but is included through campaigns and in the educational field in a conscious way so that they can take advantage of their benefits.”