It’s human nature to find a common enemy to fight against. However, when we think in a more intentional and rational manner, as opposed to an impulsive, reactionary manner, we realize that our enemies in the world of public health and infection prevention are things like imperfect science, ignorance, irrational human behavior, inequalities and similar problems. These enemies are in each one of us. That is a major reason why the war metaphor works only partially in the case of a pandemic like covid19. To complicate matters, not all microbes are pathogenic. Microorganisms, including viruses and bacteria are part of the flora and fauna in our ecosystem. It is well known that the human microbiome consists of millions of bacteria; however, viruses (i.e., the virome) are a less well understood but an important component. An alternative to the ‘enemy’ metaphor for microorganisms is neighbors and house guests which may be welcome (not disease causing, e.g., probiotics) or unwelcome (disease causing, e.g., covid19). To minimize disease burden and number of deaths related to the pandemic, we need to flatten the epidemic curve and slow the growth rate of infections and deaths. To achieve the goal, it takes a lot of upstream problem solving that many infection preventionists, public health professionals, epidemiologists and infectious diseases experts are trained to do. This work is very different from providing medical care for patients which involves disease diagnosis and management.

Here is how you can help the epidemiologists, public health and infection prevention professionals help you and everyone else.

1. Educate others as well as follow public health recommendations for shelter in place, work from home, physical distancing (alternately called social distancing), etc. Listen to one of my colleagues here as to why this is important and share videos like this freely. Infection prevention is everyone’s responsibility.

2. Become familiar with signs and symptoms of covid19 as well as commonly used terms like self-isolation, quarantine, etc. so that we can use a common terminology to communicate.  

3. Learn about how the virus spreads. This knowledge of transmission needs to be applied in prevention practices in daily life as well as for developing prevention protocols in hospitals, clinics, and other healthcare facilities. A behavior perceived as risky by one person may not be viewed as risky by another person.

4. Recognize that to prevent infections, individual rights and autonomy are frequently traded for collective good. The optimum framework is virtue-based communitarianism, which emphasizes the well-being and values of communities.

5. Support and be kind to your prevention professionals and disease detectives. They are professionals who typically work with scarce resources and their work is not valued or visible except in a crisis. Their personnel, tools and resources are constantly shifted around. They are human beings prone to stress and anger like anyone else. Show them appreciation. This video, and this news article are examples of recognition for what they do. Before covid19 became a crisis, many public health resources were being used to address the opioid crisis epidemic.

6. Contribute to science and research. The quicker we develop a vaccine and make it available to everyone, the fewer lives we will lose to this pandemic. Same goes for development of better treatments, personal protective equipment, cleaning modalities, etc.

Ultimately it takes effective leadership and excellent civic responsibility and concern for public good. Here is to ever-increasing doubling time of infections and a flatter curve.

Picture reference: