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Journal of Public Health and Diseases
Volume 6(2), pages 31-38, December 2023
Article Number: F1BFB0EF2
ISSN: 2705-2214
https://doi.org/10.31248/JPHD2023.131
https://integrityresjournals.org/journal/JPHD
Review Article
COVID-19 prevention and health promotion for the
whole community
Mohammed, M.1* and Umar, A. Y.2
1Department of Biological Sciences, Federal University Gusau Zamfara, Nigeria.
2Department of Biological Sciences, Nigerian Defence Academy, Kaduna State, Nigeria.
*Corresponding author. Email: mmohammed@fugusau.edu.ng; Tel: +2348069737482.
Copyright © 2023 Mohammed and Umar. This article remains permanently open access under the terms of the Creative Commons Attribution License
4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received 16th September 2023; Accepted 12th December, 2023
ABSTRACT: As our understanding of Covid-19 has grown, numerous techniques for preventing its spread have emerged.
Scholars and practitioners in public health have focused on four important Covid-19 prevention strategies: behavioural,
technical, biomedical, and structural/community-level interventions. Recent material in these areas provides an overview
of current Covid-19 preventive breakthroughs. Current COVID-19 prevention models, which build on traditional
techniques, use intimate partners, families, social media, emerging technology, prescription therapy, immunization, and
regulatory changes to influence change. Despite significant success, more action is required to meet the national goal of
stopping the COVID-19 epidemic. Government and non-governmental organizations are uniquely positioned to promote
prevention science in collaboration with cross-disciplinary professionals from other domains.
Keywords: Community, COVID-19 prevention, epidemic, health promotion.
INTRODUCTION
Although global commitment to control covid-19 has
increased significantly in recent years, most people
continue to recover without hospital treatment (WHO,
2023). More than 760 million cases of covid-19 have been
reported in more than 214 countries and territories,
resulting in 6.9 million deaths have been documented from
December 2019 (WHO, 2023). United States of America
remains the country most affected by COVID-19, however,
the virus continues to spread rapidly all over the world
(JHU, 2020).
Despite the rapid spread of COVID-19, several countries
have achieved important success in curbing its
transmission through various infection prevention and
control (IPC) guidelines, which include immunization,
frequent hand washing, maintenance of physical distance
from others, quarantine, covering coughs, and keeping
unwashed hands away from face (He et al., 2023;
Nussbaumer et al., 2020; WHO, 2020a).
Successes include developing a highly sensitive and
standard COVID-19 diagnostic test such as real-time
reverse transcription polymerase chain reaction (rRT-
PCR) and CT scans in individuals with high clinical
suspicion (Alafeef and Pan, 2022; Pradana et al., 2022;
Vogel, 2020; Salehi et al., 2020). Although, as of June
2023, more than 13 billion COVID-19 vaccines have been
administered while most people recover without drug
treatment (WHO, 2023). Management involves treating the
symptoms and seven trials were evaluated and approved
for treatment including chloroquine, vasodilators,
corticosteroids, immune therapies, lipoic acid,
bevacizumab, and recombinant angiotensin-converting
enzyme (Barletta et al., 2023; Olukosi et al., 2023; Hawks
et al., 2020).
OBSTACLES TO COVID-19 PREVENTION AND CONTROL
Obstacles to effective COVID-19 prevention and control
include misinformation about the disease on social media,
difficulties in implementing lockdown, stigmatization, social
hostility, lack of testing and other medical facilities, myths,
perceptions and beliefs, and social and religious factors
32 J. Public Health Dis.
which are discussed below (Klabbers et al., 2023; Khan et
al., 2022).
Misinformation about the disease in the social media
Social media also known as social network help people
spread misleading information that poses a serious
problem for public health information as fast as possible to
a wide range of viewers all over the globe (Sule et al.,
2023; Kim et al., 2019), but this effort is being defeated by
many of those who abuse this medium. Myriads of
information and incident that surge from rumours, hoaxes,
and misinformation regarding COVID-19 aetiology,
prevention, symptoms, and management were circulated
all over the globe. During the pandemic, Twitter,
Facebook, and other platforms have engaged in efforts to
combat misinformation still appearing in prominent pages
and groups (Broniatowski et al., 2023; Kousy et al., 2020)
This misinformation masked healthy behaviours in
preventing the disease and promoting erroneous
behaviours which have been generally accepted by the
population (Tasnim et al., 2020).
Lockdown challenges
COVID-19 lockdown was first implemented in Wuhan
helping to bring the epidemic in China under control rapidly
(WHO, 2020a). The lockdown is necessary to prevent the
health system from being overwhelmed and to bring the
disease under control requires the population to remain
indoors except for the sectors carrying out essential
activities such as health and security (Mockshell and
Ritter, 2023; Mboera et al., 2020). This approach has not
seemed to be successful due to setbacks in its effective
implementation (Altman, 2020). This lockdown faces
serious setbacks in low-income countries due to low
livelihood, lack of shelter, and other basic needs
(O’Connor et al., 2023; Torales et al., 2020).
Stigmatization
No person or group of people is more likely than others to
spread COVID-19 (WHO, 2020b), therefore, maintaining
the privacy and confidentiality of those seeking healthcare
and those who may be part of any contact investigation is
necessary (Gill et al., 2023; CDC, 2020). Due to fear of
stigma, potential contact has refused to report themselves
for testing which leads to isolation by the patient to avoid
discrimination which reduces the patient's possibility of
seeking medical care (Spruijt et al., 2023; Torales et al.,
2020). This reduces the possibility of diagnosing, treating,
and controlling the disease which leads to widespread
infection among those that harbour the virus unknowingly
(Malas and Malas, 2023).
Lack of diagnostics, testing kits, and trained
manpower
The most effective disease control is early diagnosis. Early
detection of infectious disease outbreaks can lead to a
decreased impact on the population (Lindsay and Petra,
2016). The infrastructure, equipment, and manpower
needed to detect COVID-19 that complies with WHO
guidelines is lacking in many low-income and developing
countries thereby narrowing the number of individuals to
be tested (Chong et al., 2023; Giri and Rana, 2020). With
the global shortage of medical masks, ventilators,
intensive care unit beds, and adequate quarantine
facilities, most developing countries rely on locally made
masks which may not be effective in preventing
transmission and insufficient ventilators result in a high
mortality rate (WHO, 2020a). In addition, lack of trained
manpower capable of performing molecular diagnosis
such as PCR required to test for COVID-19, and doctors
on the frontline come down with the disease due to a lack
of protective equipment to protect themselves (Gonete et
al., 2023; Giri and Rana, 2020).
Social and religious factors
The WHO outline practical consideration and
recommendations for religious leaders and faith-based
communities in the context of COVID-19. Religious
leaders play an important role in passing the
information to their members which may not be more
likely accepted from other sources (Nche et al., 2023;
WHO, 2020c). Gatherings have proven to be effective
in the transmission of COVID-19. Religious gathering
that does not comply with national and local should be
cancelled (Khalek and Dollah, 2023; WHO, 2020c). This
is because some communities especially in developing
countries believe religion is the cure for the coronavirus. In
some localities, lockdown and social distancing rules have
been ignored by religious groups who perform activities
regardless of the COVID-19 threat (Dauda, 2023;
Kolifarhood et al., 2020).
Burden of COVID-19
As a result of the implementation of large-scale data
collection methods for examination worldwide and
enhanced methods of validating data, COVID-19 is the
most documented pandemic in history (JHU, 2020).
Improvement in several data sources can contribute to
reasonably accurate estimates and understanding of the
pandemic trends (Wolkewitz and Schumacher, 2017). This
results in an accurate picture of where the pandemic and
the factors that explain its spread. About 214 countries
have reported 19.1 million COVID-19 cases and 715,000
deaths since China reported its first case to the World
Health Organization. The United States leads the world in
confirmed coronavirus cases. Among the 45 countries with
more than 50,000 COVID-19 cases, it has the eighth
highest number of deaths per 100,000 people: 47.93
deaths from the coronavirus 100,000 are Americans. But
in the case of fertility ratio, the United States is significantly
better than many countries. The country's case fatality
ratio is 3.3%, meaning that for every 100 people with
COVID-19, only about three die (JHU, 2020).
RISK FACTORS FOR COVID-19
These risk factors include age, diabetes, heart disease
and hypertension, smoking, blood type and obesity.
Age
COVID-19 can affect any age group, and the risk of dying
from the disease is more common among older people
with associated medical conditions requiring hospitalize-
tion which increases significantly with age (Zsichla and
Müller, 2023; Amitava et al., 2020). The tendency is
because many elderly people have chronic medical
conditions, such as heart disease and diabetes, that can
exacerbate the symptoms of COVID-19 (Haybar et al.,
2020). The ability of the immune system to fight off
pathogens also declines with age, leaving elderly people
vulnerable to severe viral infections (Zhang et al., 2023a;
Subramaniam and Usha., 2011).
Diabetes
Diabetes mellitus is a disease that results in high blood
sugar levels linked to the risk of more severe COVID-19
infections (Khunti et al., 2023; Matteo et al., 2020). People
with type-2 diabetes were more likely to have a critical
case of COVID-19 or to die from the disease compared
with those patients without any underlying health
conditions such as hypertension, heart disease, or
respiratory disease (Shi et al., 2020). This link could also
play a role in poorer outcomes in a person with diabetes
exposed to COVID-19 (Fukushima et al., 2023; Kumar et
al., 2020).
Heart disease and hypertension
Conditions that affect the cardiovascular system, such as
heart disease and hypertension, generally worsen the
complications of COVID-19 (Dele et al., 2023; Huang et
al., 2020). Attacking the lungs directly by the virus might
deplete the body's supply of oxygen to the point that the
heart must work harder to pump oxygenated blood through
Mohammed and Umar 33
the body. The virus might also attack the heart directly, as
cardiac tissue contains angiotensin-converting enzyme 2
(ACE2) — a molecule that the virus plugs into to infect cells
(Xiong et al., 2020). COVID-19 can also initiate an
overblown immune response known as a cytokine storm,
wherein the body becomes severely inflamed and the
heart could suffer damage as a result (Adair et al., 2023;
Zhang et al., 2023b; Susanna et al., 2020).
Smoking
Smoking cigarettes is associated with heightened adverse
disease prognosis(Tonnesen et al., 2019). Suffering organ
damage and requiring breathing support are prone to
severe COVID-19 infections (Park et al., 2018). Smokers
may be vulnerable to catching viral infections because
smoke exposure dampens the immune system over time,
damages tissues of the respiratory tract, and triggers
chronic inflammation (Patanavanich et al., 2023;
Constantine and Katerina., 2020). Smoking is also
associated with a multitude of medical conditions, such as
emphysema and atherosclerosis, which could exacerbate
the symptoms of COVID-19 (Klein et al., 2023; CDC,
2020).
Obesity
Obesity is generally a risk factor for increased risk of
mortality among COVID-19 patients. Obesity increased
food intake, and nutrient/energy imbalance affect immune
deficiency, especially in vulnerable populations (Adair et
al., 2023; Bornstein et al., 2020). Lung and chest capacity
are altered significantly due to fat deposits in the
mediastinum and abdominal cavities. These alterations
reduce lung compliance, chest wall, and the entire
respiratory system, and likely contribute to the respiratory
symptoms of obesity such as wheezing, dyspnea, and
orthopnea (Schachter et al., 2001; Sin et al., 2002). Obese
patients might also have reduced lung capacity or
increased inflammation in the body (Tong et al., 2023,
Adair et al., 2023; Pelosi et al., 1998).
Blood type
Blood type is associated with susceptibility to contracting
COVID-19 (Lu et al., 2020). Individuals with blood types in
the A group (A-positive, A-negative, AB-positive, AB-
negative) were at a higher risk of contracting the disease
compared with non-A-group types. People with an O blood
type had a lower risk of getting the infection compared with
non-O blood types (Moslemi et al., 2023; Cheng et al.,
2005). A person's blood type indicates what kind of certain
antigens cover the surfaces of their blood cells. These
34 J. Public Health Dis.
antigens produce certain antibodies to help fight off a
pathogen (Svensson et al., 2013). COVID-19 SARS
coronavirus (SARS-CoV), anti-A antibodies helped to
inhibit the virus; that could be the same mechanism with
SARS-CoV-2, helping blood group O individuals to keep
out the virus (Ergoren et al., 2023; Guillon et al., 2008;
Cheng et al., 2005).
MODE OF TRANSMISSION
The possible mode of transmission for COVID-19 includes
respiratory, contact, droplet, and fomites.
Respiratory transmission
Coronavirus is a respiratory virus, and as such, the
infectious agent is mainly transmitted through respiratory
droplets of different sizes (aerosols) through coughing and
sneezing that remain suspended in the air when
symptomatic people sneeze or cough. Large droplets
(which are bigger than about 0.0002 inches, or 5 microns,
in size) of virus-laden mucus are the primary mode of
transmission, fine particles that can stay suspended in the
air for hours and can travel with air currents (WHO, 2020d).
It can also occur during medical procedures that generate
aerosols (El-Kassas et al., 2023; Han et al., 2023).
Contact and droplet transmission
COVID-19 can be transmitted directly through infected
secretions such as saliva when an infected person coughs,
sneezes, talks, or sings. In that situation, viral particles
emitted from the respiratory tract of an infected individual
land on a surface. Respiratory droplet transmission can
also occur when a person is in close contact with an
infected person who has respiratory symptoms (e.g.
coughing or sneezing) or who is talking or singing; in these
circumstances, respiratory droplets that include the virus
can reach the mouth, nose or eyes of a susceptible person
and can result in infection (Ali et al., 2023; Ong et al.,
2020). The virus then sneaks into the body via the mucous
membranes, infecting the susceptible person. Indirect
contact transmission involving contact of a susceptible
host with a contaminated object or surface (fomite
transmission) may also be possible (Bahramian et al.,
2023; Zhang et al., 2020).
Fomites transmission
Respiratory secretions or droplets expelled by infected
individuals can contaminate surfaces and objects, creating
fomites (Gharehchahi et al., 2023). Therefore, transmission
may also occur indirectly through touching surfaces in the
immediate environment or objects contaminated with the
virus from an infected person, followed by touching the
mouth, nose, or eyes (Short et al., 2023; Ong et al., 2020).
GENERAL PREVENTION OF COVID-19
The following are general methods of prevention and
control of COVID-19 infection (BMJ, 2020). People should
be recommended to wash their hands often with soap and
water for at least 20 seconds or an alcohol-based hand
sanitizer (containing at least 60% alcohol), especially after
being in public, blowing their nose, or coughing/sneezing
(Begum, 2020; Rundle et al., 2020). Unwashed hands
should not be used to touch the eyes, nose, or mouth
(Jones et al., 2020; Dewangan et al., 2020). Avoid close
contact with others (at least 1 meter, including shaking
hands, especially those who are sick, have a fever, or are
coughing or sneezing (Jamali et al., 2023; Taufik et al.,
2022). Avoid travelling to congested areas (Vichiensan et
al., 2023; Hara and Yamaguchi, 2021). Use respiratory
hygiene such as covering your mouth and nose while
coughing or sneezing, disposing of tissues in a closed bin
quickly, and washing your hands (Adegbite and Ijah, 2023;
Maijama’a et al., 2020). Seek medical attention as soon as
possible if they have a fever, cough, or difficulty breathing.
In some countries or situations, wearing a mask in public
is required (Bogale et al., 2023; Sehatpour et al., 2023;
BMJ, 2020).
People going from high-risk areas may be checked using
questions regarding their journey, interaction with ill
people, signs of infection, and/or temperature testing
(Taggart et al., 2022. Zafri et al., 2022) Shielding is a
protective method used to safeguard vulnerable persons
(including children) who are at extremely high risk of
severe sickness from COVID-19 due to an underlying
health condition (Cowley et al., 2023; Ward et al., 2022).
Shielding entails reducing all encounters between
particularly vulnerable persons and other people to protect
them from virus contact (Sujarwoto and Maharani, 2022).
CONCLUSION/ RECOMMENDATION
The synergy of immunization, face mask-wearing, hand
washing, social distancing, health promotion and
community engagement form a strong framework for
preventing COVID-19. The commitment of public health
and the adoption of evidence-based preventive measures
are fundamental to overcoming the challenges posted by
the disease. Government and non governmental
organization should incorporate the use of intimate
partners, families, social media, emerging technology,
prescription therapy, and regulatory changes to stop
COVID-19. More action are required to meet the national
goal of stopping the COVID-19 epidemic.
CONFLICT OF INTEREST
The authors declare that they have no conflict of interest.
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