Deadly Droplets
Many people are still half-heartedly following the government’s call to abide by physical restriction policies and to wear face masks when in public spaces.
As part of the implementation of the 2020 Great Safety Operation, the Bali Police distribute masks and hand sanitizer to residents in Kereneng Market area, Denpasar City, Thursday (9/4/2020).
Many people are still half-heartedly following the government’s call to abide by physical restriction policies and to wear face masks when in public spaces. Such calls should be adhered to main one’s health and to prevent the further spread of the deadly COVID-19.
Limiting activities is part of the efforts to prevent the novel coronavirus transmission. Yet, some people are not fully aware of the purpose of such restrictions.
Also read: Control Citizens\' Mobility
From 13 April 2020 through 19 May 2020, the Jakarta Police conducted crack downs on 70,448 people who violated rules on social restrictions in the Jakarta area. Most of the violations related to people who did not wear face masks (29,806 cases) and motorists who did not comply with limitations on number of passengers (11,992 cases). (http://korlantas.polri.go.id/artikel/korlantas/2957? Ditlantas_Polda_Metro_Jaya_Catat_70.448_Pelanggar_PSBB,_Ini_Rinciannya)
In fact, both types of violations are crucial points in the prevention of coronavirus transmission. Not just Covid-19, some diseases like tuberculosis, SARS and respiratory infection, can also be prevented by applying physical restrictions and wearing face masks.
Those infectious diseases are transmitted through droplets. One droplet from a patient when talking, coughing or sneezing is very dangerous for people around him or her because it produces thousands of germs that are ready to infect.
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Residents who are not wearing masks are gathered in an operation for the implementation of the large-scale social restraints (PSBB) operation on Jl. Merdeka, Bogor City, West Java, Friday (1/5/2020).
Droplets are dangerous in that they can transmit infectious disease. The danger from this model of transmission is that the diseases that are spread through droplets can be transmitted by an infected person while talking, coughing or sneezing.
Droplets (https://www.ncbi.nlm.nih.gov/books/NBK143281/) can be spread through a short distance through the air or directly to someone’s eyes, mouth or nose if he or she doesn\'t wear protective equipment, or to the surface of the surrounding environment.
Patients with tuberculosis or TB, for example, in one cough, can produce around 3,000 sputum or mucus containing 3,500 tuberculosis germ (http://hukor.kemkes.go.id/uploads/produk_hukum/PMK_No._67_ttg_Penanggulangan_Tuberkolosis_.pdf). Even if a tuberculosis patient sneezes, the germs he or she produces can reach up to 1 million tuberculosis mycobacterium.
The higher the number of germs in the droplet, means the greater risk of transmission.
The higher the number of germs in the droplet, means the greater risk of transmission. In addition, the longer and more often someone is exposed to germs, the greater the risk of transmission.
In the case of tuberculosis transmission, infection occurs when a vulnerable person inhales microorganisms that contain TB germs through the mouth or nose, upper respiratory tract, bronchi to reach the alveoli.
Droplet test
An important phase in the transmission of some of these dangerous diseases is paying attention to the droplets, which can be in the form of spit or sputum droplets. Droplets are an important instrument in the circle infectious diseases such as Covid-19 and TB.
Not surprisingly, examination of sputum is an important instrument in the handling people suspected of contracting tuberculosis bacteria. Besides TB disease, sputum examination is also administered on several diseases, like MERS and Covid-19 corona.
The procedure of laboratory examination for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) at the Health Ministry requires sputum specimens to be tested. Sputum taken from the lower respiratory tract is the best specimen for MERS diagnosis. (https://www.kemkes.go.id/resources/download/puskes-haji/3-pedoman-pengambilan-spesimen-dan-pemeriksaan-laboratorium-merscov.pdf)
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An officer wears #jagajarak mask in the dissemination of information on Operation Safety 2020 by the Jakarta Police in the Gelora Bung Karno area, Jakarta, Monday (6/4/2020). Jakarta Police will continue to appeal not to gather together and maintain physical distance.
So is the test for Covid-19 disease specimens, which is now a world pandemic. The specimens that must be included in Covid-19 examination (https://bebas.kompas.id/baca/bebasakses/2020/03/06/protokol-k Kesehatan-penangan-covid-19-disusun/), includes phlegm, nasal or throat swab, nasopharyngeal swab, endotracheal, as well as blood.
Sputum examination in TB patients is performed by collecting two sample phlegm test collected in the form of phlegm in the morning (SP) and at any times (SS). In addition, there is also a quick test check molecular (TCM) which is carried out for diagnosis.
Meanwhile, the Covid-19 test can use
(https://covid19.go.id/p/protokol/edoman-prevention-andcontrol-coronavirus-disease-covid-19) antibody rapid test method or antigen rapid test. Both the antibody and antigen rapid tests can also be used to detect cases of people under monitoring (ODP) and patient under surveillance (PDP). In the antigen rapid test, the specimen needed for this test is an oropharyngeal swab or nasopharyngeal swab.
However, the two test models are only initial screening, of which the results of the rapid antibody and antigen test must be confirmed again using the RT-PCR test method.
Danger of droplet
Even if it is only droplets, infection through droplets can have a dangerous impact.
The acute respiratory illness or Severe Acute Respiratory Syndrome or SARS (https://www.cdc.gov/sars/about/faq.html) which transmitted through droplets has infected 8,096 people in 27 countries during the period November 2002 to July 2003. SARS has killed 774 people.
The World Health Organization (WHO) noted SARS outbreaks mostly occurred in China and Hong Kong. As for Indonesia (https://www.who.int/csr/sars/country/table2004_04_21/en/), there were 2
SARS cases in the period 2002-2003.
Another disease transmitted through droplets is acute upper respiratory tract infection (ISPA). Symptoms of ISPA are characterized by fever, coughing, joint pain, sore throat, shortness of breath and nasal congestion. The Basic Health Research (Riskesdas) 2018 noted the prevalence of ISPA in Indonesia (http://sehatnegeriku.kemkes.go.id/baca/rilismedia/20181102/0328464/potret-sehat-indonesia-riskesdas-2018/) was as much as 4.4 percent.
Cases of forest fires and land fires become one of the triggers of ISPA in Indonesia. Thick smoke from forest and land fires in Riau (https://kompas.id/baca/utama/2019/09/18/penderita-ispa-di-riaucapai-300-000-orang/) causes 304,994 people suffered from acute respiratory infections during January to 17 September 2019.
No less dangerous infections are tuberculosis or TB transmission. Based on WHO data in 2018, the estimated number of tuberculosis or TB cases worldwide reaches 10 million. In Indonesia TB cases in 2018 reached 845,000 (https://www.who.int/tb/publications/global_report/tb19_Report_country_profiles_15October2019.pdf?ua=1). Death rate or case fatality rate has reached 12 percent. (https://extranet.who.int/sree/Reports?op=Replet&name=/WHO_HQ_Reports/G2/PROD/EXT/TBCountryProfile&ISO2=ID&outtype=pdf)
At present, the world faces the Covid-19 pandemic which continues to be on the alert because it is easily transmitted through droplets. John Hopkins University and Medicine website noted as of 24 May 2020 there are (https://coronavirus.jhu.edu/map.html) 5,428,605 positive cases of Covid-19 in 188 countries or territories. The death toll reached 345,375 people.
Common symptoms of corona infection include fever of more than 38 degrees Celsius, dry cough and shortness of breath. Someone can be infected (https://covid19.kemkes.go.id/situasi-infection-emerging/info-coronavirus/tanya- responsible-coronavirus-disease-covid-19-qna-update-6-maret2020/#Apa_saja_gejala_COVID-19) from Covid-19 sufferers because this disease can spread through small droplets from the nose or mouth when coughing or sneezing. Someone who accidentally inhales droplets from sufferers can be infected with Covid-19.
In addition, droplets can also be harmful when they are left on objects around us. If someone else touches an object already contaminated with the droplet, then the person touches the eyes, nose or mouth, that person can be infected with Covid-19.
Self-awareness
An introduction to acute respiratory disease infections is necessary to reduce the risk of spreading the virus. Apart from droplets, there is also the possibility of transmission through other means, such as through contact with hands or by touching a contaminated object.
Hopefully, by having information about infection prevention and control, the public can help stop the spread of COVID-19.
Another way is to wear face masks, both the sufferers and the healthy citizens to reduce spread of droplets from infected patients.
At the very least, this public awareness can be realized in two stages, namely through ethical aspects of prevention and through physical distancing. Ethical aspects can be done by reducing droplets when coughing or sneezing. It can be done by closing the mouth and nose with hands when sneezing or coughing. Another way is to wear face masks, both the sufferers and the healthy citizens to reduce spread of droplets from infected patients.
Another good habit to maintain is cleaning your hands with soap or hand sanitizer to minimize infections arising from germs due to droplets.
The second aspect is awareness of physical restrictions and to avoid crowds. Given the fact that droplets may come out from the patient\'s nose or mouth when coughing or sneezing, keeping a distance of approximately 1-meter from sick people is important.
Transmission through physical contact is a risk that is always faced by the public. Precautions must be taken to avoid the risk of infection due to direct contact.
Looking at how easy it is for deadly diseases like TB and Covid-19 to spread, the government’s policies in the form of social restrictions can be understood as part of efforts to prevent disease transmission.
By understanding the substance of the government policy, public adherence to restrictions are expected to come out as a form of self-awareness to help prevent the transmission of this plague. (KOMPAS R&D)
