F.A.C.E. C.O.V.I.D.

Dr. Minhaj A. Qidwai

M.B.,B.S., M.P.H., M.B.A., C.M.C.
Healthcare Management and Public Health Consultant
4S THERAPY-ISSUES IN MANAGING COVID
• SELF
• FAMILY, WORK, HOME OFFICE, EMOTIONS, BURNOUT, FATIGUE, TIME,
FITNESS……
• SYSTEM
• HEALTH SERVICE DELIVERY, EFFECTIVE AND EFFICIENT UTILIZATION OF
RESOURCES, COORDINATION, INFORMATION, TRACKING ……
• STATE
• DISEASE CONTROL, ROLES OF NDMA/PDMA, HEALTH DEPARTMENT,
PROVINCES, RESOURCES, VACCINE-PROCUREMENT, AVAILABILITY,
ACCESIBILITY, --
• SOCIETY
• SOPs’, BEHAVIOR CHANGE, FAMILIES-PATIENTS……..
• 55%-threat of coronavirus is exaggerated.
• Willingness to get vaccinated-65% in March; in July 2021, 66%.
• Almost 60% still do not know how to register for vaccination.
• 37%-Corona is a conspiracy.
• 95%-Claim not to have contracted with Corona Virus-SOCIAL STIGMA?.
• 16%-Claim know of someone losing life due to Corona.
• 88%-Believe that Corona will be controlled in near future.
Source: Gallup Pakistan Coronavirus Attitude Tracker Survey 2021, Wave 11
1. *Proud Pakistani* (Both vaccines)
2. *Worried Pakistani* (One vaccine)
3. *Helpless Pakistani* (No vaccine)
4. *Confused Pakistani* (Which vaccine)
5. *Perplexed Pakistani* (Covid after 2 vaccines)
6. *Disappointed Pakistani* (Unable to get the desired vaccine)
7. *Courageous Pakistani* (Moving around without masks)
8. *Disbelief Pakistani* (There is nothing like Corona)
9. *Addicted Pakistani* (Daily visiting for shopping at malls, stores etc.)
10.*Panicked Pakistani* (Keep wearing 2 mask 24 hours)
11.*Suicidal Pakistani* (Keep visiting the market without wearing a mask)
12.*Arrogant Pakistani* (How dare you ask me to ware a mask?)
13.*Self-Assured Pakistani* (Keeping the mask in pocket)
14.*Appeasing Pakistani* (Wearing mask but not covering nose)
15. *Mourning Pakistani* (Family member or Friend died of Covid)
16.*Regulated Pakistani* (Take regular precautions)
17. *Undecided Pakistani* (Delayed decisions while dealing with Covid)
 COVID-DELAYS IN DECISION

PRE-ONSET OF COVID ONSET OF COVID ONSET OF COVID COVID COMPLIACTIONS

SELF
SELF SELF SELF
• ICU/VENTILATOR
• AWARE • SYMPTOMS AWARE • RETEST-FREE OF
• ASSESSMENT
• PRECAUTIONS- • TEST-AVAILABILITY DISEASE
• FOURTH DELAY
YES AND NO AFFORDABILITY • COMPLICATIONS • RECOVERY-IF
• FIRST DELAY • STIGMA-YES/NO • WHAT TO DO?
DEATH
• DANGEROUS FOR • SECOND DELAY • WHERE TO GO?
• FIFTH DELAY
SOCIETY • TEST POSITIVE- • THIRD DELAY • BODY RETRIEVAL
ISOLATION • HOSPITALIZATION • BURIAL
• FAMILY TRACING • RECOVERED

BEHAVIOUR BEHAVIOUR BEHAVIOUR

 PRE-CONTEMPLATION
SYMPTOMS DENIAL OF COVID
FOLLOW SOPs’
CONTEMPLATION
WEAR MASK SEES THE POSSIBILITY OF
THINKING TO APPLY
CHANGE BUT UNCERTAIN
PROTECTION
TEST AND APPROPRIATE
MEASURES KEEPING MASK IN POCKET
RAISE AWARENESS
BE THE ROLE MODEL HELPING TO CHOSE
Behavior Change CHANGE

MAINTENANCE Way Forward

HAS STARTED
DETERMINATION
ACTION COMMITTED TO
ACTIONS ACTIONS BUT NOT CHANGE
STABILIZED
MAINTAINING IT
DOES NOT KNOW
NOT CONSISTENT WHAT TO DO?
SUPPORT TO
MAINTAIN HELP IMPLEMENT IDENTIFY CHANGE
Relapse CHANGES STRATEGIES
F: FEAR: FUTURE EVENTS APPEARING REAL
• FACE EVERYTHING AND REGULATE
A: ANXIETY-ALLAY=PRAYING/YOGA/MEDITATION, ADEQUATE REST/SLEEP
C: COMMITMENT
E: EMOTIONS, EMPATHY, EXERCISE
C: CHANGE BEHAVIOR
O: OBSERVATION, OPTIMISM
V: VALUE TODAY
I: IMMUNITY TO BE BUILT THROUGH DIET
D: DISINFECTION
F: FEAR-FUTURE EVENTS APPEARING REAL,
• FACE EVERYTHING AND REVOLUTIONIZE
A: ACCEPT THE SITUATION
C: COMMUNICATION
E: EMPATHY, EXPECTATIONS
C: COLLABORATE
O: ORGANIZATIONS TO SUPPORT
V: VERIFY ALL THE INFORMATION
I: IDENTIFY RESOURCES TO SUPPORT SYSTEM
D: DETERMINATION
F: FEAR-FUTURE EVENTS APPEARING REAL
• FACE EVERYTHING AND RISE

A: APPRORIATE POLICY DECISIONS

C: CONFIDENT LEADERSHIP
E: ECONOMY, ENGAGE, EDUCATE, ENFORCE
C: COORDINATION, CLEARING HOUSE FOR INFORMATION/CHANGE
BEHAVIOR
O: OPENNESS
V: VACCINE PROCUREMENT
I: INFORMATION MANAGEMENT
D: DELIVERY OF SERVICES
F: FEAR: FUTURE EVENTS APPEARING REAL
• FOCUS ON EVERYTHING AND REORGANIZE

A: APPROPRIATE SERVICES
C: CAPACITY BUILDING
E: EMPOWER COMMUNITY
C: CONTROL DISEASE
O: OPERATIONAL MANAGEMENT
V: VENTILATORS AND PPEs
I: INFORMATION/INSTITUTIONS
D: DETECT-TEST-ISOLATE-TREAT EVERY CASE AND TRACE EVERY CONTACT
F: FEAR OF VACCINATION
A: AVAILABILITY
C: CONCERNS
E: EFFICACY AND SAFETY
C: CONSPIRACY
O: OBSERVATIONS
V: VACCINE SELECTION
I: INJECTION SAFETY
D: DISPOSAL OF WASTE
F: FEAR OF VACCINATION
• FACE EVERYTHING AND READ

A: AVAILABILITY: SINOVAC/MODERNA/PFIZER/ASTRA/SPUTNIK/OTHERS
C: CONCERNS:
• WILL THE VACCINE PREVENT US FROM GETTING COVID?
• WILL THE VACCINE PREVENT TRANSMISSION OF COVID?
• AFTER VACCINATION DO WE STILL NEED TO FOLLOW SOPSs’?
• HOW LONG THE IMMUNITY WILL LAST?
• WHAT ARE THE RISKS IN RECEIVING VACCINE?
• WILL mRNA BASE VACCINES BRING ANY GENETIC MUTATIONS?

E: EFFICACY AND SAFETY: SINOVAC/MODERNA, PFIZER, SPUTNIK, ASTRA

C: CONSPIRACY: REALITY OF COVID! MYTHS!
O: OBSERVATIONS:
• PAST VACCINE FAILURE

• UNKNOWN FUTURE

• PUSH FOR A QUICK SOLUTION VACCINE

• NOT A LONG PERIOD OF TRIALS AND SUBJECTS-JJ TRIAL STOPPED

V: VACCINE SELECTION: IS IT IN OUR HANDS?

I: INJECTION SAFETY: MISUSE OF USED SYRINGES
D: DISPOSAL OF WASTE: NO COMPREHENSIVE MECHANISM
F: FEAR-FUTURE EVENTS APPEARING REAL
• FACE EVERYTHING AND RISE

A: ALLAY ANXIETY-ACKNOWLEDGE AND ACCEPT THE SITUATION

C: CHANGE BEHAVIOR
E: EMPETHIZE AND ENGAGE
C: CLEARING HOUSE FOR INFORMATION
O: OPENNESS, OPTIMISM
V: VALUE TODAY AND VACCINE
I: IMMUNITY DEVELOPMENT
D: DEECTION, DELIVERY OF SERVICES AND DISINFECTION