For the third time in the written history of humankind, a war has involved most countries of the globe: The world is at war with the coronavirus.1 In this war, the soldiers are dedicated health care workers fighting tirelessly in the frontlines of the battle. “Science” is their only weapon. The generals writing the battle plans for this war must be scientists because every strategy for winning this war must be based on sound scientific evidence. Most world leaders are not scientists but they must listen to scientists.
As in every war, a key factor in winning is following a coherent strategy, and several simple but effective tactics have been implemented to one degree or another in this war. The most important ones include limiting public gatherings in general and attendance at crowded events (such as wedding and funeral ceremonies), particularly by those who feel ill or who carry a higher risk of contracting the infection (eg , older people or those with comorbid conditions); wearing appropriate face masks; frequent hand washing; and social distancing to break the chain of transmission.2
Launching social distancing requirements means closing most governmental and non-governmental workplaces, despite knowing that closure will lead to an economic recession sooner or later.3 Therefore, the government should at least partially compensate people who have lost their jobs and incomes. Otherwise, deaths caused by the recession and broken supply chains could easily exceed those caused by the pandemic. In fact, OXFAM, a confederation of 20 independent charitable organizations focusing on alleviating global poverty, recently projected that, by the end of this year, 12000 people could die each day from hunger linked to the economic crisis caused by COVID-19, potentially more than the number killed by the disease.4 If this projection is accurate, Venezuela, South Sudan, Yemen, Brazil, and India will be among the counties most affected by such widespread starvation.
To avoid recession, some countries have prematurely reopened their economies. As a result, many people mistakenly believe that the epidemic is passing, leading to reductions in the use of personal protective equipment, social distancing, and hand washing. People who have lived in isolation for several weeks, without contacts with friends and family, seem to have lost their sensitivity (la belle indifférence ) to the danger and have overlooked the gravity of the situation in their rush to return to the normal life they had had before the pandemic.
As expected, however, the number of new COVID-19 cases sharply increased soon after businesses reopened. This sharp increase has already occurred in some Iranian cities. According to the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, if Iranians continue with careless behaviors, the number of COVID-19 cases will begin to increase exponentially.5 We were supposed to defeat the virus. Instead, we may defeat our own soldiers—the health care workers.
A recent report shows that the virus, which was thought to be transmitted solely through droplets, might also have the potential for air-borne spread.6 If so, conventional face masks, which only slow the spread of the virus by stopping droplets, will provide far less protection.
To win this war, we must strictly follow the simple rules that we know are effective; otherwise, health care facilities will be stressed beyond capacity, the number of health care workers will be inadequate, most of these workers will be exhausted and some will be infected, and the health care system could collapse. Although health care facilities can be expanded relatively quickly, the number and effectiveness of health care providers can decline faster than they can be improved. Thus, we must greatly increase our “force protection” abilities by securing the logistical and social support they need to win the war.
The world is now infected with this new virus. The enemy is at the gates. Face masks substantially reduce the risk of viral transmission, but only if they are worn. Reducing transmission will protect our soldiers, the health care workers who are fighting the virus so ardently. They are real heroes and deserve so much better than we have given them so far.