EXAMINATION OF COVID-19 SAFETY COMPLIANCE LEVEL IN THE BANKING SECTOR

CHAPTER TWO

LITERATURE REVIEW

2.0 INTRODUCTION

Our focus in this chapter is to critically examine relevant literature that would assist in explaining the research problem and furthermore recognize the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps.

2.1 CONCEPTUAL FRAMEWORK

CONCEPT OF COMPLIANCE

Compliance is a type of social influence where an individual does what someone else wants them to do, following his or her request or suggestion. It is similar to obedience, but there is no order – only a request. According to Breckler, Olson, and Wiggins (2006) Compliance refers to a change in behavior that is requested by another person or group; the individual acted in some way because others asked him or her to do so (but it was possible to refuse or decline.). Generally, compliance means adhering to a rule, such as a policy, standard, specification, or law. Regulatory compliance defines the goals companies want to achieve to ensure that they understand and take the necessary steps to comply with policies, relevant laws, and regulations.

CORONAVIRUS

Corona virus is a large group of viruses that resemble a crown. The word corona is a Latin word meaning crown (https://www.cdc.gov/coronavirus/types.html). There are different types of corona viruses and people around the world commonly get infected with human corona viruses 229E, NL63, OC43, and HKU1. The Middle East Respiratory Syndrome or MERS-CoV; Severe Acute Respiratory Syndrome or SARS; and novel Corona virus or SARS-CoV-2 are all caused by corona viruses and result in severe respiratory illnesses.

The 2019 novel corona virus (SARS-CoV-2, which causes the COVID-19), was first identified in Wuhan, China, among people having pneumonia. These ones were associated with seafood and live animal market https://openwho.org/courses/introduction-to-ncov. In China as of February 14, 2020, there were 51986 confirmed cases in a single province (Hubei); out of which 1318 cases died Yong et. al (2020). The first case of corona virus reported in Nigeria was confirmed on February 27th by an Italian man who arrived Nigeria from Milan, stayed in the country for almost two days before being isolated. Before now, he had travelled through Lagos and visiting other places in the country. It was reported that he spend a night in hotel close to the airport and later visited the neighboring state of Ogun on February 25, 2020. That is, the company where he worked in Ogun state. No one suspected him until he began to develop a serious fever and body aches on the afternoon of February 26, 2020. The company Health workers then contacted bio-security authority who transferred him to a containment facility in Yaba, Lagos state The infection was confirmed on February 27, 2020 by the Virology Laboratory of the Lagos University Teaching Hospital, part of the Laboratory Network of the Nigeria Center for Disease Control were contacted, the man was quarantine under closer monitoring and responded to treatment.

Routes of transmission of the virus include respiratory droplets and fecal-oral Yong et. al (2020). The virus invades the oral cavity, respiratory mucosa and conjunctiva, and has been through coughing, sneezing, contaminated hands, foods, and water.

2.1.1 Transmission

The role of the Huanan Seafood Wholesale Market in propagating disease is unclear. Many initial COVID-19 cases were linked to this market suggesting that SARS-CoV-2 was transmitted from animals to humans. However, an ergonomic study has provided evidence that the virus was introduced from another, yet unknown location, into the market where it spread more rapidly, although human-to-human transmission may have occurred earlier [Yu W,et al.2020]. Clusters of infected family members and medical workers have confirmed the presence of person-to-person transmission [Yu W,et al.2020]. After January 1, less than 10% of patients had market expo- sure and more than 70% patients had no exposure to the market [Yu W, et’al. 2020]. Person-to-person transmission is thought to occur among close contacts mainly via respiratory droplets produced when an infected person coughs or sneezes. Fomites may be a large source of transmission, as SARS-CoV has been found to persist on surfaces up to 96h [Kramer A, et al.2016] and other corona viruses for up to 9 days.Whether or not there is asymptomatic transmission of disease is controversial. Findings about disease characteristics are rapidly changing and subject to selection bias. A study indicated the mean incubation period was 5.2 days (95% confidence interval [95%CI]: 4.1–7.0). The incubation period has been found to be as long as 19 or 24 days , although case definitions typically rely on a 14 day window (G.S 2020).

The basic reproductive number (R0) has been estimated with varying results and interpretations. R0 measures the average number of infections that could result from one infected individual in a fully susceptible population. Studies from previous outbreaks found R0 to be 2.7 for SARS and 2.4 for 2009 pandemic H1N1 influenza. One study estimated that that basic reproductive number (R0) was 2.2 (95% CI: 1.4–3.9). However, later in a further analysis of 12 available studies found that R0 was 3.28. Because R0 represents an average value it is also important to consider the role of super spreaders, who may be hugely responsible for outbreaks within large clusters but who would not largely influence the value of R0. During the acute phase of an outbreak or pre pandemic, R0 may be unstable .

In pregnancy, a study of nine pregnancy women who developed COVID-19 in late pregnancy suggested COVID-19 did not lead to substantially worse symptoms than in nonpregnant persons and there is no evidence for intrauterine infection caused by vertical transmission [Chen HEA 2020].

In hospital setting, a study involving 138 COVID-19 suggested that hospital-associated transmission of SARS-CoV-2 occurred in 41% of patients [Wang. D 2020 ].

2.1.2 Risk factors

The incidence of SARS-CoV-2 infection is seen most often in adult male patients with the median age of the patients was between 34 and 59 years. SARS-CoV-2 is also more likely to infect people with chronic comorbidities such as cardio- vascular and cerebrovascular diseases and diabetes. The highest proportion of severe cases occurs in adults 60 years of age, and in those with certain underlying conditions, such as cardiovascular and cerebrovascular diseases and diabetes. Severe manifestations maybe also associated with co-infections of bacteria and fungi [Chen N. et’al 2020].

Fewer COVID-19 cases have been reported in children less than 15 years [20,30,7,32]. In a study of 425 COVID-19 patients in Wuhan, published on January 29, there were no cases in children under 15 years of age. Nevertheless, 28 pediatric patients have been reported by January 2020. The clinical features of infected pediatric patients vary, but most have had mild symptoms with no fever or pneumonia, and have a good prognosis. Another study found that although a child had radiological ground-glass lung opacities, the patient was asymptomatic. In summary, children might be less likely to be infected or, if infected, present milder manifestations than adults; therefore, it is possible that their parents will not seek out treatment leading to underestimates of COVID-19 incidence in this age group.

2.1.3 Pathogenesis and immune response

Like most other members of the coronavirus family, Beta- coronavirus exhibit high species specificity, but subtle genetic changes can significantly alter their tissue tropism, host range, and pathogenicity. A striking example of the adaptability of these viruses is the emergence of deadly zoonotic diseases in human history caused by SARS-CoV and MERS-CoV. In both viruses, bats served as the natural reservoir and humans were the terminal host, with the palm civet and dromedary camel the intermediary host for SARS-CoV and MERS-CoV, respectively. Intermediate hosts clearly play a critical role in cross species transmission as they can facilitate increased contact between a virus and a new host and enable further adaptation necessary for an effective replication in the new host. Because of the pandemic potential of SARS- CoV-2, careful surveillance is immensely important to monitor its future host adaptation, viral evolution, infectivity, transmissibility, and pathogenicity.

The host range of a virus is governed by multiple molecular interactions, including receptor interaction. The envelope spike (S) protein receptor binding domain of SARS-CoV-2 was shown struc- turally similar to that of SARS-CoV, despite amino acid variation at some key residues . Further extensive structural analysis strongly suggests that SARS-CoV-2 may use host receptor angiotensin-converting enzyme 2 (ACE2) to enter the cells, the same receptor facilitating SARS-CoV to infect the airway epithelium and alveolar type 2 (AT2) pneumocytes, pulmonary cells that synthesize pulmonary surfactant. In general, the spike protein of coronavirus is divided into the S1 and S2 domain, in which S1 is responsible for receptor binding and S2 domain is responsible for cell membrane fusion. The S1 domain of SARS-CoV and SARS- CoV-2 share around 50 conserved amino acids, whereas most of the bat-derived viruses showed more variation. In addition, identification of several key residues (Gln493 and Asn501) that govern the binding of SARS-CoV-2 receptor binding domain with ACE2 further support that SARS-CoV-2 has acquired capacity for person- to-person transmission. Although, the spike protein sequence of receptor binding SARS-CoV-2 is more similar to that of SARS- CoV, at the whole genome level SARS-CoV-2 is more closely related to bat-SL-CoVZC45 and bat-SL-CoVZXC21.

However, receptor recognition is not the only determinant of species. Immediately after binding to their receptive receptor, SARS-CoV-2 enters host cells where they encounter the innate immune response. In order to productively infect the new host, SARS-CoV-2 must be able to inhibit or evade host innate immune signaling. However, it is largely unknown how SARS- CoV-2 manages to evade immune response and drive pathogenesis. Given that COVID-19 and SARS have similar clinical features, SARS-CoV-2 may have a similar pathogenesis mechanism as SARS- CoV. In response to SARS-CoV infections, the type I interferon (IFN) system induces the expression of IFN- stimulated genes (ISGs) to inhibit viral replication. To overcome this antiviral activity, SARS- CoV encodes at least 8 viral antagonists that modulate induction of IFN and cytokines and evade ISG effector function .

The host immune system response to viral infection by mediating inflammation and cellular antiviral activity is critical to inhibit viral replication and dissemination. However, excessive immune responses together with effects of the virus on host cells will result in pathogenesis. Studies have shown patients suffering from severe pneumonia, with fever and dry cough as common symptoms at onset of illness . Some patients progressed rapidly with Acute Respiratory Stress Syndrome (ARDS) and septic shock, which was eventually followed by multiple organ failure and about 10% of patients have died. ARDS progression and extensive lung dam- age in COVID-19 are further indications that ACE2 might be a route of entry for the SARS-CoV-2 as ACE2 is known abundantly present on cilia ted cells of the airway epithelium and alveolar type II (cells (pulmonary cells that synthesize pulmonary surfactant) in humans.

Patients with SARS and COVID-19 have similar patterns of inflammatory damage. In serum from patients diagnosed with SARS, there is increased levels of pro-inflammatory cytokines (e.g. interleukin (IL)-1, IL6, IL12, interferon gamma (IFNγ), IFN- γ- induced protein 10 (IP10), macrophage inflamatory proteins 1A (MIP1A) and monocyte chemo-attractant protein-1 (MCP1)), which are associated with pulmonary inflamation and severe lung damage [45]. Likewise, patients infected with SARS-CoV-2 are reported to have higher plasma levels of pro-inflamatory cytokines including IL1β, IL-2, IL7, TNF-α, GSCF, MCP1 than healthy adults [Huang C, et al.2020]. Importantly, patients in the intensive care unit (ICU) have a significantly higher level of GSCF, IP10, MCP1, and TNF- α than those non-ICU patients, suggesting that a cytokine storm might be an underlying cause of disease severity [Huang C, et al.2020]. Unexpectedly, anti-inflamatory cytokines such as IL10 and IL4 were also increased in those patients [Huang C, et al.2020], which was uncommon phenomenon for an acute phase viral infection. Another interesting finding, as explained before, was that SARS-CoV-2 has shown to preferentially infect older adult males with rare cases reported in children [Huang C, et al.2020]. The same trend was observed in primate models of SARS-CoV where the virus was found more likely to infect aged Cynomolgus macaque than young adults . Further studies are necessary to identify the virulence factors and the host genes of SARS-CoV-2 that allows the virus to cross the species specific barrier and cause lethal disease in humans.

2.1.4 Clinical manifestations

Clinical manifestations of 2019-nCoV infection have similarities with SARS-CoV where the most common symptoms include fever, dry cough, dyspnoea, chest pain, fatigue and myalgia [Huang C, et al.2020]. Less common symptoms include headache, dizziness, abdominal pain, diarrhoea, nausea, and vomiting [Huang C, et al.2020]. Based on the report of the first 425 confirmed cases in Wuhan, the common symptoms include fever, dry cough, myalgia and fatigue with less common are sputum production, headache, haemoptysis, abdominal pain, and diarrhoea. Approximately 75% patients had bilateral pneu- monia. Different from SARS-CoV and MERS-CoV infections, however, is that very few COVID-19 patients show prominent upper respiratory tract signs and symptoms such as rhinorrhoea, sneezing, or sore throat, suggesting that the virus might have greater preference for infecting the lower respiratory tract [Huang C, et al.2020]. Pregnant and non-pregnant women have similar characteristics. The common clinical presentation of 2019-nCoV infection are presented in Table 1.

Severe complications such as hypoxaemia, acute ARDS, arry- thmia, shock, acute cardiac injury, and acute kidney injury have been reported among COVID-19 patients [Huang C, et al.2020]. A study among 99 patients found that approximately 17% patients developed ARDS and, among them, 11% died of multiple organ failure. The median duration from first symptoms to ARDS was 8 days .

2.1.5 Diagnosis

Efforts to control spread of COVID-19, institute quarantine and isolation measures, and appropriately clinically manage patients all require useful screening and diagnostic tools. While SARS-CoV- 2 is spreading, other respiratory infections may be more common in a local community. The WHO has released a guideline on case surveillance of COVID-19 on January 31, 2020. For a person who meets certain criteria, WHO recommends to first screen for more common causes of respiratory illness given the season and location. If a negative result is found, the sample should be sent to referral laboratory for SARS-CoV-2 detection.

Case definition can vary by country and will evolve over time as the epidemiological circumstances change in a given location. In China, a confirmed case from January 15, 2020 required an epidemiological linkage to Wuhan within 2 weeks and clinical features such as fever, pneumonia, and low white blood cell count. On January 18, 2020 the epidemiological criterion was expanded to include con- tact with anyone who had been in Wuhan in the past 2 weeks [50].

The WHO has put forward case definitions. Suspected cases of COVID-19 are persons (a) with severe acute respiratory infections (history of fever and cough requiring admission to hospital) and with no other aetiology that fully explains the clinical presentation and a history of travel to or residence in China during the 14 days prior to symptom onset; or (b) a patient with any acute respiratory illness and at least one of the following during the 14 days prior to symptom onset: contact with a confirmed or probable case of SARS-CoV-2 infection or worked in or attended a health care facility where patients with confirmed or probable SARS-CoV-2 acute respiratory disease patients were being treated. Probable cases are those for whom testing for SARS-CoV-2 is inconclusive or who test positive using a pan-coronavirus assay and without laboratory evidence of other respiratory pathogens.

A confirmed case is one with a laboratory affirmation of SARS-CoV-2 infection, irrespective of clinical signs and symptoms.

For patients who meet diagnostic criteria for SARS-CoV-2 testing, the CDC recommends collection of specimens from the upper respiratory tract (nasopharyngeal and oropharyngeal swab) and, if possible, the lower respiratory tract (sputum, tracheal aspirate, or bronchoalveolar lavage). In each country, the tests are per- formed by laboratories designated by the government.

2.1.8 Treatments

Similar to MERS-CoV and SARS-CoV, there is still no specific antiviral treatment for COVID-19. Isolation and supportive care including oxygen therapy, fluid management, and antibiotics treatment for secondary bacterial infections is recommended. Some COVID-19 patients progressed rapidly to ARDS and septic shock, which was eventually followed by multiple organ failure [Huang C, et al.2020]. Therefore, the effort on initial management of COVID-19 must be addressed to the early recognition of the suspect and contain the disease spread by immediate isolation and infection control measures .

Currently, no vaccination is available, but even if one was avail- able, uptake might be sub-optimal. A study of intention to vaccinate during the H1N1 pandemic in the United States was around 50% at the start of the pandemic in May 2009 but had decreased to 16% by January 2010.

Neither is a treatment available. Therefore, the management of the disease has been mostly supportive referring to the disease severity which has been introduced by WHO. If sepsis is identified, empiric antibiotic should be administered based on clinical diagnosis and local epidemiology and susceptibility information. Routine glucocorticoids administration are not recommended to use unless there are another indication. Clinical evidence also does not support corticosteroid treatment. Use of intravenous immunoglobulin might help for severely ill patients .

Drugs are being evaluated in line with past investigations into therapeutic treatments for SARS and MERS. Overall, there is not robust evidence that these antivirals can significantly improve clinical outcomes A. Antiviral drugs such as oseltamivir combined with empirical antibiotic treatment have also been used to treat COVID- 19 patients [Huang C, et al.2020]. Remdesivir which was developed for Ebola virus, has been used to treat imported COVID-19 cases in US [Holshue ML, 2020]. A brief report of treatment combination of Lopinavir/Ritonavir, Arbidol, and Shufeng Jiedu Capsule (SFJDC), a traditional Chinese medicine, showed a clinical benefit to three of four COVID-19 patients [Holshue ML, 2020]. There is an ongoing clinical trial evaluating the safety and efficacy of lopinavir-ritonavir and interferon-α 2b in patients with COVID- 19 [Huang C, et al.2020]. Ramsedivir, a broad spectrum antivirus has demonstrated in vitro and in vivo efficacy against SARS-CoV-2 and has also initiated its clinical trial. In addition, other potential drugs from existing antiviral agent have also been proposed.

2.1.9 Control and prevention strategies

COVID-19 is clearly a serious disease of international concern. By some estimates it has a higher reproductive number than SARS, and more people have been reported to have been infected or died from it than SARS. Similar to SARS-CoV and MERS-CoV, disrupting the chain of transmission is considered key to stopping the spread of disease. Different strategies should be implemented in health care settings and at the local and global levels.

To prevent further spread of the virus, civil societies, and government agencies-initiated awareness programs for promotions of several preventive measures. Body temperature screening was conducted at airports and those returning from countries with a high number of confirmed cases of COVID-19 were advised to self-isolate. The Nigeria Center for Disease Control in collaboration with State governments also initiated tracing and tracking of victims and their contacts. On 18th March 2020, the Nigerian government prohibited all gatherings of fifty people or above for four weeks and ordered a stay-at-home (Ewodage, 2020). Similarly, the Nigerian government, on 30th March 2020 introduced various containment plan such as the closing of the national borders and airspace, schools, worship centers, and other public places, canceling of public gathering events, the complete lockdown of the Federal Capital Territory, Lagos and Ogun states for fourteen days initially (Radio Nigeria, 2020).Body temperature screening was conducted at airports and those returning from countries with a high number of confirmed cases of COVID-19 were advised to self-isolate.

Some stipulated COVID 19 preventive measures are listed as follows:

1. Social distance
2. Self-isolation
3. Washing of hands with detergent or use of alcohol based sanitizers
4. Putting on a face mask in public places

Methods of preventing the onset and spread of the virus include strengthening health publicity and education; maintaining environmental health; keeping good personal hygiene; drinking boiled water; avoiding raw food consumption; frequent hand washing; avoidance of touch (especially around the eyes, ears and mouth); disinfecting surfaces of objects in households, toilets, public places, vehicles; disinfecting the excreta and environment of patients in medical facilities to prevent water and food contamination.

COVID-19 SAFETY GUIDELINES

In line with the World Health Organization research and as also incorporated by the National Centre for Disease control, the following if adhered to can curb the spread of the virus.

• Social distancing

Social distancing otherwise known as physical distancing works if the objective is to prevent the spread of the virus causing the coronavirus disease. Social distancing, also known as “physical distancing,” entails keeping space of at least 6 feet between yourself and other people outside of your home.

The principles of social distancing or physical distancing are;

1. Keep at least 6 feet (about 2 arms’ length) from other people.
2. stay away from crowded events or places and avoid mass gatherings.

Among all COVID-19 preventive measures, maintaining social distancing among ourselves is among the best tools we have to avoid being exposed to this virus and curbing the spread of the virus in our community. (CDC, 2020).

• Washing of Hands with Detergents or Sanitizing Hands Using Alcohol-Based Hand Sanitizers:

With many viruses, including corona virus, the virus is a self assembled nano-particle in which the most vulnerable structure is the outer lipid bilayer. Detergents dissolve the lipid membrane of microorganisms; virus inclusive. The virus's outer layer breaks apart thus inactivating it. Detergents are also alkaline substances that dissolve particles like dirt, bacteria, and viruses. These dissolved articles are washed off from the surface of the skin when the detergent is rinsed off while washing our hands., The alkalinity of the detergent (pH approximately 9-10), compared with the normal alkalinity of outer skin witha pH of 5.5 or lower, also can affect the skin barrier as well as the resident skin micro flora. In a study, it was found that an acid skin pH (4-4.5) keeps the resident bacterial flora attached to the skin, whereas an alkaline pH (8-9) promotes the dispersal from the skin in assessments of the volar forearm. (Lambers, Piessens, Bloem, Pronk, & Finkel, 2006). Considering the effectiveness of hand washing against the COVID-19 pandemic, the frequency of hand washing has been shown to have a limiting impact on influenza-like illness. A study of 2,082 observations, participants who spent only 5-10 seconds washing their hands with soap were more likely to contract influenza-like illness (odds ratio, 1.37; 95% confidence interval, 1.08-1.75), compared to participants who washed their hands for 15 seconds or more. Hand washing with detergents was found to be an independent protective factor against frequent influenza-like illnesses like coronavirus disease (Abdulrahman, et al., 2019). Alcohol throughout history has been used as a disinfectant, it is recommended for disinfecting the hands since the late 1800s. Some alcohol-based hand sanitizers contain isopropanol, ethanol, N-propanol, or a combination of both. The antimicrobial ability of alcohol can be attributed to its ability to breakdown and coagulate proteins, thus lysing microorganism’s cell membranes and terminating their cellular metabolism (Toney-Butler & Carver, 2020) (McDonnell & Russell, 1999). Alcohol solutions within the range of about 60% to 95% alcohol prove to be more effective against the viruses. Notably, alcohol with concentrations lower than 60 percent and higher than 90 percent appear to be less potent because of the presence of less water in the later, and proteins are not broken down easily in the absence of water (Wesley & Talakoub, 2020).

• Putting on Face Mask in Public Places and within the working environment:

The report from a multidisciplinary group convened by the Royal Society called Delve (Data Evaluation and Learning for Viral Epidemics) has considered the evidence and concluded in favor of public use of face masks, including homemade cloth coverings to tackle Covid-19. Analysis suggests that this could reduce onward transmission by persons who have the disease but are not showing any symptoms or pre-symptomatic persons. if widely used in situations where physical distancing is not possible or predictable, it is worth noting that the use of face masks, including homemade cloth masks, can to a great extent contribute to reduction of the viral transmission (Davis, 2020)

COVID-19 SAFETY COMPLIANCE LEVEL IN BANKING SECTOR

Compliance levels indicate the degree of compliance that your organization has achieved for a program or a requirement. For example, you could define levels of 0-Lowest, 1- Very Low, 2-Low, 3-Medium Low, and so on.

Compliance with COVID-19 preventive measure is a double edge sword cutting through the fabric of the everyday life of the Nigerian citizen and in the business environment entirely.

The banking sector level of compliance to the covid-19 safety measures entails them providing all the necessary precaution necessary for the safety of the staff and customers of the bank. They do so by following the covid-19 safety guidelines. By:

1. Placing of no face mask no entry sign at the entrance of the bank and banking hall. This rule is both applicable to both staff and customers of the banks.
2. Giving customers and staff hand sanitizer at the entrance of the bank
3. Placing rules for social distancing in the sitting pattern in the bank and banking hall.
4. Providing washing hand water for staff and customers at the entrance of the bank.

2.3 MODEL FRAMEWORK

The model used for this study is the Health Belief Model.

The Health Belief Model (HBM) was developed to help understand why people did or did not use preventive services offered by public health departments in the 1950’s, and has evolved to address newer concerns in prevention and detection (e.g., mammography screening, influenza vaccines) as well as lifestyle behaviors such as sexual risk behaviors and injury prevention. The HBM theorizes that people’s beliefs about whether or not they are at risk for a disease or health problem, and their perceptions of the benefits of taking action to avoid it, influence their readiness to take action. Core constructs of the HBM: • Perceived susceptibility and perceived severity • Perceived benefits and perceived barriers • Cues to action • Self-efficacy (added more recently) The HBM has been most-often applied for health concerns that are prevention-related and asymptomatic, such as early cancer detection and hypertension screening – where beliefs are as important or more important than overt symptoms. The HBM is also clearly relevant to interventions to reduce risk factors for cardiovascular disease.

Source: Becker, M. H. & Maiman, L. A., (1975). Socio-behavioral determinants of compliance with health and medical care recommendations. Medical Care, 134(1), 10-24.