Dealing with a pandemic

Dealing with a pandemic

The understanding of epidemiology as a branch of medical science dealing with the transmission and control of disease needs one to focus on the understanding of diseases prevalent among a community at a given point in time. The route to the understanding of the epidemiological aspects of a disease needs those concerned (and unconcerned) to fully be cognizant with the inner ramifications of the given disease in a literal or figurative way.

Through hands on tactics that are practised in the face of any disease breakout, the literal side to understanding how the control and the treatment of a disease is carried out is put into action. The figurative simulation exercises also play a significant role in the understanding of epidemic breakouts in that they prepare the population in terms of dealing with the breakouts at a regional or international level. Dealing with disease breakouts is a human society’s necessity, for dealing with diseases is a fact we can never ignore, a fact we cannot deny unless we want to die out as the human race.

It could be that disease breakouts are often ignored affairs until they go rampant and the masses begin to panic and everyone then begins to run helter-skelter. It need not get to this phase where people are emptying shelves and stocking up on goods and foodstuffs as is the case now unfolding in neighbouring South Africa. The Coronavirus (One of a group of RNA (RiboNucleic Acid) viruses that infect animals and humans, primarily the upper respiratory and gastrointestinal tract) was discovered in December 2019, but the sluggish manner in which the authorities handled the whole issue led to its current pandemic status.

The lack of authoritative common-sense chose to put the blame on the country where the breakout was first spotted. It did not make sense to assume that the virus was the People’s Republic of China’s problem, it was not humanely sensible to do so, it was not scientifically sensible to do so. What should have been done from the onset was to aid China contain the virus before it spread, but the loquacity got the better of the political leadership of the world, in the process putting the vulnerable masses of the world at risk.

It is a fact that loquacity gets the better of common sense and hampers movement of the hand. Speaking does not equal action, it is in actual fact the weaker and the more useless of the two deeds. Those that talk cannot move hands or walk, do not work and can therefore not make the world well.

That old adage, “empty vessels make the most noise,” has been proven true over the past three months with political leaders wanting to sound smart instead of taking relevant action when it comes to dealing with the virus breakout before it reached the level of a pandemic. The glare of the flashlight became the focus of the moment when what should have been done could have been to highlight the core definitions of what the virus is about. Casualties are increasing on a daily basis, but one does not see any decisive action taken to quell the spread of the virus.

There are only councils of speculators and pseudo-experts speculating on the disease without actually giving the inner details of what the Corona virus is, how it spreads, and what simple ways can be adopted to deal with it. Not everyone can afford the sanitizers, not everyone can access medical help in Lesotho, and we should therefore be looking for simple ways to deal with the breakout.

I personally have not heard what the virus is from the relevant authorities. There are only short clips and snippets on the Coronavirus, the rest of the conversation is scattered amongst the useless social media speculations and videos of figures in protective suits spraying disinfectant or water or whatever it may be they are spraying. We first have to know and to understand what it is we are dealing with to take the relevant action to quell its advance. The two most important aspects of the epidemic, the prevalent and the impending should be well inculcated into the minds of the general population before resorting to political speech.

All of us old ones know how useless and ineffective political speech is when it comes to dealing with crises. It is a fact that the political class on the continent are not the smartest individuals, they are voted on the basis of popularity and not practicality. Political figures are therefore not the right people to address the pandemic or endemic challenges posed by disease breakouts. Medical experts could actually do a better job considering their familiarity with the viruses.

A look at the epidemiological history of disease breakouts reveals a clear pattern of increased fatalities where a lot of speculation was done instead of actually dealing with the breakout. Plagues or pandemics spin out of control whilst we talk and speculate, they actually seem to decrease when there is less talking and more action. There have been flu breakouts of pandemic proportions before in history; all were decisively dealt with because there was more action and less talking.

The Spanish flu killed so many (over 50 million) only because of the noise of the guns of World War One, it was beaten the second time in the new millennium because the world acted in concert to deal with its consequences. There have been recorded influenza epidemics from as far back in history as 400 BCE, and the most decisive action ever taken is found in those that took the time to develop vaccines for the different virus strains in the course of occurrence.

There could be action taken at this point in time, and it demands of the medical fraternity to stop speculation and begin to fashion the vaccine. It is not as if this Wuhan influenza is a new flu virus strain to come out of China, the Influenza A subtype H2N2 of 1952 in Guizhou went on to kill close to 4 million people and in the process went on to attain a category 2 pandemic severity index status. All the accusation at this point in time might mean more casualties.

There are three components of epidemiology; the agent, the host, and the environment. The agent is the micro-organism that actually causes the disease in question; the host is the organism that carries the disease passed on by the agent in the given environment within which the agent and the host live. What I believe should have been the question from the onset should have been: What is Coronavirus? And one should have gotten the simple definition that Coronaviruses are a family of viruses that range from the common cold to MERS (Middle East Respiratory Syndrome) and SARs (Severe Acute Respiratory Syndrome).

The second question could have been: Where do Coronaviruses come from? And the answer could have been; Corona viruses are circulating in animals and some of these Coronaviruses have the capability of transmitting between animals and humans in a spill-over event (for example, sharing the same environment with such animals or eating them).

The third and most important question would be: How can I help protect myself from a Coronavirus? The Coronaviruses typically cause respiratory symptoms and the lead recommendation is that basic hand hygiene, such as washing your hands with soap and water should be observed at all times.
Respiratory hygiene, such as properly covering your face when you sneeze, or sneezing into your elbow must be practised at all times. Other ways include protecting one’s self against a potential animal source by avoiding unnecessary unprotected contact with live animals and making sure that you wash your hands thoroughly after contact with animals and also to make sure your meat is cooked thoroughly before consuming.

The last question would be: Is there treatment? And the answer based on the current circumstances reveals that there are no specific treatments for Coronaviruses, but symptoms can be treated. This is all that should have been told from the onset, not the panic mechanic talk we have been getting from politicians. The need for unavailable masks is emphasised and I think this a noble suggestion, but the question remains: when will governments make them available to all the citizens?

Talk without deeds is a piss in the wind, a nuisance  that messes up with the minds of the already panicking masses in Africa and many other parts of the world, and many of them cannot afford a R2 meal. There is in frank terms no united commitment from the governments of the world because the focus is still more on the economic than on the pandemic. I guess the honourable thing would be to focus on the illness and living for tomorrow, the expense can always be dealt with in the aftermath.

An article 1918 Influenza: the Mother of All Pandemics by Jeffery K. Taubenberger and David M. Morens shows that before and after 1918, most influenza pandemics developed in Asia and spread from there to the rest of the world. The article further goes on to show that:

Confounding definite assignment of a geographic point of origin, the 1918 pandemic spread more or less simultaneously in 3 distinct waves during a 12-month period in 1918–1919, in Europe, Asia, and North America (the first wave was best described in the United States in March 1918). Historical and epidemiologic data are inadequate to identify the geographic origin of the virus, and recent phylogenetic analysis of the 1918 viral genome does not place the virus in any geographic context.

Further evidence in historical records since the 16th century suggests that new influenza pandemics may appear at any time of year, and not necessarily in the familiar annual winter patterns of inter-pandemic years. This is presumably due to the fact that newly shifted influenza viruses behave differently when they find a universal or highly susceptible human population. Thereafter, confronted by the selection pressures of population immunity, these pandemic viruses begin to drift genetically and eventually settle into a pattern of annual epidemic recurrences caused by the drifted virus variants.

This means that the current Coronavirus pandemic may actually trace its roots to some distant point in history, or, it may be that current human travel patterns do actually have a role to play in the spread of the virus. The virus as an agent could be from anywhere in the world, but it could be found that the environment in China was conducive to its mutation and final dispersion to the rest of the world.

How we deal with the current epidemiological scenario needs not any deviation from the necessary. There is the need to be cautious about one’s hygiene at all times, but the prevalence at this point in time has made it all the more necessary to be extra cautious when dealing with potential and obvious cases of the Coronavirus in terms of keeping high levels of personal hygiene.

Technological advancement and a relative atmosphere of peace in the world means that we can deal with the virus better than it was dealt with in the years of the Spanish influenza.
Taubenberger and Morens further show that the 1918 influenza pandemic had another unique feature, the simultaneous (or nearly simultaneous) infection of humans and swine. The virus of the 1918 pandemic likely expressed an antigenically novel subtype to which most humans and swine were immunologically naive in 1918.

There is something not new about the current pandemic if it has been treated at this point in time and there are actually statistics of people that have been ‘cured’ of its effects. There is the need for world bodies to work hand in hand, but more importantly, individual states should not consider themselves exempt from the effects of the disease because they shall end up late starters in the fight against the Coronavirus.

It is in the past week that I got the understanding that influenza pandemics in general require a basic understanding of the previous pandemic in all its historical, epidemiological, and biological aspects. It is only until we can ascertain which of these factors gave rise to the mortality patterns observed that we can learn more about the formation of the pandemic, because our predictions are only educated guesses if the basic factors are not adequately noted and understood.

We can therefore only conclude that since it happened once, similar conditions could lead to an equally devastating pandemic, thus the need to understand the conditions more than to make guesses and point fingers. It is a fact that our chance of winning even with modern antiviral and antibacterial drugs, vaccines, and prevention knowledge, the return of a pandemic virus equivalent in infectiousness to previous strains would likely kill more people worldwide if not adequately dealt with.

Whether because of viral, host or environmental factors, the Coronavirus causing mayhem in the world may not be associated with previous pandemics. Identification of what it really is first could point to a genetic basis for its uniqueness which will leave room for its differences with previous strains to be highlighted. Speculation and panic attacks will not at this moment save us. We have to be practical in our approach. More than we have ever been before.

Tšepiso S. Mothibi

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