You have to feel for medical scientists whose job it is to decipher the ways of infectious diseases and discover vaccines and/or cures. They have had their hands full in the past few years. To begin with, they have always been busy trying to stay ahead of new strains of the flu virus every year. Despite the effort, the flu still kills thousands of people worldwide every year.
That’s partly because the efficacy of the vaccines varies from year to year. It all depends on how accurately researchers predict the characteristics of each year’s flu strain and then develop vaccines that can effectively neutralize it.
Amidst the ongoing challenge come outbreaks of other deadly viruses that further tasks medical research. There have been the severe acute respiratory syndrome (SARS), the Middle East Respiratory Syndrome (MERS), Avian (or bird) flu, Ebola, etc. And now we have the novel coronavirus or COVID-19. Incidentally, it is so named because its earlier variants were responsible for SARS and MERS. This variant is tagged with its year of origin, 2019.
I asked a physician recently what the future holds with regard to such outbreaks. The usually jovial fellow turned somewhat pensive. Medical researchers have been pondering my question, he said. They are wondering whether there will be an ‘end point’ and if so what it will be.
The possibilities are polar. The hope for end point would be that medical science develops the capacity to anticipate all possible outbreaks and the vaccines to nip them in the bud. Let’s call this End Point Y.
The other possibility is that there is a lethal outbreak that is beyond the capacity of medical science to cope. That would be global cataclysm or Armageddon, in the parlance of Christian theology. Let’s call this End Point Z.
The physician didn’t say that an end point is imminent, but he didn’t rule it out either. History and experience suggest that End Point Y is improbable. So, if there is to be an end point, it is more likely to be Z.
The challenge to medical researchers is simply that there are way too many microbes out there, many of them are unknown, and they mutate in unpredictable patterns. It comes as a surprise to people that at any given moment, myriad microbes are crawling all over our body, including on our hands and in our noses, ears and eyes. The good news is that they are generally harmless.
Not so their cousins, the pathogens. They are always on a war part with the human body and they are quite capable of doing harm. Some are parasitic, among them the flesh-eating bacteria, which are contracted usually by swimming in infected waters. The most common and therefore most problematic pathogens are those that go after the respiratory system, the coronavirus being one.
Yet, lethal as they can be, they are not nearly as horrifying as the hemorrhagic viruses, such as Ebola. Because they cause internal organs to bleed profusely, their fatality rate is exceedingly high and quick. And so is the ease of their transmission. They are the more likely path to End Point Z, and that makes their outbreak the most dreaded.
So far Ebola outbreaks have been in countries and regions that are at the periphery of global commerce. Imagine that it was Ebola that broke out at Wuhan, the Chinese city of more than eight million people and a major industrial and commercial centre. If the novel coronavirus has taken so much toll and proven so difficult to contain, the scenario with Ebola could readily have been cataclysmic.
That’s why the World Health Organisation and the major countries around the world poured in much resources to contain the 2014 outbreak in Liberia, Sierra Leone and Guinea. There is a similar effort to contain the ongoing outbreak in the Democratic Republic of Congo, though it is relatively out of the news.
The novel coronavirus is not nearly as virulent as Ebola, yet the global alarm over its outbreak has exceeded the reaction to Ebola. China practically put Wuhan’s eight million people under quarantine.
In parts of Europe, notably Spain and Italy, major public gatherings such as soccer and hockey matches have been banned, voluntarily cancelled, or played in empty arenas. In places, schools have been temporarily shut. There are even questions as to whether the Summer Olympics scheduled to take place in Japan will still go on.
These measures have led to questions of whether there is an over-reaction. In the United States, that view has been expressed by the irrepressible President Donald Trump and some members of his administration. But they are not alone.
Even as the WHO raises the risk level for the spread of COVID-19, some medical researchers and physicians are questioning the wisdom of the measures taken to contain it. Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital, for example, advocates an emphasis on ‘mitigation’ rather than containment.
“(COVID-19) will not be contained, this has not been contained,” Bogoch is quoted as saying by the Canadian Broadcasting Corporation in an online story. “This is spreading throughout the world and it will continue to spread throughout the world.”
By mitigation, Bogoch refers to greater efforts to identify, house and treat the infected, as well as develop vaccines and medications. To illustrate the point, there has been a shortage of test kits even in the United States. Never mind the fever-detecting gadgets that are in wide use. Carriers of the virus take days to develop symptoms, including fever. Therefore, people have to be tested to determine their status. Yet, the test kits are so scarce that doctors are constrained as to when to use it.
As to the argument for containment, one needs just to look at the numbers. As of last week, China—the epicentre of the crisis — has more than 80,000 confirmed cases, of whom about 3,000 have died. Sixty other countries have had a combined 7,000 cases, most of those being in Iran, South Korea and Italy. Over 100 deaths have occurred in the 60 countries, including seven the US.
Unsettling as these figures are, those who urge calm note that the death rate is not any higher than those of MARS and MERS, the other outbreaks caused by earlier versions of the coronavirus.
Back to the question of an end point in infectious disease outbreaks, there probably will be none. Humanity will continue to cope with the scourge and, in all likelihood, the brave folks in medical science will continue to rise to the occasion.
If humanity could survive the plagues at a time when some of the best medical minds entertained the weirdest ideas —pathology of witches and planetary motions and use of leeches to suck out fever— we will survive whatever pathogens inflict on us at this time. So, strike End Point Z.