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Learning to live with the pandemic

Published : Thursday, 8 October, 2020 at 12:00 AM  Count : 465

Dr Kanan Purkayastha

Dr Kanan Purkayastha

In 2011, World Health Organisation's International Health Regulations Review Committee mentioned that 'The world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public-health emergency.' This prognosis becomes clear when we see that globally more than 1 million people dead due to covid-19 disease in 2020.

At present the number of coronavirus cases is rising in Western Europe. Stella Kyriakides, European Union's Commissioner for Health and Food Safety mentioned that 'This is a real cause for concern'. WHO Regional Director for Europe Hans Kluge said,'Although these numbers reflect more comprehensive testing, it also shows alarming rates of transmission across the region.' On 4 October 2020, CNN reported that the coronavirus infection cases are rising rapidly in the colder region of the United States.

It is clear that more testing are carried out now than in last February this year. Also young people, returned to education, are contributed to the number of infection cases. This indicates that spread of virus in the community is much higher than it was reported before. However, the infection mortality rate (IFR), which is the ratio of the number of death against the number of infection case, is expected to be lower during the second wave. Because the medical staffs are now more experienced then before about the covid-19 disease, number of infection cases are higher in lower age group and also some treatment such as dexamethasone have been shown to reduce the death rate.

Different countries have adopted different strategies to live with coronavirus. In UK, pub and restaurant curfew after 10 pm, rule of six, restrictions in number of guests in weddings and funerals, more mask wearing,  restriction in big sport events, home working and tougher fines have been imposed. In Japan, in order to reduce the virus transmission, they just avoid three C's: crowd, close space and contact. European Centre for Disease Prevention and Control mentioned that after taking some social measure, if still number of cases rise, then this mean that people are not following the measures or that those measures are insufficient.

Living with the coronavirus, we have observed the epidemic of fear around the world. Some activities around the world are clearly evident, such as demonstrator in Hong Kong disappears, a brief ceasefire in Yemen when first covid-19 appears, Hezbollah was staying home and Hamas declared that their sole military objective was to obtain respirators from Israel. If necessary, they said 'we take them by force.'

Also ISIS declared that Europe is a risk zone for its fighters. We also see other extreme response. For example, by mid April 12 people had died from virus in Nigeria, but 18 people killed by security force for violating lockdown in Nigeria. We have also noticed that when there is a choice between life and economy, life is winning because different countries have gone through complete lockdown process at the beginning of the virus spread ignoring the economic loss. This reminds me what Pope Francis said 'People are temples of the Holy Spirit, the economy is not.'

New data published by the social progress imperative, a non-profit organisation shows that the pandemic could deter the achievement of UN's sustainable development goals such as eradication of poverty, improving access to education and action on climate change because there are more indirect impacts of covid-19 than its direct impact. Long term health condition is one of the many indirect impacts we shall have to live with globally. The virus is affecting everyone but not equally.

According to the World Bank projection, because of covid-19 the number of extremely poor people will rise by 70 million to 100 million this year. A report published in the Economist dated 26th September 2020 suggests that governments in rich countries have spent 10 per cent of GDP to ease the economic pain. Emerging economies have spent just 3 per cent and the poorest nations less than 1 per cent.

Around the world, epidemiologists are constructing short and long term projections of the spread and impact of SARS-COV-2, the virus that causes covid-19. There are some common issues emerge from the modelling. One is that covid-19 is here to stay and other is that the future will depends on a lot of unknowns, including whether people develop lasting immunity to the virus, affect of seasonality on its spread and choices that an individual and government will make. Modellers also agreed that because of the variability of mitigation measures in different part of the world uncertainty about any future prediction is very high. A research reported in the Nature, dated 6 August 2020 mentioned that 'if immunity to the virus lasts less than a year, for example, similar to other human coronavirus in circulation, there could be annual surges in covid-19 infections through to 2025 and beyond.' The research also demonstrate that-

* If immunity from vaccine last less than 40 weeks, we shall expect annual winter outbreaks.
* If immunity lasts 100 weeks, we shall expect outbreaks every other year.
* If transmission is seasonal we shall see initial peak then winter outbreaks.
* If other coronavirus give cross-immunity, then we shall expect apparent elimination and then late resurgence.

A group of computational biologist in Brazil ran two hundred fifty thousand mathematical models of three social distancing strategies-constant social distancing, intermittent social distancing and stepping down social distancing strategy. 'Stepping down' means restriction reduced in stages. The team concluded that 'if 50-65% of people are cautious in public, then stepping down social-distancing measures every 80 days could help to prevent further infection peaks over the next two years.'

Many human respiratory viruses follow seasonal oscillations that lead to winter outbreaks, so it is likely that SARS-COV-2 will follow the same path. An immune biologist Iwasaki from the Yale School of Medicine suggests states that 'I expect SARS-COV-2 infection rate, and also potentially disease outcome, to be worse in the winter.'

It has also been predicted that 'dry winter air improves the stability and transmission of respiratory viruses and respiratory tract immune defence might be impaired by inhaling dry air.' So, in a subtropical monsoon climatic region like Bangladesh November to March time period needs to be monitored carefully for any covid-19 disease outbreak.

Above all, to end the pandemic, the virus must either be eliminated worldwide, which is near-impossible because of the spread of the virus in 213 countries and territories or people must build up sufficient immunity through infections or vaccine. An estimate by Kwok et al published in the Journal of Infection dated March 21, 2020 suggests that 55-80% of a population must be immune for this to happen, depending on the country, which is difficult to achieve.

So, we shall have to learn to live with the novel coronavirus. Even we get a new vaccine for it, we would not be able to tell how long the vaccine immunity last. But our long term behavioural change can make a significant difference.

The writer is a UK based academic, chartered scientist and environmentalist, columnist and author




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