is often said that no man is an island. Although this line is more often than not used in a more philosophical rather than scientific sense, it can be borrowed to highlight the fact that human beings are not isolated systems and constantly come in contact with both macro- and microscopic organisms. The terms microorganisms or microbes are interchangeably used to refer to the microscopic ones. Although some of these microbes exhibit neutrality in terms of the effect that they have on human beings, once in a blue moon an antagonistic microorganism appears that uses human bodies as breeding grounds and spreads through the population, causing disease and bringing whole nations to their knees.
When cases of such outbreaks are restricted to a fairly local area, they are referred to as an epidemic while when it crosses borders and starts spreading all over the globe, it is escalated to the level of a pandemic.
A simple google search of the word ‘pandemic’ reveals that encounters of mankind with such disease-causing organisms have been very common throughout human history. The most fatal pandemic ever recorded was the Black Death, which is known to have caused about 75-200 million deaths in the early 14th century. A pandemic in recent memory to have run its full course was the flu pandemic of 1918, which infected close to a billion people and caused approximately a hundred million deaths.
Irrespective of the type and origin of disease, a repetition of such outbreaks as well as these high number of cases and deaths suggests that although boasting our attitude of learning from our mistakes, we have failed to abide by these ideals. The current Covid-19 pandemic caused by the SARS-Cov-2 is a testimony of the same. As on June 15, 2020, a total of more than 7.9 million cases have been reported worldwide resulting in more than 400,000 deaths.
Although it might seem that it struck out of the blue, if observed closely, there were tell-tale signs that not only predicted the outbreak of such a disease, but also the infectious agent that would be the root cause of the pandemic.
Turning the clock back to the start of the century, we would be reminded about the SARS epidemic of 2002-2004. The outbreak was first identified in Guangdong district of China in the November of 2002. Over the course of the epidemic, a total of 8096 people across 29 territories were infected which resulted in 811 deaths, but the virus was gone by 2005. This outbreak highlighted coronaviruses as potential infectious agents that could cause the next pandemic. Fast forward to 2019 and here we are, facing a pandemic caused by a new form of coronavirus, the SARS-Cov-2.
An analysis of the Covid-19 causing SARS-Cov-2 genome revealed that it shares about 80% homology with the SARS-Cov-1. The question to immediately arise from this observation must be that if they are indeed so closely related, what makes them so different, and in what way are these differences responsible for the efficient spread of SARS-Cov-2 as compared to its older cousin SARS Cov-1! The reason for this can be because of the lower lethality of the Novel Coronavirus. In the case of SARS-Cov-2 infection, the time between the viral entry into the host and the onset of disease symptoms is about two weeks, over which a lot of people can get infected by just one carrier. This also makes contact tracing a very difficult task for the health authorities, making the containment of the disease a logistical nightmare.
To put things in perspective for the SARS-Cov-1 infection, people started to show symptoms in a matter of two days. Now, it is easy for you or me to remember who we met in the last two days, but trying to remember who we met in the last two weeks while having a running high fever can be a very difficult task for anyone. Therefore, the properties of the virus can be one of the reasons for its spread among the human population. Not being well-prepared must be the other.
This is the third outbreak of coronavirus infections in the past two decades, thus begging to ask the question, even after these small outbreaks, why were we so ill prepared for the next one?
During the SARS epidemic of 2002, vaccine development did begin and they were tested on small vertebrates, but it was not further pursued due to the mysterious ‘disappearance’ of the virus. If this is not an example of human arrogance then I don’t know what else can be considered as one. Agreed that the absence of virus from the human population makes it nonprofitable to come up with a remedy, but had it been prioritized to some extent, we would have had better ways to deal with the initial phase of the current outbreak or even be vaccinated to prevent infection altogether. We should not let the market dictate the things that we should and should not ask scientific questions about.
Therefore, the first lesson to be learned is that no outbreak is small enough to be considered unimportant and whether localized or global, any viral outbreak should be treated as a threat to public health, and research should be conducted into ways of preventing as well as treating the same. There are labs around the world begging for funds to conduct research on questions that might seem insignificant. Quick returns should not be at the back of one’s head when deciding to fund a research project. Sooner or later the question does become relevant. It’s always better late than never.
Another misunderstanding that needs to be addressed is the assumption that the advancement of science and technology is somehow going to prevent such outbreaks from escalating to the level of a pandemic in the future. While it is true that improvement in medical
science and technology have made the treatment of such diseases better than before, the assumption that humanity is impervious to such outbreaks is wrong. On the contrary, it would seem that a massive increase in globalization that has resulted in better connectivity would facilitate the escalation of small outbreaks into pandemics. A simple way of putting this is that had there not been more than a hundred flights leaving China daily, the novel coronavirus wouldn’t have spread at such a high rate. Better connectivity has made the world a smaller place and, in this way, it has predisposed us to pandemics of such sort.
Another hallmark of development is urbanization. Although sounding good, urbanization comes with its caveats. These include problems with infrastructure, sanitation and health care. In most cases this means people living in crowded spaces can be a hotspot for infectious diseases to spread in. It must be highlighted that it was the cramming up of soldiers in close quarters and their movement between continents during the first world war that facilitated the spread of the influenza virus that ultimately resulted in biblical numbers in terms of people infected as well as the number of deaths.
Lastly, climate change might also play a role in the facilitation of the next pandemic. It can be expected that as the climate of the world changes, so will the flora and fauna and this would also mean that it can increase the range of the environments where carriers of infectious disease can live. Moreover, what is preventing us from assuming that the melting polar ice caps might also release some pre-historic microbes not yet encountered by humanity, kicking off the next
pandemic! Although far-fetched, these claims are to be taken seriously for as the present scenario suggests, no single detail is to be ignored when it comes to infectious diseases.
As the pandemic evolves, some questions will be answered and more will be asked. What is for certain is that the virus has entered the human population and we will have to learn to live with it. In terms of preventing future pandemics, lessons SHOULD be learnt from the past.
Keeping previous cases in mind a proper framework for intervention should be made to ensure a better and more importantly quicker intervention by authorities that could prevent a small outbreak from escalating into a pandemic. This remains a situation similar to that of Schrödinger’s cat, and can only be understood in full as and when it happens. Only time will tell.
- The writer is a PhD student pursuing Biological Science from Indian Institute of Science Education and Research, Mohali.