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COVID-19: The acceleration of a global pandemic

COVID-19

The acceleration of a global pandemic

by Maha S. Shahid

When first it was discovered, nobody could have measured the impact of the novel coronavirus on the world. What began as an isolated incident found in China’s Wuhan province at the end of December 2019, has spread around the globe claiming thousands of lives. The World Health Organization (WHO) initially termed the spread as an epidemic, that is, an infectious disease that is widespread in a community. Soon it was clear that this was more. The WHO was forced to upgrade the spread to the level of a pandemic, a disease prevalent over a whole country or beyond.

The world started to panic.

It’s difficult to fathom something like this occuring in our lifetime. In this technologically advanced digital age, the phenomenon has been particularly disturbing for younger generations that have never before experienced a catastrophic event felt on such a universal scale. However, the spread of viral diseases in the human race is nothing new. It has been prevalent since the beginning of time. Civilizations have collapsed and fallen to disarray, and each time world leaders and societies must wonder what could have been done differently to save lives…

What is the coronavirus?

The novel coronavirus (COVID-19) is an infectious disease caused by a newly discovered coronavirus, part of a family of viruses ranging from the common cold to influenza, to more severe diseases like severe acute respiratory syndrome (SARS). Doctors began noticing a string of unusual pneumonia cases in Wuhan late December. The illness was named COVID-19. By January 8th the WHO declared it an epidemic.

Wuhan, China, 2020

Coronavirus has now spread to an overwhelming amount of territories, infecting over 600,000 people and bringing about a death toll of over 27,000 globally. On March 5th, the WHO estimated that the average mortality rate from this virus was 3.4%, but in the last few weeks the number of infectees and the death toll has jumped at a significant rate. As of now, the WHO has still not released another report on the mortality rate of the coronavirus.

So far, a majority of those infected typically experience mild to moderate discomfort but are able to recover without any special treatment. However, people with prior underlying medical conditions and weaker immune systems (like older people, smokers, diabetics, heart patients) are more at risk. Like the flu, COVID-19 is generally transmitted through droplets of saliva and mucus. It is passed on through droplets of a cough or sneeze, or other contact with an infected person. An infected person can contaminate an area or object that they touch. Another person who touches that surface picks up the virus and becomes infected when they touch their nose or mouth (or any mucus membranes).  Research indicates that germs can live in the air for up to an hour and on various surfaces for up to 72 hours.

According to the Center for Disease and Control Prevention (CDC), signs of infection include having a fever, dry cough, breathing difficulties, fatigue, body aches, and a runny nose. But in more severe cases the virus can lead to pneumonia, organ failure, and mortality. Currently, scientists believe that the incubation period before people begin to show symptoms can range from a couple of days to two weeks. What makes this virus particularly treacherous is that it also infects those who show no symptoms – making them “asymptomatic” – while still being virus transmitters.

The global spread of this pandemic

Best ways to protect yourself from the novel coronavirus:

  1. Practice good and regular hygiene
    1. Wash your hands often – ‘hand hygiene’ (for at least 20 seconds with soap) and use sanitizer after touching anything (car handle, door knob etc)
    2. Cough or into your elbows or a tissue/handkerchief (not your hands or the surrounding area)
    3. Regularly sanitize all objects you use — bag, phone, keys, credit cards. Use soapy water to wipe them down if you don’t have sanitizer.
  2. Do not touch your face — eyes, nose and mouth — especially if your hands are not clean.
  3. Practice physical distancing (the term now preferred over social distancing) and limit social movements
  4. Avoid crowded areas (maintain a distance of at least 6 feet from others)
  5. Quarantine yourself if you are sick or have recently traveled
  6. Stay informed from verified sources (CDC, WHO or UNICEF, or your local medical authorities)
  7. Listen to your public health officials
    • Please note, that those who are sick should wear masks to protect others. However, for those who are healthy, wearing a mask can offer a false sense of protection because masks may be loose loose or made of material that will allow virus droplets in.

There are those who have downplayed the severity of this virus, deriding preventive measures being taken by governments. Celebrities like Vanessa Hudgens and Evangeline Lilly have faced some serious backlash for their comments online terming the pandemic as “inevitable” and  asserting that they value freedom above life. Most recently, Pakistan’s reputed designer Maria B came in for sending her cook who had tested positive for the coronavirus back to his village via public transport. 

The case came to the limelight after she posted a video complaining about how her husband was arrested for this negligence. After he was released, the couple issued another video in their defense claiming that nobody told them what to do in this situation. A Dawn Images article critiqued their thoughtless approach noting, “the pandemic does not discriminate between race or class since everyone is at equal risk but clearly people do.”  This is a valid point. There are plenty of reports about what to do and how contagious the virus is. Anyone wanting to thoughtfully deal with the situation could do a google search. Or arrange transport for the man that wouldn’t require him to change two separate local buses, infecting goodness knows how many along the way.

Maria B impeals to PM over husbands arrest

So if symptoms are often mild, why are such strict preventive measures necessary?

In short, this is because even with all the research being conducted we still don’t know enough about the virus to treat it effectively, nor have scientists been able to find a cure. To develop a vaccine  could take as long as 2021 or longer.

Research into earlier strains of coronavirus has found that these viruses originally appear in the animal kingdom. Many coronaviruses have not yet found a way to mutate their cells to infect humans. We saw similarities to the current virus in outbreaks such as the Severe Acute Respiratory Syndrome (SARS-CoV) which was discovered in 2003 in China, as well as Middle East Respiratory Syndrome (MERS-CoV) a decade later. Such illnesses are known as “zoonoses” since they originate in animals and then find ways to make the jump to human cells. SARS was transmitted through cats and MERS was transmitted through camels, respectively.

Why is this inter-species jump so crucial?

Since these viruses originate in animals, our bodies are unfamiliar with them, and hence unable to effectively fight them off. For a virus to reach the cells of its host, it needs to attach itself to proteins and bind to these structures. In other words it needs to be able to access the cells of its host even when species differ. Just as humans have adapted to their surroundings to survive the test of time, coronaviruses have become increasingly good at figuring out how to mutate. As mentioned above, this is the third pathogenic novel coronavirus to infect the human population over the last twenty years.

This coronavirus is much more contagious and therefore more widespread than its predecessors (SARS and MERS). The WHO has classified the current outbreak at the highest warning level.  

Chinese health authorities are still working to pinpoint where the virus originated but it is likely to have emerged at a wet market in Wuhan (a process similar to SARS started) – possibly through bats, snakes, or illegally-trafficked pangolins. Genetic analysis of the COVID19 suggests it originated in bats, but since none were sold at the seafood market, scientists are looking into a third party host that could have passed it on from a primary host to humans.   

What is particularly remarkable is how fast the virus was able to transmit from:

Animal to Animal → Animal to Human → and then make the jump from Human to Human in a very short time.

A setting like a wet market is the perfect condition for a virus to spread, because all these hosts come in contact with one another frequently. Researchers who have followed the issue closely  have been warning about the possibility of such a pandemic spreading.

Viruses mutate constantly. A great example is influenza that produces new strains yearly. Single-stranded ribonucleic acid (RNA) viruses like corona mutate six times on average each time they are transmitted from one host to another. Currently, there appear to be two different strains of COVID19 but the more aggressive strain isn’t necessarily more deadly.

What does this mean? At this point, the answer is that we don’t know. We still don’t know the full capacity of the virus, as many countries, like Pakistan, have yet to reach their peak of infection. Scientists around the world are racing to find a way to immunize us from this enemy… an enemy that cannot be beaten with conventional tools and one that we do not know nearly enough about.

Corona infects Pakistan:

The World Health Organization initially praised Pakistan’s proactive, preventive response to the coronavirus and the country’s diagnostic and treatment facilities. The federal and provincial governments had arranged around 2,000 isolation beds for suspected COVID-19 patients, and made extraordinary screening arrangements at points of entry. A mobile diagnostic facility had even been dispatched to Taftan on the western border to test and diagnose pilgrims returning from Iran. The WHO had also expressed satisfaction with arrangements made at Pakistan’s airports to screen passengers entering the country. 

However, this good news was soon overtaken by reports of the escalating coronavirus incidence in Pakistan. Although Pakistan is the first South Asian country to obtain coronavirus testing kits, sent by China, enabling the National Institute of Health (NIH) to test over 400 travelers entering the country, it quickly lost its edge.

Since the first coronavirus case was discovered on February 26, the virus has spread rapidly. The first two deaths due to the virus were confirmed March 18. More than 14 patients have died since then, out of over 1,690 confirmed cases. The numbers are rising exponentially.

The NIH, which comes under Pakistan’s health services ministry, is posting regular updates on the country’s coronavirus situation on its website. It claims to have tracked most of the 7,500 Pakistani pilgrims who returned from Iran in February in the fortnight before the coronavirus outbreak exploded in Iran. As of the 18th, the NIH had located around 6,500 returning pilgrims and was trying to track the others “along with their social contacts despite resource and infrastructure constraints,” NIH executive director Major General Dr. Aamer Ikram told ‘The News’.

Since then, returning pilgrims have been quarantined at a camp at Taftan, on the border with Iran. Al Jazeera recently came out with a scathing report about how the camp is poorly run, with unhygienic conditions. Of the 213 cases detected in Pakistan on March 23, over half, 149, are reported to have been infected at the camp.

Pakistan is now frantically trying to buy more testing kits from various countries as well as working to develop these kits at home.  

Prime Minister Imran Khan has urged people not to panic and to self-isolate as much as possible. In a televised address he declared that he would not shut down cities over this outbreak, because Pakistan is already an impoverished country and he fears that a halt in production will lead to starvation for the masses.

Meanwhile the provincial authorities are also working to prevent more deaths. The Sindh government took the lead on enforcing a lockdown in the province. Chief Minister Murad Ali Shah issued a notification prohibiting employers from laying off workers during this time. However, daily wage and contract workers remain vulnerable. Various organizations and individuals are trying to put together resources to help them through this period.

The Chief Minister also announced a Rs. 3 billion fund for coronavirus affectees. Sindh government officials and PPP MPAs have pledged to donate their salaries to it. Government officials will also donate portions of their salaries to the fund depending on their levels of seniority.

The Taftan border

Where do we go from here?

Many blame globalization for the scale of this outbreak: In this increasingly connected world, despite the rising barriers between states, how could we have prevented something of this measure? However, history teaches us that even in earlier times, such as the middle ages, epidemics did spread from one corner of the globe to another.

The spread of an epidemic in any country is a threat to all mankind. We have seen this before and with the rate that viruses are learning to mutate and adapt to different hosts, we will see it again.

One truth, however, stands the test of time.

Knowledge is power.

Pooling information and resources is the fastest way to combat this threat.

Perhaps the greatest threat to humanity isn’t the inevitable spread of disease… Perhaps it is our own distrust in each other? An unwillingness to see beyond border lines, political/religious differences, and other kinds of divides.

How we respond in trying and uncertain times is the true test of our humanity. Do we put our freedom above other peoples health? Do we continue using an “us vs. them” rhetoric that has time and time again taken more lives than it could ever save?

Or do we come together in solidarity to assist those in need?

Will we learn from our mistakes of the past or are we going to let history repeat itself?

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NY Times 1NY Times 2NY Times 3Tribune 1Tribune 2Pakistan TodayThe NewsAl JazeeraVOXDawnHITCDaily MailCNNAssumptionDigital Spy

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