pandemics – denelecampbell

Scientists have no firm grip on the fatality rate for this coronavirus. That’s because no one knows who is infected and/or who has experienced the virus without significant reaction. Until testing for the virus and antibodies is widely accessed across the entire population, these answers will remain unknown.

Ask the president when widespread testing will be available and you might trigger a temper tantrum like the one he unleashed yesterday on a FOX reporter.[1]

Also, what anyone knows about the mortality rate depends on whether you’re talking about apples or oranges:

In the UK, as of 2 April, 2921 people had died out of 33,718 confirmed cases – a crude case fatality rate of around 9 per cent. For Italy, the figure is nearly 12 per cent and for Germany just 1 per cent. These figures don’t tell us what we really want to know, though: how many of those infected will die as a result, which is known as the infection fatality rate.[2]

Then there’s the vaccine. Several promising ideas are in the pipeline, including a DNA-based formulation under development by Inovio and supported by Bill Gates.[3] But by any and all accounts, a vaccine is still twelve to eighteen months away.

Bubonic Plague The Black Death caused about 50 million deaths across Africa, Asia and Europe in the 14th Century. It wiped out up to half of Europe’s population. Its last terrifying outbreak in London was the Great Plague of 1665, which killed about a fifth of the city’s inhabitants. Then there was a 19th Century pandemic in China and India, which killed more than 12 million. But the disease has not been consigned to the dustbin of history. It is endemic in Madagascar, the Democratic Republic of Congo and Peru. What’s perhaps more surprising is that it is still killing people in the US.

So why is everyone talking about an ‘end’ to self-isolating by May or June? Nothing magical happens in June. The virus will still exist. Those of us who have avoided it so far will have no more immunity in June than we have now.

Well, there is the weather. Quite a few viruses have seasonal growth and decline, and this general knowledge apparently led President Trump to assert “that the virus will be gone by April.” He claimed that when temperatures rise, ‘the virus’ will ‘miraculously’ go away.’ The idea has triggered several studies of that effect in this particular outbreak. It’s not good news.

As summarized in a report by the Center for Communicable Disease Dynamics at the Harvard School of Public Health,

The short answer is that while we may expect modest declines in the contagiousness of SARS-CoV-2 in warmer, wetter weather and perhaps with the closing of schools in temperate regions of the Northern Hemisphere, it is not reasonable to expect these declines alone to slow transmission enough to make a big dent. [This report is worthy of a full read!] [4]

So no big break from warm weather and no vaccine until 2021. Do we self-isolate for the next year?

In reality, people simply can’t and won’t self-isolate for the next year. Many aren’t doing it now either because they hold an ‘essential services’ job or because they’re stupid. Plus the government can’t and won’t send out an endless supply of money to businesses to keep people on their payrolls or send money directly to the unemployed. Jobs are jobs because things need to get done – farming, transportation, shipping and dockworkers, manufacturing of a thousand things, millions of small businesses that involve everything from plumbing to roof repair to house cleaning, haircuts and dry cleaning, auto repair and lawn mowing. Then there are the big stores where people buy groceries, batteries, and underwear, essential in their own ways.

Yellow Fever — Since the 1980s, the number of cases of yellow fever has been increasing. This is believed to be due to fewer people being immune, more people living in cities, people moving frequently, and changing climate increasing the habitat for mosquitoes

And – if you’ll remember – those charts showed a high curve and longer, lower curve – that longer, lower curve means people are still getting infected months into the outbreak. The idea of self isolation was to spread out the incidence of infection so that medical facilities didn’t get overwhelmed all at once, not so that the mitigation ended the risk.

How do we plan for the future?

Some national leaders are telling it like it is:

Canadian Prime Minister Justin Trudeau said Thursday Canadians will need to stay at home and practice physical distancing for months as the first wave of COVID-19 cases in the country won’t end until the summer and Canada won’t return to normal until there is a vaccine — which could take a year and a half.[5]

None of this should be a surprise. Outbreaks like this have been on the rise for decades and show no sign of slacking. The World Health Organization notes that in just the last three months of 2019, there were documented cases of MERS/CoV, Yellow fever, Ebola, Measles, Dengue fever, Lassa fever, Zika virus, and Cholera in multiple locations from the Middle East to Congo to Pacific Islands and including Afghanistan, the Netherlands, and France.[6]

Scientists have been trying to prepare us for the next outbreak. A 2018 article on pandemic preparedness published in Nature Microbiology stated:

As recent outbreaks of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), Ebola and Nipah viruses, and pandemic influenza make clear, emergent infectious agents pose a continued and considerable threat to human health. However, our ability to detect and predict the initial emergence of a novel human pathogen (for example, the spillover of a virus from its animal reservoir to a human host), and our capacity to observe and forecast the transmission and spread of that pathogen within and among human populations, remains limited.[7]

Zika virus attacks fetal development resulting in severely reduced brain area.

Key words: “Remains limited.”

Scientific consensus is that we are at greater risk of pandemics from both known and unknown disease vectors than in the past.

Evidence suggests that the likelihood of pandemics has increased over the past century because of increased global travel and integration, urbanization, changes in land use, and greater exploitation of the natural environment.[8]

This is why it was criminally short-sighted by President Trump to “reorganize” Obama’s Global Health Security and Biodefense unit responsible for pandemic preparedness. The unit resided under the National Security Council (NSC), a forum of White House personnel that advises the president on national security and foreign policy matters. Now merged into one “directorate” with arms control/ nonproliferation and weapons of mass destruction terrorism, the global health and biodefense team’s clout is apparently lost in the shuffle. Trump was advised as early as December that a new bio-threat was shaping up in China and again several times in subsequent weeks, yet he failed to grasp the seriousness until mid-March.

Whether that’s a failure of his leaderless and diluted biodefense team or his basic inability to grasp anything is unclear. “Responding to an epidemic requires cooperation across a variety of government agencies, but without a dedicated coordinator, none has the responsibility to solve the problem.”[9]

The hope for a vaccine within the next year seems to assume a vaccine will be developed. Surely it will–no guarantees. But even our best flu vaccines are only about 50% effective. That’s because these viruses mutate frequently, changing enough of their DNA to wriggle away from our efforts at prevention. So far scientists are optimistic that a vaccine might be more effective with COVID-19, known more formally as SARS-CoV-2.

Based on current data, it seems as though SARS-CoV-2 mutates much more slowly than the seasonal flu. Specifically, SARS-CoV-2 seems to have a mutation rate of less than 25 mutations per year, whereas the seasonal flu has a mutation rate of almost 50 mutations per year.[10]

Unless one lives in a remote location without human contact, chances are all of us are going to end up exposed, one way or the other. The sooner we face that existential reality and adjust our outlook accordingly, the sooner we can relax.

At the very least, the lessons of the current experience demand better federal oversight and a president who pays attention to his security briefings. We need national stockpiles that can immediately respond to the need in mass infections and a public educated in advance on social distancing and other mitigation steps. We need to bolster our institutional and personal preparation for such inevitable events.

It’s coming.