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How to Stop a Global Pandemic

MATTHEW EDLUND, MD, MOH
Guest Columnist
Edlund@lbknews.com

What do you do to stop a global pandemic?  Act globally.

Viruses go everywhere in your body.  The coronavirus will soon be everywhere humans live.  Which is a very big problem.

 

From Epidemic to Endemic

Viruses are promiscuous.  They infect humans and many other animals (more later.) They notoriously don’t stick to countries. They like to travel, hitchhiking on planes, ships, trucks, bicyclists.

But they like to settle, too.

When a disease settles in place, chronically infecting a population, it becomes “endemic.”  It now has a shot at permanence.

Many places with weak public health systems, like refugee camps or embattled rebel areas like Idlib in Syria, are ideal places for Sars Cov 2 to camp out, kill, and then stick around.  Any ermanent viral presence then represents a source to infect or reinfect everyone else on the planet.

A permanent population presence also makes it easier for the virus to  mutate.  Sometimes it will be less virulent, sometimes more.  But becoming endemic also makes it easier to defeat all future vaccines.

Much has been written about how Sars Cov 2 will “rewrite the rulebook” about economic globalization. Ditto health. We will need to act as we did with smallpox, working towards worldwide control and eventual eradication.

The group that normally coordinates such efforts is the World Health Organization.  Like most UN outfits, it has many, many masters and problems. Now the highest elected official of its largest funder wants to cut off its money.

To combat a global epidemic that must be defeated globally, this may not prove wise.

 

The Economics of Survival

Prime Minister Boris Johnson of the U.K. had a real dilemna.  He had won victory  as the apostle of Brexit, promising freedom from Europe and economic enhancement for a “revitalizing” Britain.

Sars Cov 2 looked disastrous for his economy.

With Dominic Cummings and other advisors, he came up with a novel plan to combat the virus: to build up herd immunity while protecting national businesses and the nation’s most vulnerable.

Old folks of 70 and above were to isolate at home for four months.  Ways of feeding them and getting them to clinic or hospital were somehow to be worked out.  Otherwise, life would go on as before until 60-70% of the population had been infected, giving presumably permanent immunity to most of the country.

His position changed when one of the major epidemiology groups that advise a sometime listening government pointed out that their models predicted 250,000 Britons would then die of the virus.

In a brief, striking and effective speech, the prime minister made a U- turn.  Everyone was to stay in place.  No leaving home except for medical need and food.  No visits with family.  No visits with friends. That’s all.

A few days later, Johnson and his health minister became infected.  He continued to work vigorously despite high fever until hospitalized and placed in ICU.  When he left hospital, he pointedly explained that his case had been touch and go.  He quite easily could have died.

People in Britain are now socially distancing as the body count mounts.  It appears that individuals are willing to pay a high social and economic cost to stay alive.

This should be of some consideration as the “lockdown” is reversed.  By socially distancing later than most countries, the U.S. will be able to see how other nations fare.  We can look to the actions of South Korea and Taiwan, which have controlled their epidemic using standard public health measures  of testing, tracing and tracking.

Taiwan, with about 5% of its population living in mainland China, the source of the Sars Cov 2 epidemic, is now up to 6 deaths among its 23 million people.

 

National Versus International

The WHO dislikes travel bans.  They argue the epidemiology is clear: once a non-source population is infected, the infection will run its course, while travel bans will prevent the sale and trade of needed medical equipment and drugs, while undermining cooperation needed to control the epidemic.

It’s of interest that many in the United States believe a travel ban from China to the U.S. was an effective move that “protected” our population.  Few have remarked that the ban was only of “foreign nationals” who came from or recently visited China. Those  carrying American passports coming from China did not experience the ban.

Viruses can appear to be very smart.  But are they smart enough to distinguish their victims by the passports they carry?

For those in suspense, they do not.  People go everywhere, and the viruses with them.

 

The Culture of Narcissism

On Marcy 13th, the University of Texas shut classes due to Sars Cov-2.  Spring break began.

Many were enticed to a trip to “escape the virus” and party by jetting  to Cabo San Lucas in Mexico.  When they returned, the original “group” of 70 holidayers contained 44 who tested positive.  More recent reports say 49 out of 211 UT students tested positive.

UT administrators explained that the students had not risked only themselves.  They had risked the lives of their parents and grandparents, friends and community.  Half the admissions for Covid-19 to Austin hospitals were between the ages of 20-40.

Their import was simple: everyone is in this together.  No one is immune.  Your health is everybody else’s health – even if you’re an invincible college student convinced you can’t infect Grandma.

 

Wild Animal Markets

The most ferocious recent human epidemics – AIDS, SARS, Ebola, MERS, Sars Cov 2, have been viral epidemics that “jumped” from other species.  This has occurred for longer than humans have been human; perhaps 8% of human DNA is retroviral like the  AIDS virus, which the sale of “bush meat” in Africa appers to have helped spread. With increasing populations and global climate change, humans abut closer and closer to wild animal environments.  The present Sars Cov 2 epidemic presumably started in bats and perhaps passed to pangolins, an endangered species of great interest to Chinese traditional medicine.  The first victims of the virus, as noted by Dr. Li Wenliang, were workers in the wild animal markets, infecting their colleagues through person to person spread.

To prevent future epidemics such wild animal food sources should be strictly curtailed or outright banned.  That will mean that populations that need those protein sources to survive will require others forms of food as replacements.

It is in the interest of all nations to see they get it.

 

Bottom Line:

A global pandemic must be eradicated globally. Otherwise,  many will die, and the pleasures of life may well diminish.  Your health is my health, my health is yours. We’re in this together whether we like it or not.

Is it possible to control Sars Cov 2 as effectively as we controlled smallpox?

We’ve done this before.  With cooperation, we can do it again.

Empathy is a powerful human force.  Now it can be harnessed to help keep all of us alive.

And can you fully enjoy a fine restaurant meal wearing a mask? Won’t it be nice to have the luxury to touch your face?

Your health is public health.

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2 Responses for “How to Stop a Global Pandemic”

  1. Thank you for a brief, sequential synopsis of how viruses are spread. I appreciated the calm approach to explain how humans have encroached on animal kingdoms. Thus it brings about untold but slowly unfolding drastic developments. The more we speak of the link to nature, famines, climate change refugees, perhaps the lights will come on for the leaders of our many nations world. Our pace of life has been far too indulgent, thoughtless with increasingly diminished focus on what really matters.

    As much as we hear about COVID19, {daily , continuously}, we also need to hear about the beginnings of the virus spread, why and how animal kingdoms have been traumatized, shifted, and paid no heed. It has mostly been in the interest of gaining more money, more power, more control. To this end? The PAUSE has given many scientists the opportunity to reveal what a global slowing can do, how quickly nature can recover. One world working towards this continuing effort is the dream yet to come true.

  2. Dennis Powers says:

    This was an exceptional article. It brings focus to viruses and plainly states COVID-19 and all viruses to follow are apolitical which means to me politics will not defeat them. Good science and a society that can return to care for their fellow man seems to be the answer.

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