COVID-19: Lessons To Learn From America
“The COVID-19 situation is changing rapidly. Since this disease is caused by a new virus, people do not have immunity to it. Doctors and scientists are working on estimating its mortality rate, but at present, it is thought to be higher than that of most strains of the flu.” — Johns Hopkins Medicine
Recently, my boss, mentor, and a professor in the discipline of Computer Science and Engineering at IIT Gandhinagar, Neeldhara Misra, shared with me some really informative content (in the form of articles, podcasts, and videos) on various aspects of the novel coronavirus disease that is causing significant destruction across the globe. This content ranges from discussions on the most pressing questions surrounding the COVID-19 illness all the way to predictions on how this pandemic would end. This article is my attempt to communicate some of these necessary and thought-provoking materials among my readers. With this, I aim to spread science literacy and awareness among people on this grave topic.
I will start by throwing some light on one of the episodes of The Daily Social Distancing Show with Trevor Noah. Originally known as The Daily Show, it is a popular American late-night talk and news satire television program. In the wake of the 2019–20 coronavirus pandemic, Noah mentioned that the show would not have a live audience. To encourage the concept of social distancing, he recorded the episode from his home, thus, giving the program its present name!
Insidious, Treacherous and the Worst Nightmare
The episode which I am talking about features Dr. Anthony Fauci, a renowned physician, and immunologist who has served as the director of the National Institute of Allergy and Infectious Diseases since 1984. An infectious diseases expert who has advised six Presidents of the USA, on ailments like SARS, Ebola, HIV, and Zika, Dr. Fauci explained that COVID-19 is a respiratory-borne illness — one that spreads easily from person to person, and exhibits a high degree of morbidity and mortality (about ten times more than the common flu), which makes it, unfortunately, the worst nightmare that one could have. Ebola was frightening, but it gets transmitted only when one is in very close contact with the infected person. But the new coronavirus disease, which is in some respects similar to influenza but in others very different, spreads rapidly and easily — it’s insidious and treacherous.
Understanding the Cycle
Elaborating further, he said that besides following social distancing (six feet apart!), do not shake anybody’s hand and wash your hands as often as you can because you may be inadvertently touching things. This virus can live on inanimate hard objects such as steel, plastic for at least several hours. Even the young population is not exactly invulnerable. The other thing is that even though they may not get seriously ill or get infected with relatively few symptoms, they can infect another person who would then go on to infect other more vulnerable, older or immunity compromised people (and in this way, the infection and death cycle continues!). Hence, it is everyone’s responsibility to protect oneself as well as society.
In response to Noah’s question about medications for this disease, Dr. Fauci expressed that, as of now, there is no proven, safe, effective, and direct therapy for COVID-19. Several randomized clinical trials are trying to get definitive answers about what does or does not work and what’s safe or not safe.
Tick-Tock goes the Clock
According to Dr. Fauci, the virus is the clock. Understanding the kinetics of the outbreak is difficult. One cannot predict when the infections or death rates will make that turnaround and start decreasing. In general, if we look historically at countries that have been through the whole cycle, in China, it was eight weeks or so before it went way up and then way down. In Korea, the same thing. This cycle is unpredictable and is usually measured in several weeks.
Taking the example of New York City, he said that it is one of the places that are suffering the most because of this pandemic. The nature of this city, its crowd, and the fact that one gets the beginning of the outbreak when you have an influx from other countries. China was the index country that came in, and New York is a travel hub. By the time people realized what they were dealing with, they had already gotten a sucker punch! All this information tells us that big robust cities and states are getting hit really hard by this disease.
Re-infection and Immunity
Addressing Noah’s question on whether surviving corona means that one is now immune to the disease, Dr. Fauci elaborated that scientists and doctors do not know about it with a 100% certainty. But there is a lot of confidence that if this virus acts like every other virus we know, once someone gets infected, gets better and clears the virus, they will have immunity that will protect them against re-infection.
How to Combat COVID-19?
The Government should be the facilitator, supplier, and supporter, and this is how we all will be able to fight this together. We are catching up on things that were not done so well in the beginning. We now have many more tests — the private industries are getting involved. Companies are making more ventilators. Strict coordination is needed between the country, state, and local levels. Implementing similar measures will be helpful for the world in combating this grave COVID-19 situation.
I hope this piece of information was worth pondering. Next, I would like to draw your attention to an interesting article published in The Atlantic titled How the Pandemic Will End. It can be thought of as a case study of America during this viral illness and, therefore, acts as a strong piece of advice for many other nations.
The Beginning — What went Wrong?
Published on 25th March 2020, this story by Ed Yong starts with counting the horrors of the novel coronavirus disease, which include crashed economies, broken health-care systems, filled hospitals, emptied public spaces, and workplaces. It has separated people from their near and dear ones and has led to the disruption of modern society on a scale that most of the world never witnessed. In such a scenario, America, which is supposed to be the readiest of nations regarding the pandemic preparedness, failed the test given by COVID-19. It was not able to accurately track the spread of the virus, which led to the inability of the hospitals towards executing their pandemic plans, ordering extra supplies, or assigning specific facilities to deal with this crisis.
The near-term future is almost set. It is a slow and long illness — the people infected several days ago will start showing symptoms now and infect others. These numbers are going to increase exponentially. If left unchecked, the hospitals will eventually be out of rooms, staff, and supplies — a lesson that the world needs to learn from Italy and Spain. Amidst all this terror, the USA has fallen behind in its fight with corona, but it is not impossible for it to catch up.
Fantastic Four to the Rescue
According to Yong, four things should happen quickly to avert significant destruction. The first is the rapid production of masks, gloves, and other personal protective equipment. The primary line of defense will collapse if the health-care workers do not stay healthy. All the manufacturers must switch to making these things of necessity. The second is ensuring a massive rollout of COVID-19 tests. With FDA’s help, tests developed by private labs are in the process of being approved. They deliver results within an hour, allowing doctors to detect COVID-19 cases quickly. The third is social distancing. This horrific exponential disease curve can be flattened if people physically isolate themselves from others to break the chains of transmission. Persuading an entire country to practice self-isolation and quarantining is not at all an easy task. In these moments, clear coordination matters, and it constitutes the fourth urgent requirement. The importance of social distancing should be emphasized to the public. They should be well informed and reassured.
Possible Pandemic-Ending Strategies?
Yong explains that there are three possible ending strategies for this disease. The first is that every country is able to defeat the virus simultaneously. But given the widespread nature of this illness and poor performance rates of many nations, the odds of conquering this virus worldwide seem pretty small. The second involves the virus doing what past flu pandemics did. It will burn through the world and leave behind some immune survivors when it is unable to find viable hosts. The problem with the current situation is that COVID-19 seems to be on an infecting and killing spree, which makes it likely to cause millions and millions of deaths and a hopeless world. The third and last, which is also the best, longest and most complicated, is the world playing a game of whack-a-mole with this virus, fighting outbreaks until a vaccine is produced. Creating and testing a novel and effective vaccine requires a lot of time, and then it also needs to be mass-produced. To overcome this enormous time lag, some countries are trying to modify existing vaccines to make new ones. Another advantage of this approach would be that if it is successful, the world would already know how to make its hundreds of doses.
Exploring the Unknown
Coronaviruses often tend to be winter infections that disappear during the summers. Is it true for this virus strain as well? The world still needs to figure it out. When the milder coronavirus strains infect people, they remain immune for less than a year. The ones who were infected by the original and more severe SARS virus stayed immune for much longer. Assuming that COVID-19 lies in the middle of these two scenarios, might the people who recovered from it stay protected for a couple of years? To confirm this hypothesis, scientists need to develop accurate tests. Similarly, Scientists can use the periods between bouts of social distancing to develop antiviral drugs.
The Ugly After-Effects
Yong writes that about one in five people have lost working hours/jobs in the USA. The hotels are empty, small businesses are closed, and airlines are grounding flights. Inequalities between different economic sections of the society will widen. This disease has destabilized the entire globe. A secondary pandemic of mental health problems, due to extended periods of continuous social distancing, will soon follow. There is anxiety, panic, and terror in the air. The elderly and children are being and will be affected the most. The health workers will require time to get back to normal.
Rays of Hope
A much better world can emerge after the people come out of this crisis. People are finding new ways of socializing and connecting with each other. Some good health habits, such as washing hands for 20 seconds, which were earlier difficult to incorporate, have now become a part of our lives. People have been remarkably quick to adopt practices like remote working, proper sick leaves, virtual conferences, and flexible child-care arrangements. In terms of the climate, the air is cleaner, the water is purer, and the wildlife is thriving.
Both the episode and the article, which I included in my write-ups today, point towards the fact that pandemics are democratizing experiences as well as catalysts of social change. An outbreak like the COVID-19 is fully capable of grabbing our eyeballs towards taking the matter of public health pretty seriously. If the world works on this constructively, one might hope that the lessons learned will prepare us better for the next inevitable epidemic.
“Be informed, be prepared, be smart, be safe. Be ready to fight COVID-19.” — World Health Organization
