Pandemics in history, Part II: Mankind will survive Covid-19

Published April 28, 2020, 12:00 AM

by manilabulletin_admin



J. Art D. Brion (RET.)
Justice Art D. Brion (Ret)

In Part I, I outlined two great pandemics in our recorded history.  The first  was the bubonic plague or Black Death that initially killed 50 million people and, in its recurrence, decimated European population by a third.

The 2nd pandemic was the Spanish flu which came in two waves, infecting 500 million people worldwide and killing as many as 50 million from 1918 to 1920.

I lay great stress on these past events as they serve as the premises of my main message in this article: Mankind survived these past plagues and will survive Covid-19. 

Survival has a price, however, and we must pay the price.  

The price includes, among others, better discipline as a people; the reform of our negative ways, and the supportive efforts of a trusting and undivided community.

Science, too, has to be there and must be given primacy; Covid-19, more than anything else, is a health and science issue and must accordingly be addressed.

These are our lessons from the past and they should now be foremost in our minds.

To continue with my recital of history, a pneumonic plague – the Great Manchurian Plague- broke out in 1911 in Manchuria. The illness came from the Tarbagan Marmot, a Mongolian rodent whose fur was a marketed in the fur trade.  The plague killed 63,000 people in various parts of China without affecting the country nationwide.

The whole of China was saved due to the lockdowns, quarantine measures, the widespread use of masks, travel restrictions, the mass cremation of victims, and the border controls that the Chinese government used, sometimes harshly. Even before the creation of the World Health Organization (WHO), China convened an international conference for the study of the plague.

Interestingly, these are the same measures we are using today and we now have the WHO, although governments have not at all really acted together in a common front for lack of effective international leadership.

After the Mongolian plague came Polio, an old neurologic infectious disease that became the first major public health concern soon after World War II.  The disease is caused by the poliomyelitis virus that infects the spinal nerve, causing paralysis. Transmission is person-to-person through exposure to infected fecal matter.

The world held polio in check beginning in the 1950s through science (the development of effective vaccines) and international cooperation. By the turn of the 21st century, it was present only in specific countries in the Middle East and was largely under control.

The next public health concern, Ebola, was first identified in 1976 in two simultaneous outbreaks – one in Nzara in South Sudan and in Yambuku, a village in the Democratic Republic of the Congo, near the Ebola River from which the disease took its name.

It is a viral hemorrhagic fever affecting  humans and other primates, and is caused by the Ebola virus. The disease carried a high risk of death, killing at an average rate of about 50%.

The outbreaks, however, were largely confined to Africa. Between 1976 and 2013, the WHO reported 24 outbreaks involving 2,387 cases with 1,590 deaths. The largest outbreak was the epidemic in West Africa, which occurred from December, 2013, to January, 2016, with 28,646 cases and 11,323 deaths.

While there is no approved treatment for Ebola, two treatments have been associated with improved outcomes as of 2019. A vaccine was approved in the United States in December 2019, although the WHO had declared as early as March 2016 that Ebola no longer involved an emergency.

The SARS (Severe Acute Respiratory Syndrome), the MERS (Middle East Respiratory Syndrome) and the Covid-19 (Coronavirus Disease 2019) that successively followed Ebola, are all caused by the Coronavirus family of viruses which affect both humans and animals.

SARS, the 1st pandemic of the 21st century, started in Guangdong, China. It came in 2002 via the horseshoe bats which contaminated civet cats, which in turn infected humans.

Due to delay in China’s notification (and consequently in the WHO’s alerts and advisories), the disease spread to other parts of China, Taiwan, Hong kong, and other parts of the world, in particular, to Canada and the U.S  But the plague was otherwise short-lived and was not as widespread as Covid-19.

Its key initial symptoms were cough, fever, and diarrhea. It was transmitted through droplets produced by coughing, sneezing, talking, or breathing. People with underlying medical conditions and the elderly were particularly at risk.

The total number of infected cases in SARS’ short life reached 8,439, 21% of whom were healthcare workers. The Philippines suffered two infections but had no fatalities.

Eight Hundred and twelve (812) people died for a fatality rate of 9.6%.  Since this tally, no SARS cases have been reported, although the WHO did not discount its recurrence.

MERS came in 2012.  It originated from Saudi Arabia; was transmitted through camels; and was mainly confined to the Middle East.  Hence, it was more of an epidemic rather than a pandemic.  To date, isolated live cases still exists mostly in Pakistan and Afghanistan.

Transmission was person-to-person by droplets and through camels. Its initial symptoms were  fever, cough and shortness of breath. Men above the age of 60, particularly those with underlying medical conditions such as diabetes, high blood pressure, and kidney failure, were particularly at risk.

The disease  infected a total of 2,519 people, 866 of whom died for a high fatality rate of 34.3%.  No specific treatment or vaccine has been developed, although the disease is now considered under control.

Covid-19 is caused by the SARS-CoV-2 virus that is closely related to the SARS-CoV-1 virus of SARS.  They share the same zoonotic origins, symptoms, and many other characteristics (such as similarity of  at-risk groups – the elderly and those with underlying health conditions; the lack of established treatment so far and the lack of vaccines).

But they are significantly dissimilar in two important respects – in transmissibility and severity.

Covid-19 appears to be more transmissible and hence has a higher rate of incidence.  Its viral load is highest at the nose and throat soon after symptoms develop, and can be transmitted even by people who outwardly show no symptoms.

The transmission of SARS occurs at a later stage when the illness is already advanced and the viral load is heaviest.

In terms of severity, SARS mortality is at 10% and is therefore deadlier, while Covid-19’s so far ranges from 0.25 to 3% but could be higher if people let down their guard; fail to act; or fail to observe the required discipline.

From these perspectives, Covid-19 – properly handled in terms of the preventive and remedial measures now applied by government; with the observance of discipline; and given the scientific initiatives of many governments – may soon fade away like SARS.

If man should have anxieties at all, these fears should lie elsewhere, specifically, on the potential causes of extinction to which we are now recklessly exposing ourselves.  These are in the imbalances we are creating on earth’s interconnected systems through our thoughtless ways, resulting in air, water and soil pollution; temperature imbalances; and irreversible loss of our flora, fauna, water and other precious resources. These losses and imbalances may yet be humankind’s undoing if they are not properly and timely addressed.

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