Dear Reader:

1. Glossary:

pathogen: the word comes from pathos which means suffering, and gen which means the producer of (disease).  A Pathogen may be referred to as an infectious agent, or simply a germ. Pathogens are viruses, bacteria, fungi and parasites that produce disease.

Epidemic: the word comes from epi which means upon and demos which means people. An epidemic is the rapid spread of disease to a large number of people in a given population within a short period of time.

Pandemic: the word comes from pan which means all, and demos which means people. A pandemic is an epidemic that spread across multiple continents, or worldwide.

Endemic infection: the word comes from en which means in or within, and demos which means people. it is an infection that is constantly maintained at a baseline level in a particular area without more added to it from other areas. The seasonal flu is an endemic infection; it occurs simultaneously in large regions of the world (not in one region and then spread out, as in an epidemic turned pandemic).

Crimson Contagion: a simulation administered by the U.S. Department of Health and Human Services from Jan to August 2019 (ending four months before the current pandemic started in China), that tested the capacity of the U.S. federal government and 12 U.S. states to respond to severe influenza pandemic originating in China. The simulation involved a scenario in which tourists returning from China spread a respiratory virus in the US, beginning in Chicago. In less than two months the virus infected 110 million Americans killing more than half a million (currently almost 1.4 million Americans tested positive for Covid-19, and over 81,000 died). Among the key findings: “Federal government lacks sufficient funding to respond to a severe influenza pandemic”, “The United States lacks the production capacity to meet the demands for protective equipment and medical devices such as masks and ventilators imposed by a pandemic”, and “Exercise participants lacked clarity on the roles of different federal agencies”.

Bryan Walsh: a graduate of Princeton University, worked as a foreign correspondent, reporter, and editor for TIME for over 15 years, has reported from more than 20 countries on science and environmental  stories like SARS nd global warming, author of the book End Times: A Brief Guide to the End of the World (2019).

2. www. bbc. com/ future/ article/ .. covid 19 the history of pandemics, article by Bryan Walsh, March 25, 2020. Summary of the article and quotes (my comments are in parentheses):

Over the past 15 years, there’ve been plenty of warnings that “a global pandemic involving a new respiratory disease was only a matter of time”. “In 2019, US President Donald Trump’s Department of Health and Human Services carried out a pandemic exercise named ‘Crimson Contagion'”.

“Throughout history, nothing has killed more human beings than the viruses, bacteria and parasites that cause disease. Not natural disasters like earthquakes or volcanoes. Not war- not even close”

Malaria (an infectious disease caused by a unicellular parasite in mosquitoes that is passed to humans via mosquito bites) still kills nearly half a million people every year. The plague of Justinian (caused by a bacterium) in the 6th Century killed as many as 50 million people, maybe half the global population at the time. The Black Death (caused by the same bacterium) in the 14th century may have killed up to 200 million people. Smallpox (cased by a virus aka viral) killed as many as 300 million people in the 20th century alone. The influenza Pandemic of 1918 (viral) killed 50 to 100 million people, the virus infecting 1 in every 3 people on the planet. HIV (viral), a still ongoing pandemic which still lacks a vaccine, killed about 32 million people, and infected 75 million, with more added every day.

Epidemics are rarely discussed in  history classes, and there are few memorials to the victims of disease. Alfred Crosby authored a book about the 1918 flu: America’s Forgotten Pandemic.

When a virus infects a host, that host becomes a cellular factory to manufacturing more viruses. The symptoms created by infectious viruses and other pathogens (bacteria and unicellular parasites), such as sneezing, coughing or bleeding, cause the spreading of the virus to the next host, and the next. Ro, the Replication Number, is how many people one sick person infects.

It is estimated that the Covid-19 virus’s Ro is at 1.5- 3.5.

The reason that at the beginning of the 19th century the global life expectancy was just 29 years was because so many died from infectious diseases beginning in infancy. Cities in the pre-modern era were able to keep up their populations through a continual infusion of migrants to make up for citizens who died off from disease.

“The development first of sanitation, and then of countermeasures like vaccines and antibiotics, changed all that… It was a victory that won us the modern world as we know it”.

“In the developed world, and increasingly in the developing world, we are now far more likely to die from non-communicative diseases like cancer, heart disease or Alzheimer’s than from a contagion”.

There has been a drastic decline of number of deaths from infectious diseases from about 800 in 1900 to about 60  at the end of the 1990’s, with a brief spike in 1918 (The Influenza Pandemic) and in the 1980s (The AIDS Pandemic).

The reason Covid-19 has been so infectious is that in the past 50 years world population has more than doubled, and cities are densely populated, and we have more livestock than ever in the past, and viruses can leap from animals to humans. Our interconnected global economy, and the ability to get to nearly any spot in the world in 20 hours or fewer, made an outbreak in one place easily arrive to a far away location and spread there. So diseases that would have died out in the past in one location without spreading to new locations, now easily spread to other locations far apart, and in a short time.

Antibiotics saved hundreds of millions of lives since the discovery of penicillin in 1928, but bacterial resistance to antibiotics is growing by the year, a development that doctors believe is “one of the greatest threats to global public health. In fact, 33,000 people die each year from antibiotic resistant infections in Europe alone, according to a 2018 study.

“The spread of vaccine skepticism has been accompanied by the resurrection of long- conquered diseases like measles, leading the WHO in 2019 to name the antivaccination movement one of the world’s top 10 public- health threats.”

When Covid-19 hit the world, human response was on one hand modern: scientists around the world are using cutting- edge tools to rapidly sequence the genome of the coronavirus, and easily communicate and collaborate, information is available to all via the internet, on one hand, and on the other hand, we are doing what our ancestors did to halt an outbreak of a plague: shut down society.

“We need to strengthen the antennae of global health, to ensure that when the next virus emerges- which it will- we’ll catch it faster, perhaps even snuff it out.”

“Just as the eventual emergence of something like Covid-19 was easily predictable, so too are the actions we should have taken to shore ourselves against its coming… We need to double down on the development of vaccines, which will include assuring large pharma companies that their investments won’t be wasted should an  outbreak end before one is ready… our health care systems should have the surge capacity to meet the next pandemic. One ongoing challenge in pandemic preparation is what experts call shock and forgetting. Too often politicians make funding promises in the immediate aftermath of a crisis like SARS and Ebola, only to let those pledges lapse as the memory of the outbreak fades… Somehow, I expect that won’t be the case with Covid-19″.

anita

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