PANDEMICS

Plagues and pandemics are not new phenomena; however the current covid-19 pandemic is new to the developed world. We live in wondrous times; we expect to have no famines, no widespread infectious diseases like the ones so common a few centuries ago, which is why the current pandemic was so shocking, it shook our complacency.

It is my intention to examine our societal response, the overall effect and how we should prepare for the future.

The last serious virus pandemic was the Spanish flu which killed millions immediately after the end of WW1, since then our medical knowledge has increased exponentially, hence no-one expected a repeat. However I would suggest that complacency is not in order.

Today many diseases, like the bubonic plague and typhoid are mainly historical curiosities. To some extent we can thank medical science, but in fact the more important factor is better plumbing and water management. In the developed world we are confident that the water that comes out of the tape is safe to drink. So in what way are things basically different than they were for the past 100 years, and why is this significant?

The most significant change in recent times is the concentration of populations in cities. When the USA was founded, over 90% of the population were farmers, today 2% of the population farms the land and not only provides enough food for the other 98%, but exports food to the rest of the world. As the developing world struggles to catch up financially this population concentration is accelerating. City dwellers not only live in close proximity to each other, but move together on public transportation, congregate in masses for work, entertainment, education and public prayer. Typhoid is rare today because the water we drink has not recently passed through someone else’s body, but the air we breathe has often very recently passed through some else’s lungs.

Viruses live and multiply in their hosts’ bodies, they cannot live long in the open. The concentration of human populations creates ideal conditions for the spread of viruses. The rapidly accelerating trend, citification, will not stop; hence as the conditions favoring viruses continues, we can expect more outbreaks occurring in the near future. Another factor favoring the rapid spread of viruses is international travel; 100 years ago most people were borne, lived and died within a 40 kilometer radius, even 15 years ago, international travel was limited to the wealthy nations, or the more affluent members of society. Cheap air travel, and the expansion of affordable accommodation worldwide has changed this, everyone travels now.

Both of these changes in human behavior make virus based pandemics more likely.

In any war or competition one has a choice of acting defensively, or offensively, or of course both.

Due to the unprecedented situation posed by the Covid-19 pandemic, governments, scientists and individuals have not reacted smartly to the challenge; it’s hard to be smart when faced with an unprecedented challenge. Of course lack of knowledge has never stopped politicians from claiming that they know better than others nor has it stopped them from criticizing others, particularly other politicians, when things turn out badly.

Today we have governments mandating wearing masks in public areas, in spite of the fact that there have been no reliable studies proving that wearing masks works. One study in Denmark showed that masks made little or no difference. We were told that viruses lingered on surfaces, so we had to wash incessantly, then we heard that this was not true. Naturally this plethora of information followed by contrary data made many people skeptical of government mandates. Sorting out what we know for sure from the avalanche of what we suspect is difficult.

Then we have all these efforts to reduce the spread of the disease by limiting human interaction, maintaining 2 meter distances from other people, avoiding entering enclosed spaces with more than a certain number of people, limiting travel, forcing educational institutions and businesses to operate remotely, and finally the lockdowns. All of these actions have had little success, partly because they may not have been effective and partly because some groups or individuals have failed to conform to the rules which many consider as quite arbitrary.

Some things we have learned. Doctors have developed better techniques for helping patients to recover; in fact most people do not die of Covid-19. We know that in most cases only older people or those with prior conditions are in mortal danger; we know that some well-known drugs, used to treat other conditions can help in recovery from the disease, particularly when administered early. Unfortunately when politicians have mentioned this, those who distrust the politician ignore the medical evidence. It is time for the medical profession to take a firmer grip, and for politicians to avoid getting into the fray.

We now have several vaccines available, but we do not know how effective they are, particularly against a virus that can mutate so rapidly; we will not know for several years.

All of these defensive measures are helpful and there is no reason to eschew them because of some vague anecdotal evidence or rumor that suggests that they may be ineffective, or perhaps dangerous. However it is naïve to believe that any or all are 100% effective. To summarize all the defensive mechanisms tried so far have been a dismal failure; perhaps because they were ill advised and perhaps because it was not possible to get a high enough portion of the population to conform. We can hope that the vaccines will work well, but it would be dangerous to assume that they will work 100%. For years we have had good vaccines against flu, but people still contract flu and some die of it. It is time to concentrate our efforts on offensive solutions.

Another approach is to take to the offensive. As mentioned earlier, we no longer fear typhoid fever because sound sanitation and careful water management make the incidence of this fearful killer very low. What we need now are systems to ensure that the air we breathe is virus free. There has been some interesting research which suggests that the Covid-19, and other viruses are vulnerable to ultra violet light. This suggests that it might be possible to devise inexpensive devices that could kill viruses before we breathe them into our lungs. One could imagine an ultra violet beam being reflected back and forth just below the ceiling; as air we breathe out is normally hotter than he surrounding air it should rise, and if the UV light is effective it could kill any viruses. Alternatively something could be added to our air conditioning units to kill viruses as well as cooling or heating the air. I do not know what would work best but am confident that something along these lines is possible. Of course there may be many other ways of ensuring that the air is safe to breathe.

Our immediate problem is dealing with the current situation. Recurrent shutdowns are not acceptable; they destroy economies and it will become increasing difficult to enforce populations to comply. Those countries like Israel which have the determination and ability to inoculate the population effectively will have the opportunity to return to a semi-normal condition provided the vaccines are effective. In spite of all the research and effort that went into developing them we won’t know for sure until several months or maybe years have passed if this is so; Covid-19 is a moving target, like all viruses it mutates, new mutations may or may not be controlled by the vaccines.

What we must do now is improve our testing facilities, accumulate and analyze data to refine our defenses against the disease and do our best to manage an unsatisfactory situation.

For the immediate future we must accelerate our efforts to fight an offensive war against the virus. Surely if we throw enough effort into it we should be able to devise methods to make the air we breathe as safe as the water we drink.

Another step we should take is to ensure that future viral diseases, and there will be future outbreaks, are properly reported as soon as they occur. The fact that China issued false information when Covid-19 first emerged was disastrous, preventing the rest of the world from limiting its rapid spread. Then the WHO disseminated these lies without any verification; this was a disgrace. A mechanism must be set up to make sure that in future any suspected new disease must be investigated by independent experts as well as those from the source country.