Health

Is COVID-19 containable

The coronavirus pandemic now rivals lifestyle diseases in its spread

 
By Richard Mahapatra
Published: Tuesday 17 March 2020

The planet is under containment. Barring lifestyle diseases, no other disease or infection ever had this grip in contemporary time: 148 countries and close to 1, 68,019 patients spread over every continent, except Antarctica.

Rich or poor, some 400 million people have been barricaded and pushed into an isolated living. At least five countries have effectively isolated themselves through universal travel   bans. This is called the containment stage in a fight against an epidemic.

But the invisible foe — COVID-19 — has already escaped our grip and spreading too fast. Since February, cases outside China increased 15-fold. Our helplessness in controlling this first non-flu pandemic of the 21st century has resulted in rampage of panic and hysteria. Health experts no more hopeful of containment but debate whether it containable anymore?

We still don’t know how and when it crossed over into a human host from an animal. But we know for sure now that it is a prolific jumper from human to human. Taking clue from the worst pandemic of 1918, we social animals have been prescribed with social distancing — measurable to 3 feet — as the best way forward to delay transmission of COVID 19, not to stop it.  

Coronavirus is not new to us, but COVID 19 is. It is the third such this century. And its characteristics are not in line with this family of virus.

Coronaviruses are supposed to have evolved in humans to widen their spread: Not to kill, but to sicken. That is not happening this time. COVID 19 has already killed more than the earlier two such infections put together — the SARS and MERS. 

Its symptoms also don’t follow observed patterns. They are mild enough to be noticed and in many cases even absent after being diagnosed.

That is where the spread is unbridled: We don’t treat or contain those who don’t show symptoms. After the outbreak in China, the immediate screening and detection elsewhere were not adequate. In Africa, Chinese workers were allowed immediately after the New Year holiday unscreened.

This also makes all of us a potential carrier of the pandemic, making it simply uncontainable. Marc Lipsitch, a professor of epidemiology with the Harvard University, says: “I think the likely outcome is that it will ultimately not be containable.” After China’s quarantining 100 million people in and around the epicentre, COVID 19 spread to rest of the world much faster.

As screening and detection became aggressive across the world, new epicentres or secondary hotspots emerged in hydra-like splits, from Europe, the ‘Middle East’ and elsewhere in Asia and now in African countries.

This means the world has to mount an even bigger and more expansive containment and surveillance to get to each suspect and scan all those in touch with the individuals. Developing countries are dense in settlement and population.

This makes containment and detection less effective, thus allowing transmission in multiple chains, almost like an uncontrolled atomic chain reaction.

T Jacob John, a paediatrician who has extensive experience of more than 25 years in microbiology and virology, says: “As much as 60 per cent of the Indian population would be infected in a year’s time because the infection would be seeded well. The reason why I put such a number is the fact that unlike mosquito- or water-borne infections, this is a respiratory infection.”

The world is now letting go the spread to such an extent that it becomes a general community infection, like any other cold and flu. It is argued that in such a scenario the community would develop the immunity thus the capacity to fight.

That also means that COVID-19 fatality would be by the thousands until we reach this level of infection.

“What is important is the time scale that this takes place over: Whether it is in a matter of six-nine months, which will completely overwhelm many health systems, or over many years which will allow health systems to cope adequately,” says Yik-Ying TEO, dean of Saw Swee Hock School of Public Health, National University of Singapore.

This is already the situation in Italy and Spain while India and African countries are waiting to erupt. As the virus spreads, the already stressed health infrastructure would be put to extra pressure. This will be overwhelming and increase fatality.

There is almost an acceptance that the world goes through seasons of flu and cold. Most of them are infections that erupted as epidemics in different points in time but gradually became seasonal.

Are we going to experience the same? Some epidemiologists believe we would soon have a COVID-19 season too. But before that, there would be a heavy human cost.

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