YEAR OF THE VIRUS: AN EASTER SNAPSHOT 2004 (2) CXLIX

Year of the Virus: An Easter Snapshot

What follows is not my regular column, but a snapshot on Easter Monday 2020.

Three months into the new decade and all bets are off. Perhaps the Doomsayers are satisfied at getting it right. Most of us are just hoping not to get it wrong! To borrow a phrase – our societies are in a medically induced coma, with no indication of when we will wake up or to what. This is the Year of the Virus; hopefully it will not turn out to be the “Decade of…” The most prosperous economies in the world are stalled, marking time as they combat a major health threat. Even after the pandemic subsides, the prospects for the world economy look bleak. We could be heading for Great Depression territory and the current crop of international politicians will be judged not only on  how they handled the virus, but also how they picked up the pieces afterwards.

Ireland’s first case of the Corona Virus was confirmed on February 29; the first death was on March 11.  Today, Easter Monday, 104 years after the Rising, the current count in Ireland is 10,647 confirmed cases  with 3365 deaths, already well over the combined total of road deaths for 2018 and 2019 (290). In the North there have been 1882 confirmed cases with 124 deaths. On St Patrick’s Day, when the Taoiseach addressed the nation, Ireland had 292 cases and two deaths. Since then Ireland has ramped up efforts to contain the virus, culminating in effectively a lockdown introduced from March 28, which is set to continue until May 5 at the earliest. Few expect more than a modest “tweaking” then and that’s only if the signs are favourable – a situation mirrored to a greater or lesser extent throughout most of Europe and North America.

The current (shifting) count worldwide is 1,929,633 reported cases (the true figure is almost certainly a multiple given the inadequate and inconsistent national monitoring and testing mechanisms) and 119,785 deaths. In the USA, the country worst hit, reported cases are 587,173 and deaths 23,644. The UK today saw the number infected rise to 88,621 and the death toll reach 11,239.  The death toll in Italy is now 19,468, in Spain 17,489 and in France 14,393. Of the major states only Germany, with 127, 916 cases has a significantly lower figure for deaths of 3022. Japan, has 7370 cases but only 123 deaths. While research for a vaccine or suitable treatment is ongoing at a frantic pace in a number of countries, there is no cure in sight.

It’s difficult to find silver linings but there are some grounds for optimism. First, as a reality check, for perspective consider the great Spanish Flu epidemic of 1918-19, which killed up to 50 million worldwide including 22,000 in Ireland, 228,000 in Britain and 675,000 in the USA , and these from significantly lower populations! The fatality rate among those infected was estimated as at least 10%. The fatality rate among confirmed cases for the Corona virus is panning out at roughly two per cent. The Corona virus is also assuredly not as lethal as the Black Death, which may have wiped out over a third of the world’s population in the Fourteenth Century. Compared to 1918, the First World generally is more prosperous, developed and educated with vastly improved medical, societal and hygienic conditions and a more sophisticated and holistic awareness of human health.  Many of the diseases which a century ago might have seriously weakened or even killed significant elements of the population have been controlled or even eliminated by antibiotics and advances in medical knowledge and treatment.

What we face now is a nasty virus, highly contagious and serious to a minority of those infected, particularly the elderly and those with existing medical conditions. How those infected react does not appear predictable, with a low percentage becoming seriously ill – Boris Johnson being the textbook example – but most people recover swiftly after just a light dose. This last should be incentive enough for people to take the recommended precautions. Prolonged exposure to the infected increases the chances of catching it considerably and one particularly disturbing development has been the high number of health workers who have contracted the virus and died in Italy, Spain, the USA and the UK; in Ireland roughly a quarter of the confirmed cases  are among health workers.

Given the urgency, the state of research already into the virus, and the track record of scientists and researchers in tackling previous viruses, including the far more deadly SARS (plus the money being thrown at it),  some form of vaccine or treatment should be developed sooner rather than later. The expectation is that a vaccine could be available in about a year. This is of no consolation to those struck down in the meantime, of course, but, properly applied there IS a Roadmap for dealing with the Virus and hunkering down until a vaccine arrives.

The Roadmap for successfully containing, neutralising and then conquering the Virus (in so far as it can) seems quite clear and has worked in several Asian countries. The measures aim at “flattening the curve” in the exponential rise in the numbers infected, eventually achieving a plateau and then a reduction in new cases.  On the micro level,  washing hands frequently, practicing social distancing ( two meters away from other people), avoiding contacts with strangers , however defined, venturing out from home only to buy necessities, watching  for symptoms, and practicing personal quarantine where necessary  – in short acting  as if you already have the virus. On the macro level the authorities should test ,test, and test – to quote the WTO – to ascertain who has the virus and mount  exhaustive contact work to identify and screen their third party contacts. Movements in and out of the country should be monitored and controlled, travel to and from countries or areas of high infection prohibited, and, where hospitalisation is necessary for the seriously infected, provision made for adequate hospital accommodation, including properly equipped intensive care units, with ventilators as necessary.

A crucial element is the protection of the front line health care workers, through adequate and high quality protective clothing and equipment.

That’s the theory. The reality has proved somewhat different. It worked in China, but China is a dictatorship which can order its citizens as necessary and which has a command and controlled economy which could bring its vast resources rapidly to bear to control the virus geographically. The separate democracies of Europe and North America have no such luxury and are struggling to cope. The vital “hardware” – everything from protective masks, clothing and equipment for the front line health workers to ventilators and adequate hospital accommodation – is in limited supply, or not immediately available, such has been the speed with which the virus has spread.

Our societies are still grappling with the situation. Yet what HAS been evident so far has been the high degree of cooperation and compliance from ordinary people who have rallied and made sacrifices that should bring about the desired results. The health workers are the heroes; ordinary people’s role should not be overlooked.

12/4/2020

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