Hard realities about the Covid-19 pandemic

By Dr R Neerunjun Gopee

As at March 29, 2020, 12:15 GMT the global tally of coronavirus cases was 680,195, with deaths at 31,905. For Mauritius the corresponding figures were: 102 and 2.

There is a literal tsunami of information circulating about the pandemic, including fake news on social media liable to cause panic and in some cases even meant for rabble-rousing. The latter can divert the energies of the law and order forces which are already overstretched in all jurisdictions. It is important therefore that people be very mindful about getting the correct information from authoritative sources, and not be swayed by all manner of claims about such issues as the extent and spread of the pandemic, medical therapies, alternative treatments, prevention modalities and so on.

There is a saying quoted in management workshops which goes: the only thing that is constant is change.

As regards Covid-19, the only thing that is certain is that, from the beginning, there have been a lot of uncertainties. And some queries that are yet to receive plausible answers.

For example, how did the epicenter shift from Wuhan in China to Lombardy in Italy and is now in New York, USA?

How come Beijing and Shanghai in the Chinese mainland have registered only about 500 cases, with only a few deaths, whereas the number of cases is rising exponentially elsewhere as also the number of deaths, which have already exceeded China’s in Italy and Spain?

We are up against some hard truths which are going to haunt us for quite a while.

Except for Singapore, no country was prepared to deal with Covid-19 as it began to spread from China. Singapore had learnt from its traumatic experience with the first SARS epidemic in 2003, and immediately thereafter began to prepare itself for another epidemic. It is considered a model for the world to emulate. There are lessons for Mauritius too, and we will have to apply them once this pandemic is over, in anticipation of another one as Singapore did.

Even the most sophisticated health systems in the world, top of the list being the USA, have been overwhelmed by the magnitude and the rapidity of spread of the epidemic, and are struggling to cope with shortfalls in medical equipment (ventilators in particular), PPE or Personal Protective Equipment such as surgical gloves/masks/ gowns, medical/nursing and other health professionals, drugs and ancillary supplies.

Allied to this is the disposal of the rising numbers of dead, which is compounded by the emotional and psychological trauma of relatives and friends not all being able to be present or to carry out the proper funeral rites.

How long will this pandemic last? Months, according to an interview in TIME magazine of Dr Bruce Aylward, senior adviser to the Director-General of the World Health Organisation who led a joint WHO mission to China in February to study the effectiveness of the coronavirus response in the country. He bases his view on the exponential growth that is still happening in Europe, North America, the Middle East, which he thinks will be replicated in other parts of the world, like Africa and parts of the Indian subcontinent where the pandemic is just beginning.

What will be the cost in terms of human lives? This will depend on whether we are able to stop the spread of the epidemic, which in turn depends on a) how effectively we apply the social distancing and other public health measures that are recommended, b) the capacity of health systems to treat cases, and c) prevention by means of a vaccine.

Right now social distancing and public health measures, which may mean lockdown for periods of up to four weeks (as New Zealand has done), are judged to be the most effective strategy.

Treatment is currently at best for the symptoms only – medication for cough, fever, aches, etc., and ventilation in extreme cases (about 5%). Countries which have the technical capacity have already begun to manufacture ventilators in large numbers by expanding capacity or repurposing factories.

Hydroxychoroquine use as an antibiotic: although there has been a small promising study in Marseille, France, a specific recommendation cannot be made. This can only be done after clinical trials have established its efficacy, and several are under way. In some countries, such as India, doctors are being advised to use their judgement in individual cases based on their experience with the drug (in cases of malaria, rheumatoid arthritis, lupus), because there are known side effects.

There are many concoctions being advised to boost immunity. Many of these contain ingredients such as lemon juice, ginger, pepper, cloves, turmeric, coconut oil which are already used in preparing food, so nothing new here. Basically one must eat healthily.

What about a vaccine? Dr Paul Young is a virologist who is leading one of the many teams across the world which form part of GVN (Global Viral Network) and are working on development of a vaccine against Covid-19. In an interview by his daughter, a journalist, this is what he says in Prospect, an English magazine: ‘At the very earliest, I don’t see vaccines, even under very accelerated conditions, being available within twelve months. And so, a vaccine may not impact this first wave

Where it probably will have an impact is in a second wave. All the pandemics we’ve seen in the past, which includes the Spanish Flu of 1918-19, have seen a second and even third wave of infection. We may ultimately see this virus establishing itself as one of the many respiratory infections we all encounter each winter season’ (italics added). Note: we have to be prepared for a second wave.

Meanwhile, locally, we have to brace ourselves up for several weeks of hardship. But this can be mitigated by mutual cooperation and collaboration, and culling the best ideas wherever they come from. Because this is much more than a health crisis: instead of being negative, let us accept any constructive criticism, not play politics, and work together to ensure that the needs of the people are being met – for food, fuel, prescription medication and human interaction especially for the elderly.

* Published in print edition on 30 March 2020

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