The Spanish flu killed tens of millions of people, the AH1N1 pandemic tens of thousands, and the COVID-19 to date thousands – with foreseeably a lower rate of deaths
By Dr R Neerunjun Gopee
‘People shouldn’t panic’ – Dr Soumya Swaminathan, WHO Chief Scientist
In an interview on NDTV on Monday 2nd March, the Chief Scientist of WHO Dr Soumya Swaminathan’s main message regarding the current epidemic of Coronavirus, named COVID-19, was that ‘People shouldn’t panic’. Instead, they can help to impede the transmission of the virus by responsibly implementing the simple precautionary measures that have been advised by the WHO as well as by other medical and health authorities. These are:
- Wash your hands frequently and properly: soap and water will do.
- Do not shake hands (for example say Namaste or hello), or greet with kisses.
- Cover your mouth when coughing or sneezing i.e. cough or sneeze into the hollow of your elbow.
- Avoid touching your face – the mouth, nose, eyes and ears are all routes into your body for viruses, and your fingers are constantly in touch with surfaces that may contain viruses. This simple measure is very hard to maintain consistently, but is essential for infection control.
- Avoid close contact with those who are already infected. Keep at a distance of at least one metre from a person who is potentially infected and is coughing/sneezing.
- Those who are sick should stay at home – that is, ‘self-quarantine’, and use masks.
- Avoid crowded places as far as possible.
- Disinfect your mobile device screen at least twice per day – once at lunch and once at dinner time (or linked to another daily routine), because viruses like COVID-19 may be able to persist for up to nine days on smooth glass and plastic surfaces, like a mobile phone screen.
And, most importantly: Spread the message about taking these precautions through your network of family and friends. Along with other large scale measures that are being taken at national and global level (such as quarantine where required, blocking entry at ports, restrictions on travel and flights, restrictions/cancellations of visas, etc.), when a very large proportion of the population consistently implements these aforementioned behaviours, the transmission of the virus will be reduced, epidemics can be prevented or vastly limited, and countries may not have to impose quarantine.
The message of the WHO Chief Scientist was echoed in a tweet by Prime Minister Narendra Modi: ‘There is no need to panic. We need to work together, take small yet important measures to ensure self-protection.’
Update on the epidemic
As of March 2, 2020, there were 88,930 cases and 3,043 deaths in more than 60 countries reported to WHO, with the largest number of cases globally distributed as follows – China: 80174 (2,915 deaths); South Korea: 4212 (22 deaths); Italy: 1689 (35 deaths); Iran: 978 (54 deaths); International conveyance (Diamond Princess): 706 (6 deaths).
What has been noted is that as the number of new cases and deaths registered in China is falling, it is rising in other countries, but in most of them it is still in single digit numbers. In fact, at the media briefing on February 28, WHO Director-General Dr Tedros Adhanom Ghebreyesus said the continued increase in the number of cases, and the number of affected countries over the last few days, are clearly of concern, and as a result ‘we have now increased our assessment of the risk of spread and the risk of impact of COVID-19 to very high at a global level’. But he added that so far what is seen are linked epidemics of COVID-19 in several countries, most cases can still be traced to known contacts or clusters of cases.
WHO does not see evidence as yet that the virus is spreading freely in communities, and thus, ‘as long as that’s the case, we still have a chance of containing this virus, if robust action is taken to detect cases early, isolate and care for patients and trace contacts,’ Dr Tedros stressed, explaining as well that ‘there are different scenarios in different countries, and different scenarios within the same country.’
He added that ‘the key to containing this virus is to break the chains of transmission’ – and this is where all the precautions outlined above to be taken by individuals, as well as the more major ones have their significance.
It is almost inevitable that countries not yet affected will register their first case sooner or later, and that applies to ours as well, but if we act as responsible citizens in implementing the recommended measures and strictly abide by any advisories issued by the health authorities, there’s every reason to believe that we can diminish both the risk and the impact of COVID-19 as it continues its onward spread globally.
It may also be noted that Dr Tedros said that work is progressing on vaccines and therapeutics. He confirmed that more than 20 vaccines are in development globally, and several drugs are in clinical trials. The first results are expected in a few weeks, but it may be a year before a vaccine becomes available for widespread use.
Getting a sense of the epidemic
There is a lot of misinformation and disinformation being spread on social media about COVID-19 ever since the first case was detected in Wuhan in China. So much so that WHO has coined the term ‘infodemic’ for this phenomenon, and leading researchers to comment that as COVID-19 spreads around the world, ‘spreading just as fast, it seems, are conspiracy theories that claim powerful actors are plotting something sinister to do with the virus’ with an apprehension that the ‘medical conspiracy theories… have the potential to be just as dangerous for societies as the outbreak itself.’
One conspiracy theory proposes that the coronavirus is actually a bio-weapon engineered by the CIA as a way to wage war on China. Others are convinced that the UK and US governments introduced the coronavirus as a way to make money from a potential vaccine. One might recall that a similar allegation regarding vaccines was made during the AH1N1 pandemic of 2009-10, but a high-level committee set up by the WHO Director General which conducted an enquiry found no evidence to support it.
What can help us put the current epidemic in proper and a more balanced perspective is to compare it with previous global epidemics. As far as the 20th century goes, the reference one is the Spanish flu pandemic of 1918-20, coming at the tail end of the First World War, which was caused by an H1N1 virus. It killed between 50 million and 100 million people, with a mortality rate of 1-3%.
In contrast, the 2009 flu pandemic, caused by a new H1N1 known as AH1N1 that lasted from April 2009 to August 2010, is estimated to have affected around 700–1400 million people (of the then global population of about 6.8 billion), and killed about 150,000–575,000. It thus had a lower mortality, much less that 1%.
Comparatively, therefore, the number of people affected by COVID over an equivalent period (three months) is considerably less. So too is, to date, the mortality rate, a fraction of 1%.
Put another way, the Spanish flu killed tens of millions of people, the AH1N1 pandemic tens of thousands, and the COVID-19 to date thousands – with foreseeably a lower rate of deaths.
Given this scenario, we need not therefore despair. Rather, we should all help to sustain this positive trend, and have the satisfaction of contributing our share, however small, to the global efforts being made to contain the epidemic.
Let us therefore – Not panic, and take precautions instead.
* Published in print edition on 6 March 2020
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