Col Ikram Ullah Khan

A prelude to more pandemics

Col (r) Ikram Ullah Khan

The devastating Coronavirus-19 variant abbreviated as Covid-19 has caught the entire globe off guard. Even the most advanced countries like the USA, China, France and Germany with their latest, most sophisticated and cutting-edge technology were rendered spineless before the pandemic virus. It has played devil with the mightiest and most robust economies of the world let alone the weak economies of the third world countries.

But despite all the palpable effects of the pandemic on human life, people are still found sceptical about the reality of the virus and are mentally not prepared to take it seriously. Conspiracy theories about the virus are making the rounds in the public belonging to third world countries in particular, especially the countries with conservative approach, and advanced countries in general. The most popular theory among them being that the virus was developed in a Chinese laboratory in Wuhan from where the epidemic originated and turned into pandemic, and that it was aimed at targeting the US economy.

The theory became so popular that even the Americans were led to believe that it could be China’s conspiracy against the US. But these theories aside, the pandemic has badly exposed the world’s abysmal health management system of even the most advanced countries like the USA and China boasting robust economy. What we are facing today in the shape of different ailments ranging from mild to serious like the present pandemic, can be imputed to our casual approach to life right away. We need to understand that human life is too serious a  business to trifle with.

It may be kept in mind that the pandemic is not going to leave us any soon. We have to live with it for a few more years preparing ourselves at the same time to brace for another pandemic, maybe more severe than the present one. According to researchers, public health practioners and epidemiologists who claim to have conducted extensive research on pandemics, even if the world succeeds in getting rid of the present disease, it would be very much likely that we may face even a bigger challenge in the form of more fatal pandemics in succession. According to them, the present viral disease is just a wake-up call and a harbinger of many more pandemics that the world is yet to confront. Sorry to present a nightmarish scenario, but the reality must be faced and we need to take the bull by the horns. Hence, there is a need to do meticulous planning on war footing to obviate any debilitating effects of future viral diseases on human health and economy and tackle the upcoming health challenges upfront which we ordinarily take for granted.

As I have said earlier that the Covid-19 pandemic took the world by surprise. For years, researchers, public health practitioners and epidemiologists have warned that we have been setting ourselves up for a global pandemic. The effects of irresponsible human activities on the climate, encroachment on wildlife habitats and global travel have helped spread animal- borne diseases like the present one. Combined with urbanization, overpopulation and global trade, we have set up an environment for more pandemics to visit us. Extreme global connectivity means that the next epidemic is only a flight away. In 2018, the World Health Organization (WHO) warned of several infectious diseases that pose a serious threat to public health most of which have no vaccines yet. It called one of them “Disease X” — a future disease that human had never experienced before that would cause a pandemic.

Covid-19 has proven to be “Disease X”, and the world is racing to develop treatments and vaccines to fight it. Many diseases identified by WHO normally exist in animals, so the likelihood of outbreak increases when animals and humans more frequently come into close contact, such as through habitat encroachment, animal husbandry and wildlife trade. So, this combined with other factors like air travel, urbanization and climate change means that even after this pandemic is over, the potential spread of other pandemics is very probable. WHO has listed a number of epidemic diseases with inherent potential to turn into a pandemic which are likely to grip the world in the years to come besides the present Covid-19. Out of this long list, today, I am going to deliberate upon only a few fatal epidemics that have the potential to badly affect our life and economy.

  1. Ebola. It’s an epidemic disease which spreads through indiscriminate gathering and is transmitted through direct physical contact with infected bodily fluids, especially blood, faeces and vomit. This puts families of infected people and health care workers at extremely high risk. In February 2020, a vaccine called “Ervebo” manufactured by a pharmaceutical company Merck was developed to treat the disease.
  2. Marburg Virus Disease (MVD). From the same family of Ebola, MVD causes similar symptoms as Ebola and is spread in a similar way. Marburg is incredibly deadly, killing as many as 88% of people it infects. The mere fact that no treatment such as vaccine has been developed so far to cure the disease, is more alarming given its extremely high rate of mortality.
  3. Lassa Fever. Like the above-mentioned two diseases, Lassa Fever is a viral haemorrhagic illness that damages organs and ruptures blood vessels, and 1 in 5 people infected with Lassa virus suffers severe disease affecting the liver, spleen and kidneys. The virus is often transmitted by the urine or faeces of rats via contaminated household objects. Health care workers who are in contact with the blood or organ tissue of patients can become infected. It can also result in long-term hearing loss after recovery. It regularly causes prolonged outbreaks unlike Ebola and Marburg that cause sporadic and deadly outbreaks and then subside. The mortality rate of Lassa Virus is 1-15 % of those infected which is much less than Ebola and Marburg.
  4. MERS-COV. Middle East Respiratory Syndrome Coronavirus abbreviated as MERS-COV is a coronavirus which has caused a significant threat to global health in the last two decades. As a viral respiratory illness, it spreads through respiratory secretions such as coughing. Unlike other viruses mentioned earlier, it doesn’t spread easily from person to person unless they are in close contact. MERS-COV vaccine has been developed and has gone through clinical trials, yet its efficacy percentage has not been established.
  5. SARS. Severe Acute Respiratory Syndrome (SARS) has already caused a global pandemic back in 2003 with insignificant mortality rate compared with Covid-19. Yet its return with more severity can’t be ruled out. The virus is transmitted through respiratory droplets when an infected person sneezes or coughs.
  6. Nipah Virus (NIV). It’s a virus from measles family with extremely high rate of mortality. Research conducted on the virus shows that it can kill 75% of people it infects. It can cause extreme brain swelling, the symptoms being headache, stiff neck, vomiting, dizziness and falling into coma. According to researchers and health professionals, the virus is common in bats and can be contracted by humans . Once the virus is transmitted into humans, it can spread through respiratory secretions such as coughs and sneezes when people are in close contact. The point of much concern about this virus is that it could mutate to spread much more easily.
  7. CCHF. Crimean-Congo Haemorrhagic Fever (CCHF) most commonly called Congo Virus is a viral disease that mostly affects animals, especially livestock, and is usually spread through the bite of an infected tick, but people can contract the virus when they come into contact with recently slaughtered infected animals. Once the virus is transmitted into human, then human-to-human transmission takes place through exposure to bodily fluids of infected people. The virus causes flue-like symptoms but later on patients can develop severe, uncontrollable bleeding. In this context I would like to make a special mention that it’s generally observed that on the occasion of Eid-ul-Azha, people neglect to exercise due care while slaughtering sacrificial animals. Some of us even prefer to keep the sacrificial animals at home for a few days or even weeks and let our children keep close contact with them and play with them. This practice can be a spreading agent of the fatal virus. So it’s advisable to exercise utmost care and keep our children away. Proper safety protocols must be observed on such occasions.

Having said all that, a million dollar question is, are we prepared to take on the health challenges? The answer is regrettably a big “NO”. Despite a few measures taken by the technologically advanced countries like the USA and China to combat the disease, much more remains to be desired as significant gaps and formidable challenges exist in global pandemic preparedness. Progress to subdue the virus has been unsatisfactory and many countries have been unable to meet basic requirements. The third wave of COVID-19 has exposed gaps related to the adherence of health protocols, tracing of contracts, quarantine and isolation procedures, and preparedness outside the health sector. Public health practioners are of the view that with the existing preparedness it would be extremely difficult to cope with any future pandemic challenges. Regrettably, COVID-19 experience has shown we are least prepared to face a health emergency. We have miserably failed to systematically invest in health sector. The GDP percentage we are allocating for health sector is much below the mark.

To make things worse, the 18th amendment has further weakened the grip of the federal government over the provinces when it comes to national coordination during emergencies like the present health emergency thereby necessitating the need to establish an authority with the name of “National Command and Operation Centre (NCOC). Besides, there is a dire need to raise a dedicated Rapid Response Force (RRF) at district level to tackle health emergency situation. We also lack a robust health surveillance system. We need to understand that Covid-19 is not the last pandemic we are grappling with. There are many more, maybe more severe than the present one, awaiting to visit us. Who knows when the next pandemic will hit us. What all the world has learnt from Covid-19 is to prepare for the worse that it has to confront in the future. Hence, there is an intense need to reset our health priorities in order to successfully deal with any future eventuality.

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