Wednesday, March 11, 2020

Coronavirus (Covid-19) is a wake-up call. Pandemics happen & we need to be prepared

Among major disasters that can potentially affect large percentages of the human race, few are as regularly recurring and as able to be mitigated as pandemics. In the 92-year period from 1918 to 2010 alone there were five influenza pandemics:

Image may contain: 1 personSpanish flu (1918–1920)
Asian Flu (1957–1958)
Hong Kong Flu (1968–1969)
Russian Flu (1977–1978)
H1N1/09 Flu Pandemic (2009–2010)

So, we know they are coming and there are more pandemics than just those caused by influenza viruses as we are now discovering.

We are currently in the midst of a Covid-19 pandemic as declared today by the World Health Organization. The World Health Organization has extensive literature and guidance on how to prepare for and respond to epidemics and pandemics. There is no reason for the countries of the world to not be prepared, but we were unprepared and that needs to change.

Covid-19 is a serious concern. It is more infectious than the flu, current estimates are that it is twice as infectious as the flu, and its mortality rate seems to be several times higher than with the flu pandemics of the last 100 years. The World Health Organization's last estimate of its mortality rate is 3.5% whereas the 1918-1920 influenza epidemic had a mortality rate of 0.9%.

At the same time we are very lucky. Children do not seem to experience serious infection by Coronavirus. The mortality rate for a pandemic could just as easily be 10%, 30%, 70% or more. If we experienced something like that in our current state of preparedness, we could lose significant proportions of the global population and the disruption afterwards to the economy, infrastructure and global supply chain could take years or even decades from which to recover.

That is why, once this crisis is over, it will be time for the globe to focus on exactly what to do once a pathogen seems to be on its way to becoming a pandemic. There should be several well thought out scenarios with triggers depending on infectiousness and mortality rate. Something like Covid-19 or worse should, among other measures, prompt a rapid shutdown of non-essential air travel, cruise travel and a mandatory 14-day quarantine for any people traversing international borders. Had that occurred towards the beginning of the crisis, we would likely not have had the virus spread even remotely as much as it has. There should also be stockpiles in each country of the medical supplies and equipment one might need in such a situation to include standby space to house the sick while they are receiving treatment. 

One of the concerns right now is that few if any countries have the ventilators, ECMO and intensive care equipment and facilities in necessary supply that might be required to give all those who become afflicted with the more serious forms of Covid-19 a chance to survive. There are also not enough respiratory therapists to treat those who will need these kinds of treatments nor can you train respiratory therapists quickly enough. This specialty requires a minimum of 2-4 years of training.

All of these types of concerns should be addressed quickly after the current crisis has abated. WE must do this planning. We know these pandemics are coming. We are paying for our lack of preparedness this time around. Let's not let this happen again.

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