The pandemic changed the way we view external threats

We have become nonchalant about viruses for too long.

The war on viruses was declared over in 1969 according to one quote: “it is time to close the book on infectious diseases and declare the war against pestilence won.” We had defeated the invisible killers. Now the focus should be on chronic diseases such as cancer and heart disease.

Guess what? Viruses are not some distant threat. They are back with a vengeance.

image: Los Angles Times

The above quote was wrongly attributed to U.S. Surgeon General William H. Stewart. No one is sure just where the quote came from but as we let our guard down, a seemingly ordinary virus punished the world with the COVID pandemic.

How blithely we forgot the pandemic of 1918 when the microscopic killer circled the entire globe in four months and claimed the lives of more than 21 million people.

For the longest time, we didn’t take viruses (and other pathogens that cause infectious disease outbreaks) all that seriously.

Now a deadly assortment of viruses is raining on our parade of indifference.

For example, Respiratory syncytial virus (RSV), human metapneumovirus, rhinoviruses are taking their toll writes medical reporter Andre Picard (Globe and Mail, December 27, 2022)

And while HIV/AIDS has been quietly forgotten, it’s still with us. Polio, which was on the verge of eradication, has popped up in New York. Ebola reared its ugly head anew in Uganda. Monkeypox is spreading in strange new ways. Measles and other vaccine-preventable illnesses are making a comeback.

We may want to forget COIVD-19 but the coronavirus has not forgotten us. We long for “prepandemic” normalcy, but 2022 was actually the deadliest year yet for COVID-19.  In 2022, Canada surpassed 17,000 deaths, more than the 14,642 deaths we recorded in 2020 or the 16,489 in 2021.

We still don’t know if SARSCoV-2 will mutate further. A fifth wave of Omicron is just beginning.

One misconception is that exposure to COVID-19 may actually provide a benefit of immunity. Antivaxxers hope exposure will protect them against further infection.  Now it’s becoming evident that the opposite is true.

COVID-19 infections cause “immune dysregulation” in which the body either underreacts to foreign invaders, causing infections to spread quickly, or it overreacts to foreign invaders.

Even at the best of times, we know that viruses mess with the immune system, making it easier for secondary infections to strike. Pathogens interact with each other in strange ways.

We had become nonchalant about coronaviruses. Ordinarily, they only cause colds. That COVID-19 could kill 6.7 million globally was unexpected.

The pandemic changed the way we interact with the world in ways that only events such as the attacks on the World Trade Center in New York and the Pentagon did on September 11, 2001.

The attacks on 9/11 spawned conspiracy theories and denial in a way that the pandemic has.

In addition to strict boarding procedures on planes put in place by 9/11, there is the additional threat of viral invaders while flying.

The pandemic has shifted our view of foreign threats. Before 9/11, attacks on North America were incomprehensible.

With COVID-19, the threat is closer that we imagined.

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Sometimes it’s not easy being a pro-vaxxer

Despite the fact that vaccines have saved uncountable lives and virtually wiped out smallpox, polio, tetanus and rabies, vaccine risks exist. When those risks result in death, people lose trust in all vaccines.

image: Skeptical Raptor

Look at what happened in the Philippines. In 2015 they purchased three million doses of a new dengue vaccine.

Dengue is not as deadly as it might seem. Three-quarters of people infected by the mosquito-borne virus don’t notice anything. The remainder fall into three groups – symptoms similar to the common cold; or a fever accompanied by headache, pain behind the eyes, aching joints and bones that sometimes leads to internal bleeding; or the most deadly, dengue hemorrhagic fever and dengue shock syndrome where plasma seeps out of capillaries, liquid pools around organs, massive internal bleeding ensues. The brain, kidneys and liver begin to fail (Scientific American, April, 2018).

In the Philippines with a population of 105,000, dengue kills an average of 750 people a year. Any death is one too many but that number doesn’t even put dengue-deaths in the top ten list of killers. Of infectious diseases, many more die from pneumonia and tuberculosis.

The dengue vaccine wasn’t cheap. Made by the pharmaceutical company Sanofi Pasteur, Dengvaxia cost more than the entire national vaccination program for 2015, which covered pneumonia, tuberculosis, polio, diphtheria, tetanus, pertussis, measles, mumps and rubella. And it would reach less than one percent of the population.

Some wondered if the vaccine Dengvaxia had been oversold to the Philippine government in a panic mode.

Here’s where the nightmare for pro-vaxxers comes in.

Internist Antonio Dans and paediatrician Leonila Dans at the University of the Philippines Manila College of Medicine discovered some startling results: young children who were vaccinated were more like likely to suffer from dengue that those who weren’t vaccinated.

They found this out by studying publications by the makers of the vaccine, Sanofi Pasteur. While it worked for older children, for younger ones, the vaccine made things worse.

The two Dans warned the Philippine secretary of health in 2016 of their findings but in the meantime, the World Health Organization said that there was no problem.

“It was either believe us or believe the WHO,” said Antonio Dans. “If I were them, I’d believe the WHO. I mean, who were we? We were just teachers in a small medical school.”

The Philippine secretary of health responded with her own warning: doctors who engaged in “misinformation” on the vaccine would be responsible for every death from dengue that could have been prevented.

Then Eva Harris, a dengue expert at the University of California, Berkeley, found strong evidence in 2017 to support the Dans:

Harris’s evidence made the world take notice. Now Sanofi Pasteur and the WHO don’t recommend Dengvaxia for young children who have not been previously infected.

The reasons why Dengvaxia makes matters worse for children who have not been infected and better for those who have is puzzling. There are a few theories but it’s debatable.

The confusion has led to lack of confidence in vaccinations. In 2015, 93 per cent of Filipinos strongly agreed that vaccines are important.  In 2018, less than a third thought so.

Now, Filipinos suspicious of vaccines aren’t getting kids vaccinated and several outbreaks of measles have occurred.

Vaccines save lives but in a rush to save lives at any cost, the rollout of Dengvaxia was too soon and the cost was a loss of confidence of all vaccines.