This is the way the pandemic ends

This is the way the pandemic ends. Not with a bang but a whimper.*

The novel coronavirus, SARS-CoV2, is sweeping the globe like wildfire killing hundreds of thousands in its wake. But its months are numbered. In a year or so, it will become part of the suite of viruses that regularly infect us –it will become endemic.

image: pingtree.com

It will be demoted to a common coronavirus, one of the seven known human coronaviruses. Four are part of the regular group that cause one-third of common colds.

But this virus will be remembered as being distinct from its older brother, SARS-CoV which caused the Severe Acute Respiratory Syndrome (SARS) epidemic of 2003. This new coronavirus is sneaky.

The older coronavirus was conspicuously clumsy. Infected people became infectious after they became sick. They were flagged with the disease before they passed it on. Infected people with serious problems breathing and a fever showed up at hospitals where the disease was largely contained. Epidemiologist Benjamin Cowling of the University of Hong Kong says:

“Most patients with SARS were not that contagious until maybe a week after symptoms appeared (Scientific American, June, 2020).”

When sick people are not contagious, they can be quarantined before spreading the disease. Containment of SARS worked so well that only 8,098 cases were reported globally with 774 deaths, mostly in Toronto and Hong Kong.

SARS-CoV’s evil younger brother, this one that causes COVID-19, uses stealth. Infected people spread the disease before they show symptoms. You can be asymptomatic and feeling fine, all the while shedding the deadly virus. No warning signal until after the damage is done.

Hospitals are particularly vulnerable. When I went to the emergency section of the Royal Inland Hospital in Kamloops to get stitched up, I was intercepted at the entrance and asked if I had any of the COVID-19 symptoms. I didn’t but I could have been infected and spreading the virus. They took a chance on treating me, for which I’m thankful.

Political leaders can play a part, or not. Trump twiddles as the pandemic wildfires rage across the land of the free. Beachgoers merrily flock together in Florida and California. As protesters defend their constitutional rights to carry guns and not to wear masks, the novel coronavirus revels in the merriment.

While SARS-CoV-2 enjoys its killer notoriety now, soon it will be just another garden-variety nuisance.

The most famous example of a virus’s fall from infamy is the Spanish flu pandemic caused by the H1N1 virus from 1918 to 1919. In over two years and three waves of assault, the pandemic infected 500 million and killed nearly 100 million.

Health officials didn’t have the control measures we have today, simple measures like school closures and physical isolation. It ended only when enough people survived the pandemic with immunity.

Governments have demonstrated their worth during the pandemic, or not. Canada is doing a good job but our neighbours to the south, not so much.

Sarah Cobey, epidemiologist at the University of Chicago, says: “The question of how the pandemic plays out is at least 50 percent social and political.”

The other 50 percent comes from science in the development of a vaccine. Only then will CoV-2 be completely vanquished.

Until, vigilance is the adage. CoV-2 will sneak up on you when you least expect it.

* My apologies to T. S. Eliot, author of the poem “The Hollow Men” (1925).

SARS reaction out of whack, but it does serve as a warning

“It’s bioterrorism without bioterrorists,” says Michael Bliss, professor of history at the University of Toronto.  He was referring to the recent SARS scare in Canada.  Reminiscent of September 11, 2001, North America was terrorized by an external force – – this time a deadly foreign microbial agent.

sars

The disease with the redundant name, Severe Acute Respiratory Syndrome, resulted in terror beyond reason.  Although it killed 23 Canadians, other respiratory infections kill far more. What was it about SARS that had the ability to generate such fear?

Other biological attacks since September 11 have been home-grown.  The Anthrax scare, for example, originated through letters sent in the U.S. mail.

Like the Anthrax scare in the U.S., a relatively small outbreak in Canada created national panic. Of the 11 Americans infected by Anthrax inhalation, 5 died.  Most of the Canadian SARS victims were already weakened by underlying medical conditions.  SARS may be as common as the common cold and Anthrax is not contagious. But that didn’t diminish the terror.

Other severe respiratory infections kill more.  Why weren’t we more concerned that 8400 Canadians died last year from pneumonia,  760 from  influenza and 125 from tuberculosis?  The SARS scare cost our economy millions, threw thousands out of work in restaurants, hotels and the airline industry.  The reputation Canada’s biggest city – – Toronto the Good – – was sullied.

That’s the nature of terror.  Terror creates unreasonable fear.  Fear strips away the veneer of civilization and we revert back to primal reflexes.  We hide in fear.  We blame foreigners for our misfortune.  We superstitiously cling to misconceptions.

The front line of public health protection barely held.  The cuts to funding for health care that were initiated by former federal finance minister Paul Martin in the early 1990s almost did us in.  By the time that SARS was under control, public health was breaking down.  Nurses were burnt out and resigning.  If the SARS infection had a slightly stronger foothold, we would have lost the war.

Health care has been cut to the bone.  There is no surplus capacity for the unexpected.  We have been seduced by politicians into thinking we can reduce deficits by cutting health care.

It’s a similar naiveté that befell North America prior to September 11, 2001.  Terrorism, like infectious disease in the majority world,  is supposed to happen elsewhere.  One million children die world-wide each year from a preventable infectious disease, measles, according to the international agency Doctors Without Borders.  Do we care?

It’s not supposed to happen here.  So, when a few dozen Canadians die from a mysterious disease, all hell breaks loose.  The deaths of thousands that resulted from the attacks on New York and Washington were tragic but the frenzied reaction was out of proportion.  Thousands of Afghanis were collateral damage in the U.S. cleansing of the Taliban.  But the deaths of thousands of foreigners was met with a shrug.

Our public health care workers heroically gave their lives in fighting the SARS.  They demonstrated the same spirit of public dedication as the firefighters who climbed the stairs of the doomed World Trade towers on September 11.  As those rescuers climbed up, office workers ran down to safety.

As our doctors and nurses treated the sick and dying they became infected by those they tried to cure.  Some died of the disease given to them by patients.  Unlike New York Mayor Rudolph Guilliani, no politician stepped forward to give a voice to public heroism and Toronto’s sick and dying.

There were no grand funerals for Canada’s fallen health care heroes.  No politicians stood in line to eulogize doctors and nurses. No monuments have built to their dedication.

While the threat to public health and safety brought out the best in health care workers, it brought out the worst in others.  Some Canadians shunned fellow citizens because they looked Asian.  Some infected Canadians selfishly refused to quarantine themselves and spread their misery to others.

North Americans better get used to biological and political terrorism made easy by globalization.  Capital moves at the speed of light down an optical fiber, and bio-terrorism and terrorists move at jet speed.

SARS should serve as a wakeup call to those politicians who would cut health care funding further.  Next time,  our first line of public health defense might not hold.