Interim journal of a plague year

As I emphasised in a recent post, I am not a doctor. However, since then, I have been somewhat reassured by one who is. I had voiced doubts whether the Covid-19 could be eliminated from the UK once it had taken hold. It appears that, though experience of other corona virus outbreaks is that immunity resulting from recovery from infection does wear off after a time, tailored vaccines do offer long-term protection.

Prime Minister Johnson and eminence grise Dominic Cummings are not doctors or epidemiologists either. But they should have listened to those who were, according to the editor of the medical journal The Lancet, as cited by Mike Buckley in the Byline Times.

The UK has wasted seven weeks. This is the judgement of Richard Horton, the editor of The Lancet. The UK’s new Coronavirus strategy of “suppression” is the course of action recommended by the journal in its first report on the issue on 24 January. It is the strategy followed by China, South Korea, Taiwan and other countries that have seen some success in reducing the rate of infection. It is the strategy recommended by the World Health Organisation (WHO), which it has been clearly stating would be far preferable to the course of action chosen by the UK Government until yesterday [16th March].

Buckley continues:
Had the UK followed WHO guidelines and the best practice of other states we could have kept infections to a much lower rate. WHO advice is abundantly clear, based on existing guidelines and the experience of countries which have successfully contained and turned back COVID-19 and previous pandemics. The essential elements for success are mass testing, the isolation of the sick and those carrying the virus, contacting and testing people who may have been exposed to it, and social isolation to prevent its spreading by people yet to show symptoms. This is not theory, it is fact.
The experience of Asian countries which lived through Sars, Mers and H1N1 has informed these guidelines and it is no coincidence that countries which learned lessons in the Sars outbreak of 2003 are the same countries which have been most successful in containing the Coronavirus. They have had time to develop systems and structures for the next infection. The only surprise is that Western countries have been so slow to follow their lead and to learn from their former failures and present success.

Taiwan, for example, as of 15 March, had just 59 confirmed cases and one death. It has managed to avoid a major outbreak of a disease which all but paralysed neighbouring China. Apart from most people wearing masks on public transport, life there goes on as usual.

The Conservative government has set great store by a strategy drawn up by the coalition government in 2011, as a back-bench Conservative outlined last Monday:

The “UK Influenza Pandemic Preparedness Strategy 2011” sets out our preparedness for a severe pandemic. It was tested in 2016 through a major three-day exercise called Cygnus, which involved about 1,000 organisations and the devolved Administrations. It demonstrated a number of things that we do well as a country and a number of things that we need to improve upon, one of which was the drafting of the draft pandemic influenza Bill, which forms the basis of the legislation today.

However, corona viruses are different from 'flu viruses, and different again from haemorrhagic fevers such as Ebola and Marburg. One trusts that the boffins in the Department of Health and Social Care are not only updating their plans for future epidemics on the experiences of the current one, both here and in the Far East, but also on models of what might happen here if a haemorrhagic disease hits our shores. To those who believe "it cannot happen here", it should be pointed out that there are serious historical scientists who believe that the 13th century Black Death was not bubonic plague, but a viral haemorrhagic disease.

There are still one or two questions about Covid-19. For instance, it is rare for a young person to die from the virus. Is it something to do with the development of the immune response, or is it down to a higher metabolic rate in the young? The latter is said to be the reason that the horseshoe bats which carry it in the wild can tolerate the virus. And how are some people in the target age range able to shrug off the infection? Answers to these questions may well help treatment.