Monday 27 April 2020

More thoughts on Covid-19

Changing attitudes

It is not all that long ago that a disease with such a low mortality rate as Covid-19 would have been accepted as at worst a punishment from God which had to be borne. Measles was one such (though it could be more generally fatal in a susceptible population, like the victims of the conquistadores). Rubella and varicella did not merit separate descriptions until the age of science.  Even consumption (tuberculosis) was tolerated. Indeed, it acquired a certain cachet: witness the deaths of poets from Catullus to Keats and the subjects of Italian grand opera.

However, there were diseases which did engender isolation measures. Leprosy was probably the earliest, as we know from the Bible. Later, plague caused authorities to act as Mary Reid points out: https://www.libdemvoice.org/isolation-diary-wishing-shakespeare-a-happy-birthday-64208.html - and, of course, the term "quarantine" derives from renaissance Venice's public health measures.

Smallpox probably came betwixt the two extremes. Fifteenth century China did endeavour to reduce the impact of the disease by variolation. The practice seems to have spread along the trade routes to Turkey, where Lady Mary Wortley Montagu learned of it and promoted its use in Britain. However, the use of a live virus was always a bit iffy and it was not until Jenner came along with his cowpox that the safer vaccination (from the Latin word for "cow") became common practice.

Although that remedy was pragmatic rather than based on scientific theory, it may well have marked the turning point. From then on, it became clear that, given the right method, many infectious diseases could be prevented. The identification of bacteria towards the end of the 19th century and of viruses later hastened the process. The outbreak of severe influenza at the end of the Great War, which was calculated to have taken more lives than did the conflict. was therefore intolerable.

The practice of deliberately spreading so-called childhood diseases by means of "pox parties" persisted into the twentieth century, but as the long-term dangers became known and safe vaccines became available, these are now unknown in the Western world.

The history of Covid-19

It is rare to find a clear time-line for the emergence of Covid-19. (It surely could not be that national media find it convenient to fog the issue because of their governments' failure to act in time? Perish the thought!) However, there is a very clear one here: https://shorthand.radionz.co.nz/coronavirus-timeline/

Note that, though it took almost a month for the Chinese authorities to realise they had a serious novel respiratory disease on their hands, by the end of December 2019 they had notified the World Health Organisation of its existence. Seven days later:
On 7 January, a new type of coronavirus is identified and isolated by Chinese authorities. Five days later, China shares the genetic sequence of the virus for countries to use in developing diagnostic kits.
- which gives the lie to those national leaders who blame their shilly-shallying on Chinese secrecy.

Note also that contact tracing was clearly in operation in both Taiwan (which started screening* from day 1 of the WHO notification) and New Zealand. Contrast that with the lackadaisical attitude of the authorities in Sussex who failed to inform the contacts of a businessman from West Sussex (who had returned from a known hot-spot, a French ski resort) including a NHS doctor who almost certainly passed the infection on to other GPs before she became symptomatic and succumbed to the disease. [Source: Phil Hammond, MD, in Private Eye] The Sussex man may not even have been UK's "patient zero".

What now?

New Zealand is beginning to relax her restrictions. In my (admittedly non-expert) opinion, this may be too soon before we know enough about the virus, even though PM Ardern believes Covid-19 infection has been practically eliminated there. But there is no excuse for governments who cannot be certain whether infection has even peaked in their countries to be talking about imminent transition to "normality".

* Taiwan's screening initially consisted of simply picking out the known symptoms of the disease - not as absolutely certain as identifying the virus in a lab., but a good practical first step, especially when combined with other measures.


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