- The coronavirus tightens its grip
Perhaps the most remarkable thing about the coronavirus epidemic is that it is named after its cause, rather than its symptoms. The bubonic plague was so named because of the buboes (swellings of the lymph nodes) caused, not after the yersina pestis bacterium which caused it. First cholera was named, after the gutter into which it is expelled, and the vibrio cholerae bacterium which causes it, was named after it. Typhus and typhoid are not named after the bacteria causing them. Most previous epidemics were caused by bacteria, but the last one, the Spanish influenza, was viral.
The Second World War saw the discovery of antibiotics, and thus control of bacterial infections. However, it still has not found an effective antiviral, and thus relies on vaccines for protection against viral infections. After a viral infection, one develops antibodies against it, if one survives the illness, of course. The most common is the common cold, and COVID-19 (to give it its proper name) causes cold-like symptoms, such as fever, sneezing and other respiratory distress. Humans are liable to the flu every year in the shape of colds. COVID-19 thus came at a very wrong time, when it mixed in with peoples’ colds. It may re-infect, which might indicate more than one virus at work.
There may have been a benefit for Pakistan, in the fall of oil prices, but the downside has been the collapse of exports, as orders for its textiles re cancelled because of collapsing demand abroad, which have also caused intimations of payment delays. The only assurance from an economist is the throwaway remark by John Maynard Keynes, who was oddly prescient when he said, “In the long run, we’ll all be dead”
Because it has only just started infecting people, it kills off its carriers. As it matures, it will presumably accommodate itself to the human body, and not kill those it infects, merely cause a cold. It postulated that that has happened to the Spanish influenza, which killed as many as 100 million worldwide in just a few years after World War I. Similarly, in a few decades, it is possible that the coronavirus may cause nothing more severe than a common cold.
One of the reasons why children seem to get more colds than adults is that adults developed the immunity which the children are developing, by getting infected as children. However, waiting until then could mean that a lot of people would die. Though the most vulnerable are the very old, being in between is no guarantee of life. Children may not get sick, but that does not make the disease less harmful for those who get it.
Perhaps this epidemic is remarkable for its economic impact. Though the Spanish influenza was a major epidemic, coming just after the First World War and the Communist Revolution, it is not ascribed as a cause of the economic turmoil of the 1920s and 1930s. However, the current epidemic has been predicted as costing trillions of dollars globally, and has already had a major impact on human societies. This impact has not just been economic, as the public health measures are disruptive of human activity, including social activity. Schools are being shut, sports events cancelled or held without audiences, restaurants having their hours cut, all to stop people gathering in crowds, so the spread of infection could be stopped, or at least slowed.
The spread has been swift. Past epidemics were slower to spread, though as inexorable, not having the present globalised world, with its free movement of people allowing the spread of carriers, and thus the swift spread.
It seems policy makers are accepting that infection will proceed inexorably, as they have accepted that people will get infected without immunity, or a vaccine. If millions are infected, in a world population of over 7 billion, with a death rate of 3 percent, there would be about 30,000 deaths per million. That’s about 30 million per billion.
The death rate shows it is less virulent than smallpox, which had a 30 percent mortality, with survivors were often horribly disfigured. COVID-19 does not disfigure or cripple. The latter is done by polio, another disease which the WHO is trying to eliminate. The poliovirus remains in just three countries, Pakistan, Afghanistan and Nigeria. The polio containment slippage in the last year in Pakistan has caused some of the doubts about the ability of the present Pakistan government to contain the coronavirus. Perhaps, there is no containing the virus, and the teleconference of the SAARC heads of government would not act to prevent its natural spread, which would decimate about a billion and a half people. If the population of China was to be added, the epidemic would reach over two and a half billion people, and millions would die.
Another aspect is the strain on healthcare services, with two particular points of pressure: healthcare providers and hospital beds. Healthcare providers face peculiarly harsh pressures. As the initial efforts in China showed, doctors and nurses run a particular risk of being infected, and of being carriers. Further, it takes years of hard work and dedication, and most likely some hard exams, to generate a competent doctor or a proficient nurse, while the virus takes a few days to kill either. Then there are hospital beds. Doctors and nurses need them to function. However, in the Subcontinent patients lying two to a bed, or on corridor floors, are clichés. In an epidemic, there is no knowing where the urge to improvise, born from a chronic shortage of resources, will lead. Wuhan provides an example, where public facilities (like basketball courts) were taken over for temporary hospitals. In the Subcontinent, perhaps wedding halls might be used. The Big Fat Subcontinental Wedding is probably over for the foreseeable future anyway.
One of the major difficulties is heading towards us, with weddings about to peak suddenly soon, before summer. Not only will guest lists be more exclusive, but attendance will probably be more selective. The problem will be the rural areas, with pre-epidemic attitudes. Also, not only are there fewer beds there, but fewer public facilities to convert.
Politics is continuing as usual, as while there is an almost constant stream of the news of the cancellation of sports and cultural events, there are no indications of the cancellation of US presidential campaign events. The Kashmir lockdown was brought up at the SAARC teleconference on COVID-19 by the Pakistani SAPM on Health, ostensibly as a public health issue, but actually as a political indication that the PTI government was promoting the Kashmir cause.
Governments are coming under greater scrutiny, and are often found wanting. For example, while Imran Khan was hailed for his speech to the UN, his speech to the nation on the coronavirus won little adulation.
One of the most glaring lessons should be that viruses do not recognise national boundaries. The Kashmir lockdown is thus no longer primarily a political issue. Pakistan should realise that. At the same time, it is an international public health issue, and India cannot expect other countries, especially its neighbours, not to take an interest in its affairs.
There may have been a benefit for Pakistan, in the fall of oil prices, but the downside has been the collapse of exports, as orders for its textiles are cancelled because of collapsing demand abroad, which have also caused intimations of payment delays. The only assurance from an economist is the throwaway remark by John Maynard Keynes, who was oddly prescient when he said, “In the long run, we’ll all be dead.”