How the COVID-19 Outbreak Turned Into a Global Pandemic

As of 19^th April there are more than 2.2 million COVID-19 infections globally. The pandemic has also caused over 1.5 lakh deaths. By the time you read this, the numbers may be significantly higher. Never before has the world witnessed a global pandemic on this scale. Unfortunately, we should have seen this coming. Health care experts and philanthropists like Bill Gates have been warning about the risk of such a pandemic for decades. This makes it important for us to take a closer look at how this virus spread so rapidly and why the risk of pandemics is only increasing. 

Origins of the New Coronavirus

We know that the first COVID-19 case emerged in Wuhan, China. The origins of the virus itself are not as clear. However, most experts agree that it emerged from a ‘wet market’ in the Chinese province. Wet markets have already been criticized as a pandemic threat by the world’s leading health experts, including CDC’s Dr. Fauci. Wet markets are markets where live animals and meat are sold, including livestock and wild animals. While meat itself does not pose a high risk, close contact with animals, especially wild animals poses a huge risk. By wild animals, we specifically refer to animals from forests or non-domesticated species.

As pointed out in a 2017 World Bank publication, most pandemics to date have originated through zoonotic transmission (transmission of pathogens from animals to humans). They presciently noted that the next pandemic would likely emerge in this manner too. This is not surprising when you look at the historical precedent for the emergence of new diseases. Both Ebola and HIV are caused by viral infections that were first transmitted to humans through close contact with wild animals. Pathogens can also spread easily when animals are housed in cramped and unhygienic conditions like stacked and dirty cages. Under these circumstances, viral pathogens can easily jump between species, swapping bits of genetic code to mutate and continue moving between species. 

In the case of the new coronavirus, the pathogen would have gone on to mutate after infecting the first human. This mutation would then allow it spread as an airborne infection from human to human. 

Tracking the Spread of the COVID-19

The world’s first case of COVID-19 surfaced on 1^st December 2019 with the appearance of symptoms. Roughly 2 weeks later another patient at the same Central Hospital of Wuhan experiences a persistent fever and is tested. Results reveal a virus similar to SARS and the hospital’s head of ER begins sounding warnings on social media, along with other doctors from the region. 

By the end of December, there are reports of dozens of cases of a new and mysterious type of pneumonia in Wuhan. As these reports start to emerge from China, neighboring South East Asian countries like Taiwan and Singapore start taking precautions with fever screenings for all airport arrivals from Wuhan.

By 11^th Jan, Chinese scientists sequence the virus genome, allowing experts around the world to identify infections and patients. 2 days later, Thailand confirms its first case and Japan reports its first just 3 days after. By 20^th Jan, cases are also being detected in Beijing and the southern Guangdong province. This is when China finally reveals the risk of community spread. 

By 23^rd Jan, China starts to grapple with the enormity of the problem initiating a massive lockdown of Wuhan. This quarantine soon expands, sealing in about 60 million people. Soon after, cases emerge in Philippines and the cruise ship Diamond Princess is also quarantined off the Japanese coast. At roughly the same time South Korea emerges as the second largest pandemic center. Thanks to the rapid testing and effective response of its government, their outbreak is controlled within weeks.

On 30^th Jan, the virus finally reached India, detected in 3 students returning from Wuhan. This was well-contained and no further cases were recorded through the rest of the month. In the meantime, by mid Feb, COVID-19 cases begin to surface in France, Italy, and elsewhere in Europe, as well in Iran. The pandemic starts to explode with Italy’s aged population absorbing the worst impact and Europe grinds to a halt with even UK PM Boris Johnson contracting the infection. 

By the first week of March the pandemic starts to take hold in India too, as it is brought home by tourists and travelers returning to the country from pandemic-struck regions. Numbers in the United States have also been growing exponentially within this same timeframe. The rapid spread of the disease becomes apparent from WHO data. The first 100,000 cases emerged within 3 months of the first infection, but it then took just 1 week to double from 500,000 to a 1 million, and so on. As of this moment, there are less than 20 countries across the world without COVID-19 cases. 

Why COVID-19 Turned into a Global Pandemic

Lack of transparency

Although some leaders look to cast blame to evade their own responsibility, it is true that there were failures in the early response. Doctors from Central Hospital of Wuhan who sounded the alarm were penalized by Chinese authorities and information was heavily suppressed. There were delays in revealing the risk of human to human transmission or community spread. 

Asymptomatic Infections

We now know that infected individuals can be asymptomatic for 1 to 2 weeks, spreading the infection without presenting symptoms. This made early detection efforts by neighboring countries who initiated fever screenings at airports ineffective. Even after this information was made available, many countries and airlines, including India and the US, chose to continue such ineffective screenings instead of initiating quarantines and tracking for arriving passengers. This allowed infections to pass through the cracks, leading to community spread. 

Inadequate testing

Experts agree that because of high transmission rates and silent transmission (patients infected but without symptoms), there is a need for large scale testing. This was done in South Korea, which is why the country overcame the pandemic rapidly. Unfortunately, many leaders and countries have been unable or unwilling to conduct widespread testing, limiting tests to those at high risk, with symptoms, or with known contact with an infected individual. As a result, efforts at containment are not as effective. 

Pandemics to Come

COVID-19 may be the first global pandemic of this scale, but it certainly won’t be the last. While illegal trade in wild animals for meat or as pets is the biggest risk factor, this is not the sole cause of pandemics. Climate change and deforestation are both amplifying pandemic risks. 

Unrestricted population growth has led to an increased need for living space and farmland across the world. As a result deforestation has accelerated and populations have moved into areas that were previously forested. This increases contact with new animal species and previously isolated infections. The Lassa fever is an excellent example of this. The disease began infecting humans as forests with infected rodents were destroyed to make way for farming. With nowhere to go, these infected rodents began moving into populated areas, transmitting the disease to humans.

This makes the traditional wisdom of Ayurved even more relevant today. We need to live in harmony with nature and should move away from consumerism to conservation. Governments also need to take the warnings of scientists more seriously, using them to shape health care policy. Preparedness is after all the key to preventing and fighting such a pandemic. On a personal level, you should make it a point to live a more natural lifestyle, strengthening your immune system and health with healthy dietary practices, lifestyle changes, and Ayurvedic herbs.

References:

• Coronavirus Disease 2019 (COVID-19) Situation Report – 90.” World Health Organization, 19 Apr. 2020, www.who.int/docs/default-source/coronaviruse/situation-reports/20200419-sitrep-90-covid-19.pdf?sfvrsn=551d47fd_2
• Loria, Kevin. “Bill Gates Thinks a Coming Disease Could Kill 30 Million People within 6 Months - and Says We Should Prepare for It like We Do for War.” Business Insider, 27 Apr. 2018, www.businessinsider.in/tech/bill-gates-thinks-a-coming-disease-could-kill-30-million-people-within-6-months-and-says-we-should-prepare-for-it-like-we-do-for-war/articleshow/63946206.cms
• Nelson, Joshua. “Dr. Fauci Says It's 'Mind-Boggling' That Any of China's Wet Markets Are Still Operating.” New York Post, 13 Apr. 2020, nypost.com/2020/04/03/dr-fauci-says-its-mind-boggling-that-any-of-chinas-wet-markets-are-still-operating/
• Madhav, Nita, et al. “Pandemics: Risks, Impacts, and Mitigation.” Disease Control Priorities: Improving Health and Reducing Poverty. 3rd Edition., U.S. National Library of Medicine, 27 Nov. 2017, www.ncbi.nlm.nih.gov/books/NBK525302/
• Leroy, Eric M et al. “Human Ebola outbreak resulting from direct exposure to fruit bats in Luebo, Democratic Republic of Congo, 2007.” Vector borne and zoonotic diseases (Larchmont, N.Y.) vol. 9,6 (2009): 723-8. doi:10.1089/vbz.2008.0167
• Sharp, Paul M, and Beatrice H Hahn. “Origins of HIV and the AIDS pandemic.” Cold Spring Harbor perspectives in medicine vol. 1,1 (2011): a006841. doi:10.1101/cshperspect.a006841
• Huang, Chaolin et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.” Lancet (London, England) vol. 395,10223 (2020): 497-506. doi:10.1016/S0140-6736(20)30183-5
• Ji, Wei et al. “Cross-species transmission of the newly identified coronavirus 2019-nCoV.” Journal of medical virology vol. 92,4 (2020): 433-440. doi:10.1002/jmv.25682
• Coronavirus Disease (COVID-19) - Events as They Happen.” World Health Organization, World Health Organization, www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
• Wolfe ND, Daszak P, Kilpatrick A, et al. Bushmeat Hunting, Deforestation, and Prediction of Zoonotic Disease. Emerging Infectious Diseases. vol. 11(12), 12 (2005):1822-1827. doi:10.3201/eid1112.040789
• Jones, B. A., et al. “Zoonosis Emergence Linked to Agricultural Intensification and Environmental Change.” Proceedings of the National Academy of Sciences, vol. 110, no. 21, May 2013, pp. 8399–8404., doi:10.1073/pnas.1208059110