Tracking back from a Pandemic
It is our fancy to call a certain block of time, a certain age — the stone age, the industrial age, the information age etc. Until recently, this age was known as the “Artificial Intelligence Age” given the widespread impact that AI was beginning to have on our lives.
That nomenclature has probably been upset by the emergence of COVID-19, a disease caused by the SARS-COV2 virus that has now been deemed a Pandemic by the WHO. Given the widespread infection across countries in almost all continents of the world, the almost exponential growth of the number of infected cases per day, the never before norms that are being thought of as being vital i.e. Social Distancing, Quarantine, this may truly be termed as perhaps the Pandemic Age or the Quarantine Age.
The COVID19 age has brought humanity together with a sense of purpose that I have never seen before in my life. Neither religion nor faith nor economic downturns have managed to bring humanity together as one species. That may be because a pathogen like COVID19 knows no borders — no geographical fault lines, no race, no religion, no color, no gender, no age and no sexual preference — in that, it is truly “Universal”.
The biggest challenge that the world seems to be tackling now is a race to find a cure, a therapy or a vaccine. Those who know portend that unless that is done, life as we knew it and the freedoms that we enjoyed as a people may never be the same. The adversary for life and liberty this time around isn’t a hostile country or aliens or the state but an invisible but potent pathogen. Researchers in their labs are racing against time to find that miraculous cure or vaccine — this is the highest priority — governments are supporting it, regulatory authorities are easing the norms, funding is being arranged, all options are being evaluated with no stone un-turned. As of this writing, the first trial of a vaccine has been given to a human volunteer who would now be observed for an extended length of time. Perhaps, there will be many more such trial vaccines before one is found to work for humanity at large.
I applaud all the research effort in shrunk timelines and all the policy makers that are bending the rules to make sure there are no obstacles in this effort — kudos to every one of them — the whole world is waiting with bated breath to hear some good news on this front and soon.
That said, I see this as yet another effort to find a “drug” that will make the symptoms go away without exploring the larger and holistic question of what are the background reasons that contributed to the situation getting this far. Taking a Tylenol or Panadol makes the fever go away or taking an Ibuprofen makes the pain go away but note that the fever and pain may just be external manifestations of a problem that lies much deeper within. An infection may be triggering the fever and an internal bleed may be causing the pain.
So, where do we begin our journey to find the underlying reasons that got us here? What may such a journey reveal to us humans about ourselves?
As you may have heard, COVID-19 as well as SARS or MERS or Bird Flu or Swine Flu are all Zoonotic diseases or Zoonoses. Zoonotic diseases are caused by harmful germs like viruses, bacteria, parasites, and fungi that inhabit animals referred to as reservoir hosts. Note that these germs may not cause any harm to the reservoir hosts but when they spread to their human hosts, they end up causing illness which could even lead to death. That’s because humans do not have natural immunity to these germs that inhabit non-human reservoir hosts. When infected with these germs, it takes time for the human body to recognize this as a foreign body and mount an immune response (more on immunity in a later article). The antibodies and immune cells that are generated from this immune response fight off the disease causing pathogen.
The question to ask then is why does a virus crossover to humans? Is this a chance event in nature? What factors increase the odds of this chance event?
This question led me to explore more questions — which animal hosts act as reservoirs for viral zoonoses, what makes viruses leap to humans and is there any connection between human activity and the pandemics that we have seen in the past and the one we are living through now?
There is a whole body of research done on these questions and it involves a number of experts from different fields — Ecologists who study environments and habitats, Veterinarians who cater to the well being of pets and farm animals, Virologists who are routinely on the lookout for never been seen viruses, Farmers and Ranch owners who often are the first ones to be at the receiving end of an epidemic that affects the farm animals or poultry, Researchers who travel to the jungles, caves, rivers as well to the live animal markets to trace out the whiff of a potential new outbreak etc.
The USA CDC has information on Zoonotic diseases which describes the ways in which Zoonotic germs may spillover from reservoir animal hosts to humans — by direct or indirect contact with animals and animal fluids, being food or water borne or due to insect vectors that bite the reservoir hosts and then humans.
I came across some excellent articles written on the subject by some experts in this area. A couple of excerpts that really made me sit up and think are listed below the article link.
- We made the Coronavirus Epidemic by David Quammen in The New York Times.
“… this Wuhan emergency is no novel event. It’s part of a sequence of related contingencies that stretches back into the past and will stretch forward into the future, as long as current circumstances persist.”
“Long term: We must remember, when the dust settles, that nCoV-2019 was not a novel event or a misfortune that befell us. It was — it is — part of a pattern of choices that we humans are making.”
- Destruction of Habitat and Loss of Biodiversity are creating the perfect conditions for diseases like Covid-19 to emerge by John Vidal in Ensia.
“Pathogens are crossing from animals to humans, and many are now able to spread quickly to new places. The U.S. Centers for Disease Control and Prevention (CDC) estimates that three-quarters of “new or emerging” diseases that infect humans originate in nonhuman animals.”
“Wet markets make a perfect storm for cross-species transmission of pathogens,” says Gillespie. “Whenever you have novel interactions with a range of species in one place, whether that is in a natural environment like a forest or a wet market, you can have a spillover event.”
Digging more into this domain, I found a number of books that have been written on the subject by various authors. Here is a list of them (in no specific order or preference).
There’s even a new series on Netflix titled Pandemic (2020) that digs into how these pathogens crossover to humans resulting in pandemics. Besides this, there are several movie titles on similar themes like Outbreak(1995), Contagion(2011) and Virus(2019). Of these, I especially like Virus which is an Indian Malayalam movie that focuses on the Nipah virus outbreak in the state of Kerala in India in 2018. What touched me in the movie was the sensitive portrayal of how the community dealt with such an outbreak despite the commotion, confusion, social stigma and lack of the best medical facilities.
From the digging that I have done so far, it seems clear that human activity has a clear and unambiguous role in contributing to the spillover of pathogens into humans that lead to pandemics. David Quammen in his book Spillover lays out this argument wonderfully in clear terms, a gist of which is as follows -
- Indiscriminate human activity in the name of development or the need to drive the economy and fulfill the needs of the 7+ billion people on earth is tearing apart nature’s ecosystems — logging of forests, slash and burn agriculture, wild game hunting, quarrying, rapid urbanization, mining, unsustainable fishing in the oceans, massively scaled up poultry farming and animal rearing, destruction of wildlife habitats, human animal conflict etc.
- Viruses and millions of creatures like bacteria, fungi, protists and other organisms live within natural ecosystems — these are mostly unknown to humans as they have never been found or classified into a species and they live within reservoir host organisms that may be themselves undiscovered yet.
- By destroying natural ecosystems, these microbes including viruses are shaken loose. When they get evicted from their natural hosts, they need to find a new home, a new host and most often humans are it because they are available in abundance at these hotspots of ecosystems’ destruction. Note that these microbes are not essentially looking out for humans to jump on but just that humans happen to be readily available.
- Having made the leap to humans, zoonotic microbes have to survive and replicate in their human hosts. Some, in the process, end up killing their human hosts too soon and therefore are less successful in spreading to other human hosts e.g. Ebola. Some successfully establish themselves within their human hosts and spread e.g. HIV, SARS-COV2 etc.
Humans in order to feed the billions of them are also creating unnatural environments and procedures as may be seen in poultry or cattle or pig farming.
In the case of poultry, hundreds of thousands of chickens (if not millions) are placed in confined spaces with limited or no mobility. This typically would not be the case if the chicken were grown in more natural environments (free range chicken) for a family at the farm or in a village to sustain a group of families at best. In these massively scaled up poultry farms, the chickens are fed growth hormones and antibiotics as their natural immunity is decreased to a very large extent. The use of antibiotics has several other effects on the chicken population such as weight gain and there are subsequent dangers of antibiotic rich effluents from these farms polluting the nearby water bodies (more on antibiotics in a later article). A pathogen can easily spread among the chickens rapidly and decimate the entire chicken population and pose a risk for immediate spillover to human handlers of poultry. The same case holds true for cattle farming as well where cattle are reared in small spaces and fed a diet designed to boost meat or milk yield curated with supplements like growth hormones and antibiotics.
The desire for game and exotic meat have given place to the growth of “wet markets” where wild animals are kept caged and slaughtered in front of customers based on their choice. Note that wet markets are mostly unregulated i.e. there are no hygiene and safety norms to be taken care of and neither is there any enforcement of such norms. Such wet markets are places where humans have a high probability to come in contact with bodily fluids of wild animals, birds, rodents and insects and these present an opportunity for the spillover of viruses from their reservoir hosts (wild animals) to humans who become the new hosts.
Perhaps a century ago, a spillover that led to an outbreak could’ve been contained locally. With globalization, the ease of air travel for people and the shipments of goods across every part of the world, it becomes almost impossible to contain an outbreak locally. Viruses ride on their new hosts — humans, as humans fly across countries and what started as a local outbreak quickly turns into a global pandemic as evident in the case of COVID-19.
Today, it is heartening to see the purpose with which all arms of the governments, policy makers, world organisations, the medical fraternity, industry, civil society and every common citizen are contributing to contain or mitigate this pandemic and see a way out of it.
That said, when we get out of this experience in the long term, and get out we will, we as a people, must not dismiss this just as a “one-off random chance event” or as an “act of God” but rather introspect into how our way of life, our own needs and wants and our own greed has been a major factor behind the pandemic. If we do move on just as before, then our normal way of life will be peppered with newer pandemics occurring at a more quicker rate, each one establishing a “new normal” for us.
(A big thank you for her inputs — Revati Masilamani, an Immunology and Infectious Diseases Researcher with the Center for Science Education, Tufts University School of Medicine. Check out their Twitter: @greatdiseases)
