The exponential progression of the novel coronavirus infection (coded COVID-19) would seem to qualify as such an event; but for the severely draconian emergency measures to restrict the spread of the disease taken by the Chinese government, the consequences might be ever more serious and globally widespread.
History teaches us that public health preventative measures provide the most effective defence against contagions. But when a mass outbreak on this scale happens, it cannot be planned for in the conventional sense. However, the speed, scale and efficacy of the response once the crisis erupts is key to restricting the virulent spread of the disease. As I write, the latest published figures would seem to suggest that the strict containment efforts appear to be working as the disease is very largely limited to China and more specifically to its epicentre located in Hubei province. However, hopes that the rate of the contagion is beginning to subside may yet prove to be optimistic as the disease is now thought to be more virulent than suggested by earlier released information. This underlines all that is not yet known about the contagion and the amount of reliable information that is coming out of China where concerted effort is being made to control the narrative alongside the outbreak.
The reassuring images of clinically efficient looking emergency and healthcare workers in hazmat suits would appear to belie the initially late and understandably chaotic response. It is now clear that many of those infected were not helped in time as medical facilities were overwhelmed and even healthcare staff could not be adequately protected despite the scale of administrative efforts and the huge resources that were expended to isolate the sick as the authorities struggled to regain control.
Many of those infected were not helped in time as medical facilities were overwhelmed and even healthcare staff could not be adequately protected
The upsurge in the numbers of those infected and dead is more likely explained by the lag effect of the data catching up with reality on the ground. If anything, the heavy-handed response was probably the best early indicator of the seriousness with which the crisis was viewed at close quarters. Whilst we marvelled at how China was handling the emergency, the fact is that its actions were guided by extreme pragmatism and the priority given to containment rather than the care of the sick.
Let us not kid ourselves; other than the health emergency and the toll it has taken on human life, it is self-interest deriving from the high economic stakes which are driving both cooperative as well as the individual protective responses of various countries including that of China. While the negative effects are expected to be relatively short-lived, globalisation has given rise to perverse attitudes and calculations. In the present instance, these are primarily driven by China’s heft as the world’s factory with linkages to virtually every product supply chain and compounded further by the overreaction of markets in times of uncertainty. And while we can feel good that the world community ultimately comes together to take care of itself, it has also given rise to schadenfreude and xenophobic attitudes with some countries looking for opportunities to step in to take advantage of China’s travails.
One must remain guarded as there is a fine balance between uninformed complacency and unrealistic fear; one can quickly turn into the other as there is no knowing if there are still more blind spots in the detection and recording of the disease in countries with fragile health facilities. On a global level, the battle is far from won; questions continue to be raised as to why there are no COVID-19 cases (excluding one in Egypt) being reported from any number of African countries where China has invested heavily and where there is significant travel traffic, often via third countries due to large expatriate Chinese workforces residing there. Whereas many countries have temporarily suspended flights to China early on, the UAE, which is the largest regional hub, restricted flights only after February 5 (flights from all China destinations were not suspended) despite four cases being detected there on an incoming flight on January 29. Close proximity over extended periods on long haul flights or in cruise ships provide ideal conditions for spread of viral infections between people as well as from infected surfaces inside such craft. Thankfully, the virus is not air borne and infections have mainly been traced due to droplets from those who are symptomatic. The possibility of a global pandemic nevertheless remains real and the WHO has announced USD 675 million for preparedness and response measures covering February to April 2020 focused on countries with poor healthcare management infrastructure and are more exposed due travel and trade linkages with China.
With its close economic relations with China, Pakistan also falls in this category. It will be surprising but very fortunate if there are no cases reported in the country as there is the inevitable risk of lapses in the enforcement of quarantine conditions. However, this time around, early information, assistance and coordinated action between the Chinese and Pakistani health authorities may have saved the day.
Whilst there is undeniably a very real human dimension that impels us to give in to emotional and populist impulses, I very much fear that we are incapable of handling an emergency if things do not go well. A large urban population, overcrowded housing and public spaces and bad hygiene are all factors that unfortunately keep us primed for an epidemic. Nor do we have the science or the will and wherewithal to mount a campaign to control an outbreak. Even in China, it is the mishandling of the initial response which enabled up to one million people to leave Wuhan before the quarantine was imposed and ultimately triggered the wider outbreak. Today, 15 cities and over 50 million people remain in virtual lockdown since January 23. People all over China returning from holidays are to undergo a compulsory 15-day quarantine period. It is these unprecedented measures - taken at great political risk and injury to China’s economy (estimates range from 0.5-1.0 trillion USD) - that has bought the world time to react and limit the extent of the outbreak. We are, therefore, well-advised to stay the course as even a small outbreak will bring unwelcome attention and complete isolation from the world. Fears of FATF-related sanctions will pale in comparison to the economic turmoil that would result as a consequence in this country. Better then to be safe than sorry. According to the WHO, every year approximately every second person on the planet becomes infected with one of the three main types of helminths, which leads to enterobiosis (1.2 billion people), hookworm (900 million) and trichocephalosis (up to 700 million) . Helminths include representatives of tapeworms, or cestodes, flukes, or trematodes (both of these groups belong to flatworms) and roundworms, or nematodes. Overview of the drug against helminths Bacte OFF In general practice, albendazole (nemazole), mebendazole (vermoxa) preparations are used for cestodes, levamzole, pyrantel, piperazine, a
Finally, a coronavirus pandemic simulation coincidentally run by the John Hopkins University in October 2019 which provided the basis for disinformation that that COVID-19 was predicted to cause 65 million people to eventually lose their lives is nevertheless thought provoking. Human impact through globalisation, population, climate change, conflicts and new technologies, all now provide ingredients for a fast evolving, uncertain and unsafe future. That would suggest that black swans will become less of a rarity in time to come.
The author is a former of CEO Dawood Hercules Corporation Ltd and can be reached at email@example.com