Wuhan, the capital of China’s Hubei province, is located some 3,900 kilometers west of Islamabad. Although it is a major industrial and commercial center, few here had heard of it until recently. Now, the name is constantly in the news, being the home of a new, potentially lethal, strain of coronavirus. While knowledge about it is being gathered by scientists, we already know that it belongs to a large family of viruses that cause a constellation of diseases, ranging from the common cold to the deadly acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS-CoV). Meanwhile, Wuhan has become a virtual ghost town with strict quarantine restrictions imposed by the government.
Coronaviruses share a common feature. At some stage, they jumped from animals, often bats and birds, and mutated to infect humans. The new coronavirus, formally named COVID-19 by the World Health Organization (WHO), is believed to have moved from bats, via an unknown intermediary, to humans and is extremely contagious. In societies where humans and animals live and interact in close proximity, such as rural China, such transitions are more frequent.
The symptoms of the current coronavirus infection are similar to flu, although their causative agents are quite different. Thus far, compared to the normal flu, the coronavirus outbreak has not been very lethal
So far, the disease has largely been confined to China, where at the time of writing this, more than 76,000 cases have been documented and approximately 2,000 deaths recorded, prompting the World Health Organization (WHO) to declare it a World Global Health Emergency. Some 1,700 health workers have also become infected, raising the spectre of breakdown of the country’s health care system. Worried about importing the virus, many countries have discontinued airline services to China, removed their citizens and are instituting strict screening for those returning from China. The Pakistan Government apparently has decided not to undertake these measures. However, screening and quarantine would have been a wise precaution, given the country’s moribund, ramshackle medical system which would be unable to cope with any large-scale outbreak. Currently, no effective treatment or vaccine exists to combat the disease, although frantic efforts are underway in the US and China to develop a vaccine against it.
A scene from the Spanish Flu epidemic
The current outbreak has resurrected memories of the pandemic of 1918, often termed Spanish influenza, that devastated humankind and ravaged the world more than a century ago. The symptoms of the current coronavirus infection are similar to flu, although their causative agents are quite different. Thus far, compared to the normal flu, the coronavirus outbreak has not been very lethal. In the US, where data is meticulously collected by the Center for Disease Control and Prevention, there have been an estimated 19 million cases of flu since the start of the season and 10.000 deaths, a number far higher than caused by the new virus worldwide.
The 1918 Spanish flu, its name notwithstanding, did not originate in Spain. The name resulted from the exigencies of the First World War. During the height of the war in Europe, propagation of the news of the pandemic was not allowed by the censors, lest it demoralized the troops. However, when the contagion reached Spain, which was one of the few European nations not involved in the war, the news was extensively reported by the local media. It received further notoriety when the Spanish King Alfonso XIII suffered a devastating flu attack. Since that time, the illness became known as the Spanish Flu.
Although no one alive today experienced the Spanish flu, its nightmarish details have been well documented and preserved. It infected an estimated 500 million people – nearly one-third of the planet’s population and killed between 50 to 100 million of them. In its virulence and mortality rate, the pandemic is unparalleled in history and dwarfed the number killed in the two world wars combined.
US Navy Notice during the Spanish Influenza era
Initially, the destructive potential of the illness was not fully realized. The City of Philadelphia in the US, where in September 1918 a huge parade was being organized to sell bonds to support the ongoing war, went through a harrowing experience. Despite advice by several doctors against the parade, the organizers went on with it. A week later, 636 new cases of flu and 139 deaths were recorded in the city. Within a few months, the number of dead had climbed to a staggering 12,191.
The pandemic quickly traveled around the world. India was particularly hard hit, as some 18 million people perished. Curiously, for some unknown reason, China remained largely unaffected by it.
The Spanish flu had some unpredictable effect on the geopolitics of the time. American president Woodrow Wilson was in Paris in January 1919 to negotiating the treaty of Versailles to settle terms for Germany to pay reparations for unleashing the war. There were major differences in the terms proposed by the Americans and the French. The gulf between the two was so wide that the American president nearly walked out of the conference. But then Wilson caught severe flu that greatly weakened him and sapped much of his energy. He acquiesced and signed the treaty on French terms.
Why was the Spanish flu so deadly, surpassing in viciousness all previous pandemics except for the Black Death of the Middle Ages? The question has puzzled many scientists over the years, and even after a century of investigation, no definitive answer has emerged. Meticulous research carried out on preserved specimens drawn from flu patients and those extracted from frozen corpses that had remained sealed in Alaskan earth failed to provide unambiguous answers. Most likely, there was more than one reason for the observed high mortality rate.
To start, the state of knowledge of the infection process was relatively primitive at the time. Viruses had just been discovered and there was only meagre understanding of their role in causing diseases. And there were no preventive vaccines. Augmenting the virus’ virulence, was its tendency to infect the upper respiratory system, thus, promoting its ready transmission through sneezing and coughing. There were no antibiotics to fight the secondary bacterial lung infections, such as pneumonia, that resulted.
The battle between humans and pathogens – viruses, bacteria and parasites – has been ongoing ever since humans appeared on the face of the Earth. Pathogens have been evolving into newer strains to avoid and overcome natural human defenses. Many have now become resistant to antibiotics, our most potent weapon against bacteria. It is hoped that medical sciences will be successful in discovering newer and more sophisticated tools to fight these ever-changing ancient adversaries.
