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March 28, 2020

Corona: after me, the flood

Opinion

March 28, 2020

“A plague o' both your houses! I am sped. / Is he gone, and hath nothing?” – Romeo and Juliet

The devastating power of epidemics in changing world history is well known to historians. They range from the apocryphal 1343 story of the Mongols catapulting dead bodies over the walls into cities which then spread the Black Death to the rest of Europe. Then we have the more recent tragedy of Dr Li Wenliang who desperately tried to warn people about the dangers of the coronavirus before his death.

Similarly, the story of how the devastating Spanish flu was named is equally interesting. While the rest of the major powers, amidst the carnage of the First World War, suppressed the news of the outbreak of flu, it was from neutral Spain where the truth finally came out. So the Spanish flu is in fact named so because one country was honest with the world.

Closer to South Asia, there were cases from the 1850s that again originated in China and killed tens of millions in India and South Asia as late as in Karachi in the 1890s and continued till as late as the 1960s. Smaller outbreaks including Iran, Afghanistan and Northwest British India were being reported in 1906. Like now, there were cases of people angry at being quarantined or at being forced to stop socialising.

Even though the coronavirus has more in common with the common cold and SARS or MERS than with the bacterium Yersinia pestis of the Black Death.

The common factor in all these epidemics is that they become pandemics whenever the world opens up to new trade routes. Whether it is the millions who came in contact during the First World War or whether it was the new trade routes opened up by the destruction of the old order by the Mongols. While yesterday’s ships and horses have now been replaced by large-scale use of planes, simultaneously borders have come and trade has grown exponentially.

The challenges posed by the coronavirus are new for another reason. This is the first pandemic we face as a global community in which we have modern technology to fight illness. The most common response to this, throughout history, tends to be the one that does not work. Closing borders on their own does not work. The most successful responses have been shown time and time again to be global and collective responses.

Another change we face is that as a global community we now live with more medical challenges like diabetes, hypertension and heart disease; this is a huge change from generations prior. We, as a global community, also live longer with the global life expectancy double than from a century ago. This complicates things because of the peculiar nature of the coronavirus in that it is especially dangerous for those two groups of people.

Despite these, here lie the lessons from Italy and China: no healthcare system runs with so much surplus space and capacity of staff to allow for a deluge of patients all at once. The other lesson is that no healthcare system can survive unless it looks after the staff that are frontline in these times of crisis.

This ‘organisational kindness’ is especially important in a country like Pakistan where infection control measures are often inadequate and resources are so limited. While the lack of ventilators is a definite issue, the cost of losing staff to the illness is far more damaging as they are irreplaceable.

All this aside, there is one final lesson that all disasters teach us and which is the most unsettling. Every disaster eventually burns itself out one way or the other. The reason could be collective or herd immunity, it could be concerted global responses like those towards polio and AIDS. It could, more morbidly, also be because there is nobody left for the epidemic to kill.

And yet that should not comfort us as it is the consequences of that devastation that can create a second wave of ruination.

This second metaphorical great flood poses a question for the world’s decision-makers in this uncertain time. Are they ready for the great flood to follow?

The writer is the founder of thewebsite: www.qissa-khwani.com

Twitter: @qissakhwani