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May 31, 2020

Betting on hope

Opinion

May 31, 2020

With ‘Great’ wars come the expectation of great endings – decisive moments when pale, sickly people re-emerge, squinting at the sun as it bathes them in forgotten warmth. Grainy war documentaries capture, in these moments, kids on rooftops flashing monochromatic grins – flags aflutter with the crisp gust of reclaimed youth.

With the virus, these scenes are unlikely.

In the common imagination, our moment will come when headlines around the world proclaim that some saint of the scientific method – having sacrificed months of sleep, nutrition, and hygiene – has finally found ‘The Cure’.

Here, the narrator leaves us with a few solemn words of caution, cuing the credits to roll and audiences to reach for the remote.

At some level, an expectation of clean, clinical closure is hard-wired to the point of entitlement. The Prince Charmings of our childhoods taught us to demand more than, “...and they all (gradually) began to enjoy (marginally) better living standards (for a bit)”.

Adversity without a glorious moment of triumph is a run-on sentence, without a full stop. It is Bruce Willis cutting the asteroid down to size in installments. It is David beating Goliath in a rematch, and by split-decision. Anything that inflicts upon us such protracted discomfort cannot but meet a fantastic ending.

And yet, it is tremendously improbable that one glorious day, Chinese helicopters will begin airdropping magical pills to cure the infected, and protect the healthy.

Consider, first, the pill – there isn’t necessarily going to be a single vaccine to rule them all. The Cure, with a capital C, would ideally raise antibody levels and keep them there for life. But we may, instead, end up developing an array of vaccines, piecemeal – each one playing its own part.

Over a hundred drugs are at various levels of trials. The WHO’s 100-country Solidarity Test is, for now, focusing on four. A frontrunner, remdesivir is an antiviral that’s previously been helpful against Ebola. The drug promises to cut down Covid-19 recovery time by a third. Another, chloroquine, previously helped against malaria. Now, it may help the pneumonia that our novel virus tends to cause. But none of these drugs will, necessarily, prevent infection. People may still catch the virus, but the ordeal may end quicker – or be less fatal.

Even a vaccine that does prevent infection won’t necessarily work for everyone. With dengue, the vaccine left many worse off. Initial SARS and MERS vaccines – both coronaviruses – produced similar results. And even if a vaccine works perfectly for everyone, the illness may just recur – in which case people will need to keep getting seasonal shots. Some viruses also mutate, necessitating regular vaccine software updates, so to speak.

The ‘some time in 2021’ timeframe for the vaccine is also on the optimistic side. In fact, it would be unheard of. The mumps vaccine, generally considered to be the fastest ever approved, took four years to evolve into a licensed drug.

Still, there are reasons to be optimistic. There is the sheer volume of resources being diverted to the search, for one. There is also a previous body of coronavirus research to build on. But as scientists scramble towards a vaccine in record time, the careful act of winnowing its side-effects will be all the more important: this will be a drug administered to billions.

Then, there’s the problem of the helicopter. A globally synchronized hailstorm of magic pills may be just as likely as precipitation in the form of ventilators. We’d like the vaccine to be free, and we’d like seven billion doses to be manufactured and distributed instantaneously – and several manufacturing deals have, indeed, already preemptively been inked. But as you may have heard, human beings have a strict limit on lunch discounts.

In the end, Lahore will probably watch, with practised patience, as London heals – clenching a moist, calloused fist on a waiting-room token that is just shy of triple digits. It's happened before: smallpox was eradicated from Africa a quarter of a century after it was eradicated in North America and Europe. With swine flu, rich countries ended up with vaccines while the rest blinked at empty bowls. In death, the indignity of poverty is particularly inescapable.

But unless governments in developing countries are able to foot the bill, it’s just as likely that Gulberg will heal before Gawalmandi. As part of this publication’s readership, it’s quite likely that you, too, will eventually be the focus of someone else’s ire. Alas, the lining of the bubble will remain porous: unless you’re certain that the vaccine’s made you bulletproof, how likely are you to loiter?

Fortunately, the biggest cause for the spread provides the biggest incentive to stop it. In a world of globally fungible frequent flyer-miles, and multi-lane routes for silk and silicone, it’s in everyone’s interests to get rid of all this as soon as possible.

‘As soon as possible’ will be a while, though. Countries that can afford to will, understandably, want to vaccinate their own populations first. After this, they will probably want to make sure they’ve saved up enough for a rainy day. Only after this will they look outwards.

Then, there is that whole range of self-inflicted hardships in which we have cultivated such distinguished expertise. Not only are we one of the last three countries in the world to still have polio, but when people try to help us, we drain them of their good nature and send them back with a message. WhatsApp conspiracies suggesting a nefarious scheme by Bill Gates to insert microchips into our cortexes certainly won’t help, either (an actual survey of Fox News viewers revealed that half share this belief).

And then there’s the most cheerful bit of all: there may be no vaccine at the end of the rainbow. If you ask the fine folk who have spent the better part of the last thirty years searching for a vaccine for HIV, many will return a wry smile and tell you to get in line. There are technical reasons why HIV may not be the best comparison, but vaccines for previous forms of coronavirus have historically performed poorly at defending entry points. There’s just no guarantee.

All of which is to say that not only is the finish line probably farther away than you think, it’s more likely to be a fat smudge than a fine line. Of course, making sense of these things is a bit like casting light on an object from a distance: we’re still too far away to see the edges clearly. Still, there are many reasons to believe that the edges are probably going to remain blurry.

Certain things are clearer, though. In Pakistan, we have decided we aren’t waiting any longer (to use ‘we’ rather liberally). And a couple of weeks back, our prime minister announced that “...we’ve come to terms with the fact that we have to live with the virus. Perhaps until a vaccine is found.”

Lest this article fall into the hands of quarters that have taken great liberties with selective portions of a certain Yale paper, let me make very clear what this article doesn’t say. This article does not validate the timing of this decision. It does not validate the lifting of a lockdown before healthcare capacity, testing capacity or awareness are at adequate levels – or as close to ‘adequate’ as is possible within our resources. Neither is the case. There’s a difference between coming to terms with living with the virus, and coming to terms with dying by it.

This article changes none of that. It was pretty clear that we were going to be one of the countries where the lockdown was temporary. If our lockdown wasn’t going to last six months, then it makes little difference if the end-point shifts from a year away to two. This article is about neither our policies nor our politics. It is simply about the truth that we must live with.

Reading a thousand words on the frailty of “when-all-this-is-over” plans isn’t the greatest dopamine workout. But here, the urge to apologize must be resisted. There’s no shortage of rose-tinted, padded perspectives all around us – many come with official seals. Some will even tell you this isn’t a pandemic at all. What a shame it would be, then, for the truth to require apology.

The truth is sad, and it is unfair. ‘Normal’, as it turns out – for all its flaws – was rather beautiful. It deserves to be grieved. Because Normal won’t be back for a while. The truth is that we are lucky to be alive, but it may be a while before we live again.

The writer is a lawyer.

Email: [email protected] .edu

Twitter: @brainmasalaar