We do not know what 2020 would have looked like without a pandemic, but we already know that some losses could have been prevented. And, if the future lies in the spectrum of pandemics, as the WHO warns, we should learn all the lessons that can be learned from this long journey.
The pandemic has shown how difficult it is to float in the unknown, but also how tempting it is to look for simple answers from those who claim to have them, while specialists are making slow progress in gathering reliable information. In recent months, it has been difficult to keep up with pandemic news, especially since contradictory data and explanations were often provided: statements made by specialists, counter-statements made by amateurs or experts in other fields, contradictory news about the effectiveness of possible treatments, news about the making of a vaccine, (successful) attempts to politicise the crisis, failed predictions, discussions about saving lives versus saving the economy, changes in mortality caused by COVID-19, decreasing of the age of SARS-CoV-2 infected people. But what seems clear from all this diversity of news is that we have not reached the end of the pandemic and that the way we react to it can change the indicators of the crisis, indicators which we have become accustomed to seeing grow continuously.
Using numbers to reconstruct the face of the pandemic
Statistics say that the number of those infected with SARS-Cov-2 has already exceeded 28 million, and the number of deaths has exceeded 900,000.
The number of patients recovered has surpassed 20 million globally, and mortality has fallen, but the way the numbers vary from week to week shows that we have not yet entered the desired one-way street.
The decline in global mortality is some of the good news of the crisis, but the causes of this decline are not fully elucidated.
Social distancing, the use of more effective treatments compared to those used at the onset of the pandemic, and the increasing infection of young people are some of the factors that could intervene in reducing mortality, but researchers are advancing several explanations, some of them raising new questions.
India recently set a new global record after reporting more than 90,000 new cases of SARS-CoV-2 infection in one day, surpassing Brazil and ranking second among countries with the highest number of infections. According to experts, the country is facing the second wave of the pandemic in some regions, as a result of easing travelling restrictions.
With 114 infections per 100,000 people, Spain faces a spread of the virus twice as fast as in France and 10 times as fast as in Germany. The good news is that mortality has dropped to 6.6% from its 12% peak in May. The bad news is that the country is going through the second wave of the epidemic, according to a study in Catalonia, which shows that “the effect of bars and restaurants could have huge repercussions on the evolution of epidemics”, because the prevention measures are much less respected there.
“Perhaps Spain is the canary in the coal mine,” said Professor Antoni Trilla, an epidemiologist at the Barcelona Institute for Global Health, expressing fears that other European countries could be hit by a second wave of the epidemic.
Although states have implemented more or less rigorous solutions for reopening schools, there are fears that things may not go according to plan. In the US, the infection rate of children and adolescents is higher than that of other age groups, according to data compiled by the American Academy of Pediatrics. By the end of May, 5% of all cases of infection from the US were children, but the proportion increased to 9% by August 20th. Although the forms that children develop are usually lighter, the number of hospitalisations and deaths has increased among children, says Sean O’Leary, vice chair of the committee on infectious diseases at the American Academy of Pediatrics.
A survey conducted by The New York Times in more than 1,500 American colleges and universities showed that there had been at least 51,000 infections and at least 60 deaths among students since the onset of the pandemic.
According to a new report by Amnesty International, more than 7,000 health workers worldwide have died as a result of COVID-19. This represents further evidence that the damage usually caused by influenza and that caused by SARS-CoV-2 cannot be compared.
“Many months after the pandemic began, the mortality rate of health workers remains terrible in countries such as Mexico, Brazil and the United States,” said Steve Cockburn, head of social and economic justice at Amnesty International.
In fact, the report figures could be significantly underestimated due to underreporting or difficulty in centralising data. Thus, Romania is registered in the report with three deaths of medical workers, but, in reality, their number reached 35.
Happy examples from the pandemic pouch
A West African country was effective in managing the pandemic to such a great extent that even economically developed countries have a reason to be envious. This is Senegal, a country with a fragile health system; their hospitals do not have enough beds and there are about 7 doctors per 100,000 inhabitants. After 6 months of the pandemic, Senegal has 14,000 cases and less than 300 deaths, out of a population of 16 million.
An analysis of how 36 countries managed the pandemic, conducted by Foreign Policy magazine, placed Senegal in second place, with the United States far behind, in 31st place.
Using their experience in dealing with the Ebola outbreak in 2014, Senegal prepared an emergency plan as soon as the World Health Organization declared an international public health emergency on 30 January 2020. The first case of COVID-19 appeared at the end of March. Travelling between the 14 regions of the state was restricted and mobile testing laboratories were created, where the test results could be obtained within 3 to 24 hours. The population wears masks and there have been no disputes over the prevention rules established by the government. The Ministry of Health also communicated the number of new cases and deaths on a daily basis, playing the transparency card to make the population aware of the seriousness of the crisis.
Shannon Underwood practices law in Senegal, where she immigrated two years ago. Originally from Seattle, she says she felt safer in her adoptive country and that her friends in Senegal are stunned that Americans do not take the severity of the threat they face seriously, challenging restrictions that increase health protection.
Although many experts and political leaders warn that, in terms of the evolution of the pandemic, we are at the mercy of the population, the case of Senegal shows that it is only one side of the story and that political decisions and a robust health system complete the picture of general responsibility.
Successful pandemic management is not an “accident”
Prudent in estimating the duration of the pandemic, the World Health Organization spoke only of the hope of the pandemic ending sooner than in the case of the Spanish flu, which lasted two years. On the other hand, five weeks ago, WHO Director-General Tedros Ghebreyesus stressed the need to fight with all available tools against the virus as long as many countries that have gone through the most difficult phase are now facing new outbreaks.
We could still be feeling the effects of this crisis in a few decades, the WHO Director recently pointed out, also explaining that this pandemic will not be the last and that we need to be much better prepared for future pandemics.
The countries that have managed to navigate with minimal losses due to the coronavirus pandemic are those that have had efficient strategies and well-organised health systems, Ghebreyesus explained during a press conference held in Geneva.
Thailand has been one of the countries that has now reaped the fruits of decades of healthcare investment. Thanks to trained medical staff, one million community medical volunteers and the adoption of preventive measures following the best recommendations of specialists, the government has managed to convince the population to cooperate and comply with measures to prevent the spread of the virus (the country has had fewer than 3,500 cases of COVID-19 and only 58 deaths).
The list of countries that have managed the crisis well includes many who have learned their lessons from previous outbreaks of SARS, MERS, measles, polio, Ebola, flu or other diseases. For others, however, the new coronavirus was like an unannounced test paper, for which they could barely get a passing grade. And when the grade reflects actual lives lost or saved, we’d better understand why we can no longer treat the medical system like Cinderella.
Carmen Lăiu is a writer for ST Network and Semnele timpului.