This opinion article was written by an independent writer. The opinions and views expressed herein are those of the author and are not necessarily intended to reflect those of DigitalJournal.com
The Italian death toll may be a defining moment in the pandemic. Italy has moved into progressively tougher lockdowns, but apparently the spread outpaced the initial countermeasures. The obvious inference is that the sooner you lock down, the better. 99% of virus deaths had pre-existing conditions. Iran’s death toll is looking worse. According to News Corp, one person is dying every ten minutes in Iran from the virus. Iran is attempting to lockdown as fast as possible, but the spread of the virus is clearly very rapid and widespread. Infections are currently at about 1,000 per day. It’s unclear what percentage of deaths were related to pre-existing conditions. The United Kingdom is scrambling to meet the virus with lockdowns of pubs, restaurants, and general measures to restrict exposure by social distancing. 144 people have died in the UK so far. The government has invoked emergency powers to manage the crisis, to a general roar of doubt from anti-Johnson critics. In the United States, 17,000 people are known to be infected and over 200 have died. No statistical breakdown is available at this point. Americans are being told to stay home as the most populous states put in place the standard precautions. American experts are saying many more people have been infected, and the overall trend is to recommend severe control measures. “Severe” effectively means total lockdown, which might seem ultra-drastic, but statistically, the infection curve is far lower than other options. Meanwhile, back in Epidemiology Land With any disease, a few basic issues need to be resolved to control it: 1. What sort of environments are high risk for that disease? 2. Is the disease seasonal? Many of the worst diseases are. 3. How does the disease transmit to lots of people? 4. Does the disease persist in the environment? 5. Who’s most at risk? With COVID-19, some partial answers are now available, but it’s hardly a clear picture. Why would Italy and Iran be so severely hit? A few possible clues based on these primary issues: 1. Wuhan in China is in a valley in a mountainous region. Iran and Italy have many mountainous areas. 2. Did the disease start to abate as a result of the onset of northern Spring in China? 3. The Chinese lockdown worked to reduce human transmission; why didn’t Italy’s and Iran’s? 4. There’s no indication if the virus will return in the next winter in China or not. Its predecessor, SARS, another coronavirus, didn’t return. 5. Information so far is entirely consistent that people with existing medical conditions are most at risk. If this very limited amount of information is anything to go by, and it’s highly debatable: 1. Mountainous areas are possible high risk zones. 2. The disease should be most severe in the cold months. 3. Lockdown does work, but can it be done to the same extent as in China? 4. The situation will need to be monitored to see if it does return next year. 5. People with pre-existing conditions will require some form of medication to be available to minimize risk. Not a particularly sparkling view of the future, but unless controls are systematic and global, this thing can be a problem for decades to come. An all-out effort is required to destroy the virus to ensure the pandemic doesn’t become a permanent fixture.
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