16 November, 2020
Global Health Crisis: The Flaw in Our Desires
Dr. Muhammad Hashim Ghouri, Gulab Devi Hospital
Dr. Aqsa Shafique, Combined Military Hospital
Dr. Mah Rukh, Jinnah Hospital
More than 100 years and yet we face another pandemic that devastated the state of usual affairs. A young physician asked about what he should do to aid and assist for the 1918’s pandemic, was told that he should learn how to build coffins. Spain, a noncombatant state in the World War 1, discerned the “Spanish flu” in February of 1918, hence named “Spanish Flu”. It infected a third of the world’s population, killing more people than the World War I, II, Korean, and Vietnam Wars combined (CDC, 2018).
Sadly enough, as soon as an epidemic crosses borders of a country, it becomes a pandemic, and the world health authorities are high alert. The history of pandemics date earlier than 430 B.C. and yet the 1918–1919 H1N1 influenza pandemic was among the most deadly events in recorded human history; killing an estimated 50–100 million persons (Morens and Fauci, 2007). Losses fell most heavily not only on the weak but on the strong as well; nearly half the deaths from influenza and pneumonia were among men and women in the prime of life, between 20 and 40, and the disease in 1918 occurred most frequently among children five to 14 years old. The greatest loss in proportion to population fell between 25 and 29 years of age (Walters, 1978). Superimposed with the successive waves of the pandemic caused by a new strain each time. What makes a pandemic worrisome is the limited time frame to understand the cause, the rapid increase in suspects and deaths, as well as the depleting resources whether healthcare workforce or hospital care appliances. What makes the pandemic last long is realizing what factors would flatten the curve and their implementation worldwide. Moreover, the public disbelief in a certain disease until it hits their vicinity poses detrimental effects to all efforts made by any particular state. Various other factors make the response time and efforts count.
Had the world known what a virus is in 1918, the health authorities would have better dealt with the Spanish flu pandemic as compared to COVID-19 pandemic. Early 19th century was the dawn of modern medicine, viruses were yet not discovered hence the flu treatment, prevention and the understanding of its transmission was out of question. Whereas today, when the world has already experienced multiple waves of respiratory pandemics, COVID-19 despite not having vaccine or treatment was timely recognized and managed. The transmission was reduced and prevented due to global networking and technological advancements. Deterioration in most of the patients was prevented with existing medications.
1918 was the earliest stage of industrialization with an ongoing “Great War”, also known as ‘the war to end all wars’. Cold winters, crowded camps, troops shifting from one camp to the other, consumed governments, exhausting economic resources and the dwindling fate of certain states after a 4-year long war effort. More than 30% of doctors and nurses had to leave hospitals and clinics to work for the military, leaving hospitals understaffed when the pandemic hit. Terror upon terror, struggle upon warfare, deaths upon deaths. Only palliative therapies that included turpentine and beef tea were mainstay treatment, which could have caused more harm than actually helping. ‘Purple death’, the vicious type of pneumonia; cyanosis spreading from the ears to all over the face, until the white were undistinguishable from colored men. Pictures were created to explain the disease in the era of meagre technological and media advancement. Having no coffins and the picture of bodies stacked in morgue from floor to ceiling looked as fierce as cordwood. The high fatality three pandemic waves with an estimated 50 million deaths globally and an overall depressed average life expectancy by 12 years had left the rapidly advancing world stunned and paralyzed the most modernized systems.
Today the world is going through a similar pandemic yet in far better circumstances. We have no war to exhaust human or economic resources, rapid social media communication, far mechanized medical resources. Aware of the viral existence, era of antivirals with experience of multiple respiratory pandemics. Alas, the world suffered massive loss of human life, at the hand of cooperation, lack of multilateralism and global governance. Many nations outperformed others in containing the pandemic and preventing as great a loss as others by exercising essential measures. The fragmentation and polarization more than 100 years ago that led to the great war itself had been the center of reasons that failed countries at COVID-19 pandemic. In this rapidly developing world where multi-polarization for the sake of personal development has refrained us from executing global preparedness despite the experiences and individual preparedness of epidemics and even pandemics.
These Pandemics have opened new avenues for the world of research, a critical step was taken by Taubenberger and his colleagues in sequencing the entire 8-segment genome of 1918 H1N1 virus (Taubenberger et al., 1997). This has galvanized the researchers and world into advancement towards discoveries relevant to the pandemic paradox. A reason to catalyze the process of unveiling the obscurity of this riddle we yet faced again in 2019, where the world struggled to adapt and respond to COVID-19 pandemic, despite having recovered from the pernicious incessant 1918 Spanish flu. A shifted attention towards social and psychological trauma has gained appositely unusual recognition. The widespread fear, helplessness, illness and death, economic hardship, and disruption of social support caused by the pandemic will create a global need for both supportive crisis counseling and formal mental health treatment. An era of modern advances has thus shifted the perspective to an e-health framework (Rosen, Glassman and Morland, 2020).
The COVID-19 pandemic is indeed a disaster; it is a global event that involves threat of harm or death to large number of people, causing loss of resources and disruption of services, and is likely to have long lasting physical and mental health impacts (Goldmann and Galea, 2014). To have peace, the world requires unity and solidarity. To limit the pandemic and its causalities, demands cooperation and global preparedness. Are we ready to accept and coexist for the sake of our world?
Centers for Disease Control and Prevention (CDC (2018). 1918 Pandemic Partner Webinar. YouTube. Available at: https://www.youtube.com/watch?v=4czg3aKmfXs&feature=emb_rel_end.
Goldmann, E. and Galea, S., 2014. Mental health consequences of disasters. Annual review of public health, 35, pp.169-183.
Morens, D.M. and Fauci, A.S., 2007. The 1918 influenza pandemic: insights for the 21st century. The Journa of infectious diseases, 195(7), pp.1018-1028.
Rosen, C.S., Glassman, L.H. and Morland, L.A., 2020. Telepsychotherapy during a pandemic: A traumatic stress perspective. Journal of Psychotherapy Integration, 30(2), p.174.
Taubenberger, J.K., Reid, A.H., Krafft, A.E., Bijwaard, K.E. and Fanning, T.G., 1997. Initial genetic characterization of the 1918 “Spanish” influenza virus. Science, 275(5307), pp.1793-1796.
Walters, J.H., 1978. Influenza 1918: the contemporary perspective. Bulletin of the New York academy of medicine, 54(9), p.855.