Humbled by nature: 600,000 dead in U.S from COVID-19

“Fully vaccinated.”

Today’s the day. Wednesday, June 16, 2021. Two weeks have passed since my second dose of Moderna COVID-19 mRNA vaccine was administered.

Our parents generation had V-E Day or Victory in Europe Day, the public holiday celebrated on May 8, 1945 to mark the end of the Second World War in Europe, while V-J Day or Victory over Japan Day was celebrated Sept. 2, 1945 in the United States, Aug. 14-15, elsewhere by our Allies. But as he witnessed the first detonation of a nuclear weapon on July 16, 1945, a piece of Hindu scripture from the Bhagavad Gita ran through the mind of Robert Oppenheimer: “Now I am become Death, the destroyer of worlds.”

Our generation now has its own individual V-Day: Vaccinated against COVID-19 Day.

Some 675,000 Americans died over three years between January 1918 and December 1920 during the three waves of the Spanish Flu pandemic when the country’s population was 103.2 million. Today, the population of the United States is more than 331 million. The world population in 1918 was about 1.8 billion, compared to about 7.8 billion people today.

COVID-19 is the second-deadliest plague in modern history, having killed as of June 15 more than 600,000 people in the United States in slightly more than 16 months. The COVID-19 death toll stands at about 3.8 million case fatalities worldwide. It’s unusual clinical course of unpredictability in patients, ranging from an asymptomatic infection the person isn’t even aware of to death in a hospital intensive care unit (ICU), often with no good explanation available even after age and comorbidities are accounted for, makes it all the more terrifying. Some diseases are so deadly death is almost certain. COVID-19 is not like that. Rather it is like playing a macabre viral version of Russian Roulette. Maybe. Maybe not.

At the same time, effective messenger Ribonucleic Acid (mRNA) and viral vector vaccines offering full protection against COVID-19, some of which were relegated to the scientific research backburner since their initial discoveries and on-again, off-again preliminary work in the mid-1980s, were brought to fruition in warp speed in 10 months rather than the normal 10 years it takes to bring a new vaccine to market. Despite the COVID-19 vaccines impressive efficacy and good safety record to date, I’m under no illusion that we the vaccinated are not all part of a population level experiment. We surely are. Not something I would have said in advance I’d be anxious to sign up for, but as the Scottish philosopher James Boswell’s Life of Samuel Johnson, quotes in 1777 the latter to say: “Depend upon it, sir, when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully.”

And, of course, as the last 18 months have unfolded, all of this has been accompanied by an “infodemic” of social media and real life (if there is still that separation for some) sometimes accidental misinformation but more often deliberate disinformation from modern-day armchair Barbarian Visigoths, who revel in the propagation of their anti-mask and/or anti-vax propaganda. Until they die of COVID-19. It’s not like we didn’t have a heads-up of what to expect on this front in the battle against COVID-19. In 1998, Andrew Wakefield and 12 of his colleagues published a case series in the Lancet, which suggested that the measles, mumps, and rubella (MMR) vaccine may predispose to behavioural regression and pervasive developmental disorder in children. Despite the small sample size (n=12), the uncontrolled design, and the speculative nature of the conclusions, the paper received wide publicity, and MMR vaccination rates began to drop because parents were concerned about the risk of autism after vaccination.

All pretty remarkable, since the name COVID-19 didn’t exist prior to Feb. 11, 2020 when the World Health Organization (WHO) named what had been provisionally known as Novel Coronavirus 2019-nCoV and first reported from Wuhan, China on Dec. 31, 2019. In terms akin to chaos theory, think of it perhaps as the as the Wuhan butterfly effect, regardless of whether the origins of COVID-19 should someday prove to be natural or the result of a gain-function experiment gone awry resulting in an accidental lab leak at the Wuhan Institute of Virology. The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2 for what would become known as COVID-19. The World Health Organization, perhaps finding the recommended name a tad too resonant politically to SARS from the not-so-distant past, opted instead for the official name COVID-19.

Human beings live in the realm of nature, they are constantly surrounded by it and interact with it. Man is part of nature, a humbling reminder for all of us to what we so quickly forget 15 minutes after the last pandemic ends. Until the next one begins.

The first time I wrote on what would soon be characterized as the current pandemic was on Jan. 23, 2020. A week later on Jan. 30, WHO Director General Tedros Adhanom Ghebreyesus, an Ethiopian biologist, following the recommendations of the WHO Emergency Committee, declared that the Novel Coronavirus 2019-nCoV outbreak constituted a Public Health Emergency of International Concern (PHEIC). On March 11, the WHO elevated the viral outbreak to the status of full-blown pandemic.

The headline to my Jan. 23, 2020 post wondered, “The fire this time? Pandemic prose, and waiting and watching for the ‘big one’ (The fire this time? Pandemic prose, and waiting and watching for the ‘big one’ | soundingsjohnbarker (wordpress.com) In a matter of weeks, there was no question the question mark could be dropped and the sentence turned into a categorical statement; it was indeed the fire this time, and the “big one” had arrived as an unwanted New Year’s Eve 2019 guest.

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Misplaced patriotism and public health propaganda are no disinfectants for a pandemic

John M. Barry’s 2004 book The Great Influenza: The Story of the Deadliest Pandemic in History, chronicles the 1918-19 Spanish Flu pandemic. It is a compelling read, and placenames such as Haskell, Kansas, an isolated and sparsely populated county in the southwest corner of the state, remain etched in my mind.

Barry also serves as an adjunct member of faculty at the Tulane University School of Public Health and Tropical Medicine in New Orleans.

But what really struck me was the very, very rapid breakdown in public order, Barry chronicles, despite official protestations to the contrary.

Nurses, who were right on the front lines, and truly, truly heroic in the earliest stages of the pandemic, in many cases soon just stopped coming to work. Many, of course, were too sick to, gravely ill or dying themselves, but many who were still well stopped coming to work out of fear of becoming infected themselves, and perhaps also infecting their loved ones. The same happened across many different public offices. Can any of us really know what we would have done faced with similar circumstances? I think not.

Government in many cases, and particularly at the municipal level, pretty much ceased to function – and that happened very, very quickly. State and provincial governments weren’t much better in many cases, and federal governments were, to be very charitable, slow off the mark. The international institutions we have now, for the most didn’t exist in 1918.

Philadelphia is one of Barry’s chilling examples that has stayed with me. Things were so bad there in the fall of 1918, when the Spanish Flu pandemic arrived in the city, that a group of volunteer women, holding no official titles or offices, who lived on Philadelphia’s “Main Line,” home of the city’s old money and prestige, essentially took over the key functions of the city government and co-ordinated Philadelphia’s response to the pandemic.

In essence, the Ladies Auxiliary, albeit a very well off, and a very well connected one, saved the day in Philadelphia in 1918, but it was a very close thing indeed.

But how did things get so bad in Philadelphia in the fall of 1918?

On Sept. 28, 1918, despite sound advice and warnings to the contrary, Philadelphia public health director Wilmer Krusen insisted on allowing a Fourth Liberty Loan Drive parade, with some 200,000 people jamming Broad Street, “cheering wildly as the line of marchers stretched for two miles.” It was after all the patriotic thing to do in the final Allied push to defeat the Central Powers and win the First World War.

“Within 72 hours of the parade, every bed in Philadelphia’s 31 hospitals was filled,” Kenneth C. Davis wrote in Smithsonian magazine in September 2018. “In the week ending October 5, some 2,600 people in Philadelphia had died from the flu or its complications. A week later, that number rose to more than 4,500. Allison C. Meier in an article for Quartz last November noted that historian James Higgins, writing in Pennsylvania Legacies, observed that by the first week of October 2018, roughly five weeks into the outbreak, “Philadelphia’s mortality rate accelerated in a climb unmatched by any city in the nation –perhaps by any major city in the world.”

We really are not very particularly good at learning the lessons of history. Or when we think we have, we often draw the wrong lessons. Misplaced patriotism. Public health propaganda. These are no disinfectants for a pandemic.

The original name of the new coronavirus was provisionally known as Novel Coronavirus 2019-nCoV, before the World Health Organization (WHO) adopted the name COVID-19.  The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2 for COVID-19. The World Health Organization, perhaps finding the recommended name a tad too resonant politically to SARS from the not-so-distant past, opted instead for the official name COVID-19.

The revised World Health Organization’s case fatality rate earlier this week of 3.4 per cent from 2 per cent for COVID-19 on March 3 is a 70 per cent fatality increase.

“I think the 3.4 per cent is really a false number,” U.S. President Donald Trump told Sean Hannity, one of his favourite conservative Fox News hosts, in a phone interview broadcast live March 4.

In the early 1980s, I watched with surprise and unexpected admiration as C. Everett Koop, an evangelical Christian, who served as surgeon general under U.S. Republican president Ronald Reagan from 1982 to 1989, and was well known for wearing his uniform as a vice admiral of the United States Public Health Service Commissioned Corps, had the singular political courage to speak the truth about the science of AIDS as our knowledge increased. According to the Washington Post, “Koop was the only surgeon general to become a household name.”

Who will be the next C. Everett Koop, with the courage to speak truth to power, afflicting the comfortable, while comforting the afflicted? Someone Ike the late Dr. Li Wenliang, the whistle-blower ophthalmologist who sounded the alarm after contracting the virus while working at Wuhan Central Hospital.

There have been some exemplary public health responses to the COVID-19 public health emergency of international concern, such as those of Dr. Bonnie Henry, British Columbia’s, provincial health officer, whom André Picard, the health columnist at The Globe and Mail, earlier today described as setting “the standard for public health communication. Too often, public officials are dispassionate and robotic. Using clear language and showing genuine emotion makes your message more relatable and impactful.”

And then there have been the less than exemplary public health responses – or perhaps more accurately – lack of response.

When is a pandemic not a pandemic? When the World Health Organization (WHO) has Dr. Tedros Adhanom Ghebreyesus as its director-general apparently.

“I think it’s pretty clear we’re in a pandemic and I don’t know why WHO is resisting that,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Devi Sridhar, a professor of global public health at the University of Edinburgh who co-chaired a review of WHO’s response to the 2014-16 Ebola outbreak in West Africa, said a pandemic declaration is long overdue.

While none of this is easy when we don’t yet have a clear idea of the transmissibility and virulence of COVID-19, it is equally true the absence of true, timely public health information and honest decision-making, we risk further fostering a not insignificant climate of international government and institutional distrust, leading to social media platforms being lit up with stories such as the ones suggesting that the novel coronavirus is a genetically engineered biological weapon with a protein sequence included elements of HIV, the virus that causes AIDS – either a Chinese one that had escaped from a laboratory in Wuhan or an American one inflicted on Wuhan, or that COVID-19 is perhaps some kind of so-called “false flag” operation to distract us from someone or something else.

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