Dr. Sanjay Gupta: One year living in the shadow of a pandemic

Dr. Sanjay Gupta: One year living in the shadow of a pandemic

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In the early months of 2020, as the unprecedented health crisis quickly crossed borders – China, Italy, Spain, South Korea, Japan and soon the United States – it began to take the form of a growing global threat . Something beyond an epidemic.

While doing research, I was surprised to learn that there was no universally accepted definition of “pandemic”. But a growing number of medical experts and public health officials with whom I spoke were telling me that the situation was unfolding quickly.

In general terms, a pandemic is an outbreak of a virus that can cause illness or death, where there is constant transmission of that virus from person to person and evidence of its spread in different geographical locations. Check, check and check.

A few days later, WHO adopted the same language.

To be fair, WHO has been sounding the alarm continuously for almost six weeks, since January 30, 2020, when the director general, Tedros Adhanom Ghebreyesus, declared the situation a “public health emergency of international interest” – the highest level of health alert under international law. The definition is “an extraordinary event that may pose a risk to public health for other countries through the international spread of the disease and may require an internationally coordinated response”.

For this symbolic anniversary, I spoke with Maria Van Kerkhove, WHO technical leader for the response to the coronavirus, to reflect on the year of the pandemic and beyond.

Different countries, different responses, different results

Van Kerkhove – who said that WHO tries to do for the world what the US Centers for Disease Control and Prevention does for the US – told me that the goal of a public health emergency of international interest is to raise the alarm before an emergency comes in. pandemic, when there is still time to possibly prevent and, in any case, prepare for what is to come. Similarly, for more than a year, WHO has been trying to change the path of the pandemic through, among other things, experience, guidance, advice and support, as well as frequent press conferences.

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While each country responded to the emerging threat in its own way, some countries took the first warnings more seriously, she said.

“It was not about rich or poor countries. It was about experience. It was about those countries that knew the threat it was; they heeded our warnings,” said Van Kerkhove. This experience came from dealing with previous infectious outbreaks, such as SARS, MERS and Ebola. And these countries quickly implemented strong public health measures, mobilized community health workers, contact trackers and laboratory technicians.

Van Kerkhove points to places like South Korea, Japan and Nigeria – all of which have managed to keep the transmission of this new virus relatively under control.

For me, South Korea has been one of the clearest examples of success. She reported her first case of Covid-19 on January 20, 2020, hours before the United States confirmed its first case on January 21.
But the two countries ended up in extremely divergent places: the United States has more than 29 million reported cases and more than half a million deaths. South Korea? Less than 100,000 cases and less than 2,000 deaths. You cannot rule this out, as the United States has a larger population than South Korea, because when you look at deaths per capita per 100,000 inhabitants, the United States has more than 161 compared to South Korea 3.
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Van Kerkhove said that South Korea learned lessons from the 2015 MERS outbreak. “What they learned from this was to rebuild their system and improve their public health system, which was used during this pandemic,” she said.

As an example, she cited what happened in the city of Daegu, when there was a major outbreak linked to church activity in February. “The case numbers were apparently out of control,” she said. “And Korea came out on top.”

How did they do that? For being strategic and taking advantage of the tools they have, said Van Kerkhove. “They observed the situation they were in. They improved their cluster investigation. … They increased their screening capacity, their testing capacity. They used the quarantine effectively and controlled the outbreak. But at some point, it seemed almost impossible – and they changed everything, “she said.

She added that other countries have also changed things, for example, Cambodia, Thailand, Rwanda and South Africa, even with the emergence of a more contagious variant there. “People’s resilience is what is encouraging and inspiring,” she said.

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What has always impressed me is that, although outbreaks of infectious diseases often destroy the poorest countries, this new coronavirus has disproportionately affected many of the richest nations in the world. Consider that there are about 9,000 cases per 100,000 people in the United States. Compare that to India, where it accounts for about a tenth of that, although they have some of the most densely populated areas in the world.

As they say, money cannot buy everything, especially good health. “You can have really good medical systems in countries … the best treatments in the world. But that doesn’t make up for the fundamentals of public health,” said Van Kerkhove.

Variants and vaccines

Now that we are in the second year of the pandemic, vaccine cavalry has arrived. But with him, a more contagious enemy and, possibly, in some cases, more deadly. New variants of the virus are decimating cities in Brazil; different variants have occurred in the United Kingdom and South Africa. And they are establishing themselves in this country as well.
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This can be resolved by providing better access to the vaccine for poor countries. According to the People’s Vaccine Alliance, a global vaccine surveillance group, wealthy nations are now vaccinating one person every second, while most poorer nations still need to administer a single dose.

But that is changing, thanks to COVAX, a global initiative that promotes equitable access for developing nations to Covid-19 vaccines. Led by WHO and other organizations, COVAX distributed 20 million doses of vaccine to 20 countries last week during the first week of distribution, according to WHO Director-General Tedros. An additional 14.4 million doses of the vaccine are scheduled to leave this week for another 31 countries.

“We are all part of this global community. Every life on this planet is important,” said Van Kerkhove. “Everyone on this planet deserves to be protected.”

Plan by plan, the world is beginning to see some hope. And countries that have followed WHO’s warnings and followed public health guidelines are giving us a glimpse into post-pandemic life.

“I have glimpses of hope in many countries around the world,” said Van Kerkhove, pointing to places like Australia, New Zealand, China and Japan. “I see societies opening up. I see sporting events happening. I see a resilient community that is living his life, which reduced transmission in some situations to zero. ”

Van Kerkhove, myself and many others were humiliated by this virus – a virus that taught us that rich and poor do not matter, borders do not matter and that unexpected things can happen and happen. She and I hope that all nations, but especially Western ones, will use the unfortunate lessons that we have all been forced to learn to put systems in place so that we are in a better position to face the next unexpected event, the next pandemic, the next infectious pathogen – because this certainly won’t be the last.

Andrea Kane and Amanda Sealy of CNN Health contributed to this report.

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