The Pandemic Playbook
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DRC Ebola Outbreak 2019 Blog 6 Are Developed Countries Safe from Pandemics?
Some experts believe the USA and other developed nations are ready for any pandemic and point to developed countries that have robust, extensive health care systems. These experts cite older data that suggests microbes like Ebola virus are poorly infectious and therefore pose no threat to wealthy nations. They also state that ‘properly trained staff and physicians will know what symptoms to look for in pandemic exposed cases entering the US.’ They believe that it is easy to contact trace and determine all contacts of EID patients. During a pandemic, these experts expect no major complications in treating any EID-infected patients who enter the country and that any EID outbreaks inside the US will be easily controlled (36-38).
Other experts strongly disagree with the idea that developed nations are safe from pandemics, regardless of the strength of the health care systems. These experts point out the problems that international travel has exploded over recent decades and that travelers returning from abroad with EIDs may not realize that they were infected until they return to their home country. While some carriers who become ill seek medical help, others with infectious diseases are harassed or stigmatized, leading to their persecution which forces them to deny any symptom of the disease (39-41). In the years between 1340 and 1400, stigma and violence against carriers and suspected carriers of plague bacterium Yersinia pestis
demonstrated societal breakdown during a pandemic. In that case, some people hid out of fear of political scapegoating and violence. These defensive reactions to a deadly epidemic can help drive the disease ‘underground,’ hidden by the fear of public anger and violence, where the communicable disease festers among segments of the population that are unreachable by modern health care systems (42).
Several examples of how politicians use pandemics to make minorities scapegoats to gain popularity and votes are illustrated here. The first example is the 1349 Strasbourg, Germany massacre of Jews, falsely accused of bringing plague to the region. The second example among many in the developed nations is the extreme discrimination that Haitians experienced, along with intravenous drug users, homosexuals and others during the 1980s discovery of the acquired immunodeficiency syndrome and its cause, Human Immunodeficiency Virus I.
Upon entering the healthcare system the initial diagnosis of EIDs like Ebola virus can be missed and the patient sent home. Once the infectious disease is correctly diagnosed, there is often fear and confusion as to how to manage these highly infectious and potentially lethal cases (43). Without enough test kits or probes for each hospital in the affected region, a backlog of undiagnosed or incorrectly diagnosed patients becomes problematic as the EID spreads. While there are a handful of hospitals equipped for EID patients in the US and elsewhere, a large influx of EID cases would quickly overrun these specialized institutions and most hospitals in developed countries. There would not be enough isolation capacity (patient beds), resources such as EID trained staff or dedicated equipment to handle large numbers of EID cases. Experts have discussed these issues and sought public assistance to address these problems for decades (44).
In 2015 an independent commission of USA political and intellectual leaders asked how well prepared was the US nation to face natural or human-dependent biological threats. This blue-ribbon panel held meetings, interviewed many experts and did significant research to reach several conclusions. They discovered that despite several decades of efforts, there was still a severe lack of readiness, a limited understanding of the issues related to pandemic and biosecurity preparation, and that it would take years to properly prepare for such threats. One of the panel’s conclusions was that there was a lack of focus by the top US leadership within the US government. Another finding of this commission was that there was almost no political will to understand why it is necessary to prepare for these events (45).
In 2018, during a separate forum to address US pandemic preparedness, 10 government leaders in national security and epidemic response ran a live tabletop simulation for a hypothetical EID outbreak. Again, the question of USA readiness to protect the public from pandemics was asked. In this analysis the question was how would various government departments, at the local and national level, function, communicate and coordinate a response to a pandemic entering the US. This tabletop simulation was run using seasoned national US politicians and bureaucrats mimicking a pandemic spillover into the US. These 2018 exercises, video-recorded and available on YouTube, show the vulnerability of the US and perhaps other developed nations in coordinating their national response to a pandemic threat. The 2018 real-time videos of this exercise expose many unforeseen issues in pandemic preparation (46). The sum of all these data shows that there are no low-risk zones, only zones of early or late pandemic entry (47).
In conclusion, it’s all about opportunity. While some believe that lethal microbes will not exterminate a host species for their own self-preservation, these experts have yet to describe a communication system or gene complex used by microbes which spares mass human death. Other experts point out that most EIDs, including communicable non-respiratory EIDs such as Ebola virus, Bolivian hemorrhagic fever virus or Nipah virus have not killed as many people as any of the major infectious diseases like malaria, tuberculosis (Mycobacterium tuberculosis), Human immunodeficiency virus I or the 1918 pandemic influenza virus (24). In the 21st century opportunities for global travel and pandemics have never been more favorable for acutely infectious EID dissemination. If EIDs like Ebola virus are unleashed and permitted to roam freely on this planet of 7.6 billion people, it may be easier to count the remaining living rather than the dead.
Copyright © 2019 Na’eem A. Abdullah All Rights Reserved
Morning fog on the African river Sangha. Congo. Sergey Uryadnikov Photographer/ Shutterstock Photos.
Many emerging infectious diseases originate in tropical ecosystems. See About Page - Sangha River.
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