Difficult to predict the end of pandemics


PANDEMICS have been occurring since humans became an agrarian society 12,000 years ago. Pandemics that occurred over the past 2,000 years are known to have left radical changes in society, their economy, religion and geopolitics.

The world is now experiencing the impact of another major pandemic and a lot of people must be wondering how and when it will end.

Although statistical models can calculate the course of pandemics, the reality is it is very difficult to predict how and when they will end. The micro-organism responsible for the disease may not completely vanish, but the prevailing conditions that are enabling it to thrive may be rectified or fade away.

In general, pandemics end in two ways – medical end and social end.

The medical end of pandemics occurs when the disease does not have any more hosts to infect or spread it. This can happen in several ways:

1. When most of the people have contracted the disease and there is no more susceptible hosts left to infect;

2. When majority of the population have acquired immunity (herd immunity) from the disease. Immunity can be attained through effective vaccination:

3. Mutation of the bacteria or virus to a mild virulent strain or loss of virulence due to changes in temperature, humidity or other environmental factors; and

4. When health measures such as physical distancing, rigorous contact tracing, quarantine and wearing masks (in the case of Covid-19) are effectively followed, thereby preventing new infections.

It is understood that although pandemics apparently come to a medical close, the micro-organisms that cause them are never really gone.

They could return after decades as another pandemic or an isolated outburst of epidemics or even continue to be present as endemic in some parts of the world. With the exception of smallpox, it is almost impossible to fully eradicate diseases.

Although efforts are underway to eradicate diseases like malaria, measles, leprosy and tuberculosis, these are still present in some parts of the world. Relatively new pathogens such as HIV, Ebola and coronavirus add to the already existing disease burden.

History shows that pandemics can last for a long time, even years, causing people to grow weary and frustrated, rebel against the social restrictions put in place, and learn to live with the disease in their midst. This leads to the social ending of pandemics.

An account written by Italian writer and poet Giovanni Boccaccio describes the coping methods of the people in Florence during the raging Black Death pandemic in 14th century. Many people at that time had accepted their fate and resorted to heavy drinking, singing, merry-making and gratifying all their cravings. While these people may or may not have succumbed to the disease, they certainly contributed to the social ending of the pandemic!

The Covid-19 pandemic seems to have ended socially, too – at least in some parts of the world. People are growing weary of the public health measures and started going about their usual work. Vaccines are being rolled out, and there’s hope that the pandemic would be contained soon, providing a possible medical end.

Controlling pandemics takes immense social and political will. The efforts should be coordinated within countries and among nations and regions with equitable distribution of vaccines and treatment. Lessons learnt from history should also be put to good use.

Humans have time and again proven their resilience against pandemics, and it is hoped that Covid-19 will be overcome soon and humanity will emerge triumphant.

DR MANIKANDAN NATARAJAN

Faculty of Dentistry

AIMST University

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