Wednesday, October 20

Was covid-19 a predicted disaster?

A fierce battle in a few countries had saved the world from a global pandemic. The problem was that few saw it that way. The picture: A Chinese doctor treats a SARS patient in Beijing in 2003.

In fact, we received a warning 18 years ago that a corona pandemic could affect the world. We just don’t follow it.

Knowledge is Aftenposten’s commitment to research and science, where researchers and professionals from all over the country contribute articles.

There are two things that impress me when I read about the SARS epidemic in 2003: How lucky we were! And how quickly everything was forgotten. Sars could easily have spread as widely as covid-19 does now.

At the same time, the World Health Organization (WHO) harshly criticized the use of too many resources in this disease. Now, at the time of the corona pandemic, it is a strange thing to read this review.

Unknown fatal pneumonia

On March 12, 2003, the WHO announced a new type of severe pneumonia that appeared to have a high death rate. It particularly affected health professionals and was caused by a hitherto unknown microbe.

The outbreak started in China and had already spread to Hong Kong, Vietnam and Canada. Taiwan quickly followed suit. Both rich and middle-income countries appeared to be at risk for outbreaks of this disease, which eventually became known as severe acute respiratory syndrome. sars.

Sars and covid-19 are caused by two closely related coronaviruses: sars-cov and sars-cov2.

Sars had a death rate of nearly 10 percent. But less than four months later, the outbreak stopped. Just over 8,000 people were affected, of which 771 died.

The four Southeast Asian countries and Canada accounted for more than 95 percent of all cases and deaths in the world. A fierce battle in a few countries had saved the world from a global pandemic. The problem was that few saw it that way.

The media about sars in 2003

The WHO’s handling of the SARS epidemic received much criticism at the time. They received huge criticism when they warned the rest of the world not to travel to areas affected by SARS. Canadian authorities in particular were furious: a travel warning to Toronto hurt the country’s tourism industry!

The BBC’s David Frost had one longest critical interview with the then WHO Secretary-General Gro Harlem Brundtland that year. At that time, the epidemic was at its peak with around 200 new cases of infection daily.

Frost criticized the Toronto travel ban as a policy. In addition, Brundtland was faced with the amount of money and resources that were spent fighting SARS, compared to the amount that was spent fighting malaria, where 3,000 children die a day.

Brundtland’s arguments were that if SARS spread to every country in the world, it would cost us all much more, especially poor countries. And sars would come in addition to HIV and malaria, not in its place.

This did not reach Frost. But she was adamant.

A fierce battle in a few countries had saved the world from a global pandemic.

It was right to try to stop sars by all available means, for as long as possible. At this time, not everyone was sure that they could prevent sarra from becoming a global epidemic. There were voices in the medical community in both Hong Kong and the United States that expressed doubts that they could do so.

WHO in management

What is also surprising about the SARS outbreak is that the WHO took the initiative to address it early on. This management stands in stark contrast to WHO’s handling of the West African Ebola crisis, which lasted two years, 2014-2016.

WHO never took a leadership role in this. A total of 28,600 were infected and 11,325 died.

Therefore, it is necessary that professionals who understand how much is at stake, take the initiative. And that they dare to make the important and sometimes unpopular decisions.

Although the WHO advised against traveling to areas with ongoing SARS infection, the Norwegian Institute of Public Health did not recommend quarantine here for people who came from these areas. Norway never received any cases of SARS. We were lucky. Sweden got five.

Western media and decision makers never realized how close we were to a global disaster in 2003. We are paying for it now.

Dress test

But the professionals got it. The head of the WHO Regional Office, the Japanese Dr. Shigeru Omi, writes in a summary book that “… we must be prepared for new outbreaks. We can think of the sars as the dress rehearsal we learned from. ”

The book was published in 2006. Professionals understood that it was only a matter of time before something similar happened again.

The countries most affected by SARS seem to have learned. All were quick to act and have had a much lower incidence of covid-19 throughout the epidemic than virtually any other country in the world.

In the book, Omi lists three interesting lessons to take from sars.

1. Transparency is the most important thing. It is pointed out how in the initial phase time and control of the situation were lost, since China was initially reluctant to share information. But along the way, they turned around, and this was crucial for them to be able to stop the outbreak.

2. The infection control measures of the 19th century (quarantine, isolation and limitation of the number of close contacts) still proved to be the most important and effective weapons against infectious diseases.

Innovations such as genetic engineering and the Internet also played a role. In less than a month, the genes of the virus were identified and genetic engineering tests (PCR) were developed to detect the virus. Researchers from nine different countries contributed.

The Internet was a prerequisite for researchers to exchange information quickly and efficiently. The internet also quickly brought information about the outbreak around the world.

However, the measures against the spread of the disease were the same as 100 years ago.

Poor animal husbandry makes us vulnerable to new diseases. Trading animals in markets where they are poorly cared for, and at the same time close contact between various species, gives the virus the opportunity to find new hosts. We too.

A malnourished, injured, and weakened animal is prone to illness. Then it will carry more viruses and bacteria. With extensive contact between animals and humans, the virus has a high chance for mutations to occur at the critical time when the virus can jump from host to host.

Most infectious diseases that are considered childhood diseases in humans originally originated in animals. Sars is believed to have come from bats and humans infected via the Asian sable palm, which is sold in cages in Southeast Asian markets.

Asian palm civet

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