Foreword by Dr. Harper Randolph
Spring 2020 - The year we discovered the SARS-CoV-2, COVID-19 global pandemic.
In the story of humanity, communicable diseases play a starring role. From the bubonic plague to cholera to HIV, we have been locked in a struggle for supremacy with deadly maladies for millennia. They attack our bodies with impunity and without prejudice. They’re a merciless enemy, just one-billionth our size, and they’ve existed on Earth longer than man.
In 2020, we were a world under siege. In America, with the whole of the nation in the midst of a declared national state of emergency, most communities were ordered to abide by a mandated lockdown. Infections totaled over a million and deaths were recorded in the tens of thousands. The efforts to protect public health from this novel coronavirus was a striking example of this continuing war. As governments and health authorities battled to stop the spread of the new virus, they considered lessons from history.
As epidemiologists, we strive to understand the exact effects and nature of any strain of virus, a relative of the common cold. Our greatest concern is accepting that this information can remain unknown for months as scientists gather evidence as to its origin, spread, and immunology.
Experts are concerned about the speed at which the disease can mutate. Oftentimes, its presumed that animals may have been the original source—as was the case with severe acute respiratory syndrome, SARS, another virus in the same family as coronavirus—reflecting the proximity that millions in China share with livestock and wild animals.
Once an outbreak occurs and is identified, governments must grapple with a response. Today’s strategy of containment—one of the key measures deployed against endemic diseases—would be familiar to civil authorities and medical personnel as far back as the ancient world. The concept of a quarantine has its roots in the Venetian Republic’s fourteenth-century efforts to keep out the plague by blocking boat travel.
But the maritime power would have been hard-pressed to institute a cordon sanitaire on a scale required in China, where many of these infectious diseases originate. Using the early outbreak of COVID-19 by way of example, the ability to lock down the presumed place of origin, Wuhan, a city equal in size and population to the entirety of Los Angeles County, was a reflection of the power of China’s Communist-authoritarian rule. To stop the spread of the disease, every citizen of Wuhan was ordered to stay in their homes. No exceptions for essentials. No excuses to visit a friend. No walks in the park. No mowing of grass. It was a severe measure, strictly enforced.
In 2020, mistrust and politics played a role as well. The Centers for Disease Control and Prevention has always been dedicated to identifying, containing, and eradicating diseases of all types. Too often, however, the CDC had become a political football, but not one handed off or passed from one side of the aisle to the other. Rather, the CDC was often punted, kicked, and fumbled as a result of never-ending budget battles or desires to use the agency’s efforts to exploit its findings for political gain.
Misinformation and disinformation are also still prevalent, as they have been in the past. During the outbreak of Spanish flu in 1918–19, conspiracy theories of enemy bioweapons circulated. During an 1853 outbreak of yellow fever in New Orleans, immigrants were to blame. On social media during the COVID-19 pandemic, wild claims were circulating that the coronavirus was exacerbated by 5G cell phone towers. Fear and mistrust may be one of the greatest challenges we face in eliminating infectious diseases.
Technological changes have proved to be a double-edged sword. Modern diagnostic techniques have sped up identification, while data science has made it easier to track the spread of a contagion. But some advances, such as improved modes of transportation, have contributed to the rapid proliferation of infectious diseases around the globe.
Even global health cooperation has been less than straightforward. The conversation has far improved from 1851 when European nations sought to standardize maritime quarantines. Yet the World Health Organization, despite its message of worldwide solidarity and cooperation, continues to exclude Taiwan from key meetings and information sharing, under Chinese pressure. China, one of the most secretive nations on Earth, continues to closely guard information and delay announcements concerning outbreaks for economic and geopolitical reasons. Both of these examples are the kinds of unnecessary risks that create windows of opportunity for infectious diseases to proliferate. Frankly, pandemics and politics do not mix well.
However, perspective is needed. SARS, a disease that spread worldwide within a few months in 2002, gripped the nation’s headlines, but killed fewer than 800. The perennial scourge of influenza concerns most pandemic watchers. An estimated fifty to one hundred million died from the Spanish flu during a time when commercial air, rail, and auto travel didn’t exist. Even with modern medicine, the CDC estimates an average of 34,000 Americans die from influenza each flu season.
Outbreaks of unidentified diseases demand our vigilance and study. Novelty does not necessarily make them inherently more dangerous than older foes, only more difficult to establish testing, treatment, and vaccination protocols.
I will leave you with this. Deadly outbreaks of infectious diseases make headlines, but not at the start. Every pandemic begins small, subtle, and in faraway places. When it arrives, it spreads across oceans and continents, like the sweep of nightfall, killing millions, or possibly billions.
Know this. Throughout the millennia, extinction has been the norm, and survival, the exception. This is why the Virus Hunters, the disease detectives on the front lines, work tirelessly to keep these deadly infectious diseases from killing us all.
I am Dr. Harper Randolph and this is our story.
Real World News Excerpts
MYSTERY PNEUMONIA INFECTS DOZENS IN CHINA’S WUHAN CITY
~ South China Morning Post, December 31, 2019
Hong Kong health authorities are taking no chances with a mysterious outbreak of viral pneumonia in the central Chinese city of Wuhan, warning of symptoms similar to SARS and bird flu as they step up border screening and put hospitals on alert.
With Wuhan reporting 27 infections so far, Chan said the Department of Health would increase vigilance and temperature screenings at every border checkpoint, including the city’s international airport and high-speed railway stations.
News of the outbreak in Wuhan came to light after an urgent notice from the city’s health department, which told hospitals to report further cases of “pneumonia of unknown origin”, started circulating on social media.
Thus far, no deaths have been reported.
CHINA REPORTS FIRST DEATH FROM NEWLY IDENTIFIED VIRUS
~ KAISER FAMILY FOUNDATION Global Health Policy Report, January 13, 2020
The Chinese state media on Saturday reported the first known death from a new virus that has infected dozens of people in China and set off worries across Asia. The Xinhua news agency cited the health commission in the central Chinese city of Wuhan, where the illness first appeared, in reporting the death.
A Chinese woman has been quarantined in Thailand with a mystery strain of coronavirus, authorities said on Monday, the first time it has been detected outside China.
The novel coronavirus resembles known bat viruses, but not the coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).