The Many Faces of a Pandemic.

The human factor is the best epidemic fuel.

Bournemouth Beach, England: Not distancing, no masks, not protection Photo: MSM News. ©Toby Melville

An exciting aspect of epidemics is the high variability of their dynamics. Even though caused by similar microbes, Flu is an excellent example. The pandemic new coronavirus, too.

Simple things are very often too complicated.

The patterns of epidemic behavior may seem similar, but they are never the same. This assumption is valid for all types of influenza. It is right to the old and new coronaviruses: epidemics of SARS (2002), MERS (2013), and COVID-19. The latest is a new disease. They are not the same dog with a different collar.

Suppose we focus on COVID-19, more than six months after its official birth (December 2019). One knows many aspects about the virus and the pandemic dynamic. And about non-pharmacological effective measures, some drug treatments, and the near future vaccines. But the question is: How many things are still unknown?

Science is not resting, as the devil does, nor when it is sleeping. Technology and knowledge are powerful. Research talent is formidable. The scientific and general ignorance decreases in short to medium term.

Sometimes, it happens daily or almost every hour. Many journals and the web publish thousands of articles related. Scientific, medical, and of opinion and reports about the item every day.

Science is not resting, as the devil does, nor when it is sleeping. Technology and knowledge are powerful. Research talent is formidable.

The disaster began only six months ago.

The first outbreak in the Chinese city of Wuhan spread at lightning speed to its neighbors. Then, to the world. Now the SARS-2 coronavirus is showing us all its power. But it looks that it is hiding some cards in the sleeve of its Hanfu (a historical Chinese costume).

The Wuhan outbreak spread within days or weeks. Within one month, it sent many metastases a distance. Like a micro tumor occult and unstoppable. Later, each hidden epidemic did become autonomous. They marked its different and exclusive profiles. Several mathematical models and many epidemiological studies probed it.

Interdisciplinary teams analyze what is happening in each place where the virus appears. It is a rule. After the equator in March, the epidemic is not already monomorphic. Each satellite shows autonomy.

The mother of all local epidemics.

The current pandemic is the sum of many epidemics. And many outbreaks at different geographical and administrative levels. National, regional/state, local/county, or local levels. Until reaching the current intercontinental (global or planetary) dimension.

A little more than two months after the initial outbreak, China not declared new cases. After the first epidemic shock, the campaign hospitals built in ten days closed. Chinese provided solidarity aid to other countries. In Japan and South Korea, its neighbors, the behavior was different.

Italy inherited the most significant epidemic aftermath. With vocation to become the epicenter of the infectious earthquake. A high number of cases meant that the country suffered a medieval plague. Like that immortalized by Giovani Boccaccio in his Decameron. It faced a very aggressive variant because of the speed of diffusion. And by the significant damage exhibited. Physical, economic, and moral. Then, the evil arrived in Spain, and all Europe, Africa, and America. A pandemic.

Each one got is looking at the epidemiological dynamics in many countries at their own pace. Africa and Latin America (the southern hemisphere) are relentless virus targets.

A single case of infection by a virus contagious can lead to an outbreak.

An epidemic can result from the lack of immediate detection, containment, and immunity. It is a problem of uncertain scope. Similar to a brief flame match at a gas station next to a cardboard store, a pine forest will become a catastrophic fire.

A single case of infection by a virus contagious can lead to an outbreak.

It is the human factor, stupid!

Each outbreak or epidemic brings together elements of a primitive geographical origin. Three factors intervene in the disaster: the virus, the environment, and human behavior. In this pandemic, the third one is the most important. It is a big problem. We can say, “It’s the human factor, stupid!” paraphrasing James Carville, President Bill Clinton’s adviser.

Three factors intervene in the disaster: the virus, the environment, and human behavior.

The human factor is key to the evolution and consequences of many epidemics. Asian discipline is not the same as Mediterranean (or American) “anarchic” individualism. The methods of communist dictatorships differ from western democratic behaviors. A stable government and a complicit citizenry respond better than a weak coalition. And what to say about populism and its lunatic leaders?

Having sensible and empathetic political leaders is a blessing. To have Mr. Trump or Mr. Bolsonaro as Commanders in Chief is a sad condemnation. A very crucial pandemic factor.

We already know the problem but, what is the solution?

In addressing the COVID-19 pandemic, one must know that it does not stop throwing new data. The astonishing infectivity of the asymptomatic carriers. An aerosol route of contagion. The existence of thousands of hidden cases. The spreading and clinical severity in young people. And the viral mutations.

But, global and local efficacy of outcomes depends on several circumstances: 1. The immediacy of the response (political decision).

2. How to explain the choices to public opinion (communication).

3. Health system potency and its material resources (financial allocation).

4. The forcefulness of the implementation of prevention measures (firmness).

5. The public’s compliance.

Photo: Getty Images

Conclusions.

In this biological war between the virus and humanity, nobody can act as a passive subject.

The virus takes advantage of complacency. And also of non-scientific denialism; instead, it abhors prevention measures.

Protect people’s physical and spiritual health (Health security). Also, guarantee economic well-being must (Economic security). Better yesterday than tomorrow.

The best solution is in the hands and everybody’s conscience. It is an affair including most influential leaders and all citizens.

A fundamental goal is to achieve herd immunity. Something that, until now, seems complicated. It is necessary to ensure the total protection of society. This goal goes beyond infectious and immunological aspects.

It would try to redirect the human factor in favor of humans.

Medical Doctor (Infectious Diseases specialist/Professor of Medicine) and writer (narrative, theater).

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