Dr Sanjay Gupta: A year living in the shadow of a pandemic

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In the first months of 2020, as the unprecedented health crisis rapidly crossed borders – China, Italy, Spain, South Korea, Japan and soon, the United States – it began to take the form of a global threat. imminent. Something beyond an epidemic.

During my research, I was surprised to learn that there was no universally accepted definition of “pandemic”. But a growing number of medical experts and public health officials I spoke with told me that the rapidly changing situation suited the situation.

Basically, a pandemic is an outbreak of a virus that can cause illness or death, where there is sustained human-to-human transmission of that virus and evidence of its spread to different geographic areas. Check, verify and verify.

A few days later, the WHO adopted the same language.

To be fair, the WHO has been sounding the alarm bells regularly for almost six weeks, since January 30, 2020, when Director-General Tedros Adhanom Ghebreyesus declared the situation a “public health emergency of international concern” – the highest health level. alert under international law. The definition is “an extraordinary event which may constitute a public health risk for other countries due to the international spread of the disease and which may require a coordinated response at the international level”.

For this symbolic anniversary, I spoke to Maria Van Kerkhove, WHO Technical Officer for the Coronavirus Response, to reflect on the year of the pandemic and beyond.

Different countries, different answers, different results

Van Kerkhove – who said the WHO is trying to do for the world what the United States Centers for Disease Control and Prevention is doing for the United States – told me that the goal of a health emergency public policy of international concern was to sound the alarm bells before you find yourself a real pandemic, when there is still time to prevent and, in any case, to prepare for what is to come. Likewise, for over a year now, WHO has been trying to change the trajectory of the pandemic through, among other things, expertise, advice, guidance and support as well as frequent press conferences.

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While each country has responded to the emerging threat in its own way, some countries have taken early warnings more seriously, she said.

“It was not about rich or poor countries. It was about experience. It was about countries that knew the threat this posed; they heeded our warnings,” Van Kerkhove said. This experience came from the management of previous infectious epidemics, such as SARS, MERS and Ebola virus. And these countries quickly implemented strong public health measures, mobilized community health workers, contact tracers and laboratory technicians.

Van Kerkhove points to places like South Korea, Japan and Nigeria – all of which have been successful in keeping transmission of this new virus relatively under control.

For me, South Korea has been one of the clearest examples of success. He reported his first case of Covid-19 on January 20, 2020, hours before the United States confirmed its first case on January 21.
But the two countries have found themselves in wildly divergent places: The United States has more than 29 million total reported cases and more than half a million deaths. South Korea? Less than 100,000 cases and less than 2,000 deaths. You can’t dismiss this because the United States has a higher population than South Korea, because when you look at the number of per capita deaths per 100,000 people, the United States has over 161 compared to Korea. South 3.
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Van Kerkhove said South Korea had learned from the 2015 MERS epidemic. “What they learned was to rebuild their system and improve their public health system, which has been used during this pandemic, ”she said.

As an example, she highlighted what happened in Daegu city, when there was a large epidemic linked to church activity in February. “The number of cases was apparently out of control,” she said. “And Korea turned the tables.”

How did they do it? By being strategic and taking advantage of the tools at their disposal, Van Kerkhove said. “They looked at the situation they were in. They improved their cluster investigation. … They increased their testing capacity, their testing capacity. They used quarantine effectively and they brought the epidemic under control. But at one point it seemed almost impossible – and they knocked him down, ”she said.

She added that other countries have made a difference as well, for example Cambodia, Thailand, Rwanda and South Africa, even with the emergence of a more contagious variant there. “People’s resilience is what is encouraging and inspiring,” she said.

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What has struck me often is that while infectious disease outbreaks typically crush the poorest countries, this new coronavirus has disproportionately affected many of the richest countries in the world. Consider that there are almost 9,000 cases per 100,000 people in the United States. Compare that to India, where it’s about a tenth of that, even though they have some of the most populous parts of the world.

As they say, money cannot buy everything, especially good health. “You can have very, very good medical systems in countries … the best treatment in the world. But that doesn’t compensate for the fundamentals of public health,” Van Kerkhove said.

Variants and vaccines

Now that we are in the second year of the pandemic, the cavalry in the form of vaccines has arrived. But with him, a more contagious and, perhaps in some cases, more deadly enemy. New variants of the virus are decimating cities in Brazil; different variations prevailed in the United Kingdom and South Africa. And they also settle in this country.
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This can be addressed by providing better access to vaccines to underserved countries. According to the People’s Vaccine Alliance, a global vaccine watchdog group, rich countries now vaccinate one person per second while the majority of poorer countries have yet to administer a single dose.

But that is changing, thanks to COVAX, a global initiative that promotes equitable access for developing countries to Covid-19 vaccines. Led by the WHO and other organizations, COVAX delivered 20 million doses of vaccine to 20 countries last week in the first week of distribution, according to WHO director-general Tedros. An additional 14.4 million doses of vaccine are expected to be distributed this week in 31 other countries.

“We are all part of this global community. Every life on this planet matters, ”said Van Kerkhove. “Everyone on this planet deserves to be protected.”

Shot by shot, the world is starting to see some hope. And countries that heeded WHO warnings and followed public health guidelines give us a glimpse of post-pandemic life.

“I have glimmers of hope in many countries around the world,” Van Kerkhove said, pointing to countries like Australia, New Zealand, China and Japan. “I see societies opening up. I see sporting events happening. I see a resilient community that is living its life, that has reduced transmission in some situations to zero.”

Van Kerkhove, me and many others have been humbled by this virus – a virus that has taught us that rich and poor don’t matter, borders don’t matter and that unexpected things can and do happen. She and I both hope that all nations, but especially Westerners, will use the unfortunate lessons we have all been forced to learn to put the systems in place so that we are better able to cope with the next unexpected event. , the next pandemic. , the next infectious pathogen – because this one will surely not be the last.

CNN Health’s Andrea Kane and Amanda Sealy contributed to this report.

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