Endemic pandemics?

Endemic pandemics? So what of the 2019 Covid Sars11 “pandemic” that has become so expensive to militate against; it has so paralysed the UK’s economy, this is also not unlike many other affluent countries that have taken on debt to cover the complex financial cost and a range of economic activity loss. It’s impact is still rolling on with efforts and moves to “get back to normal”, a normal that, for the foreseeable future, seems most unlikely for apart from the uncertainty of eradicating it the shift in the way businesses have adopted in the use of premises, staff, activity, resource streams, streamlining and mitigation cost via input / output measures to survive, would suggest that there will not be a back to (old) normal. The exceptional cost of defending against Covid is a debt that hides the addition expanding problems caused by Brexit that will also probably compound into a new poorer standard of normality. But the pandemic is currently a very useful tool for government in which to hide bad economic policies of its past decade while over exaggerating the efflorescence of an uncertain blossoming (fragile) economy.

However as a pandemic, does it really go well with a notable reputation as other pandemics? Perhaps the position it occupies and the importance attached to it is to do with the underprivileged understanding of the term pandemic, as its use is to indicate a global infection akin to saying a new dangerous disease is found that has to become named a ‘pandemic’ as it spreads worldwide. To quote The WHO (World Health Organisation) “Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear or unjustified acceptance that the fight is over, leading to unnecessary suffering and death” (It’s out of control). “Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do. We have never before seen a pandemic sparked by a coronavirus. This is the first pandemic caused by a coronavirus. And we have never before seen a pandemic that can be controlled, at the same time”.

Within this one could add that the word pandemic also has a strong connotation to the term ‘disaster’ of national to global proportions as could be depicted with the “Black Death” 1346 to 1353 or 1918 flu outbreak generally accepted now named as Pandemics.

On a global level many deaths can be attributed to a declared pandemic, a definition which is a relatively recent term used to express global deaths of note too and afflicting the developed world. There have been many in the recent past such as three influenza pandemics happening over a number of decades during the 20th century, the most well known one which was the called "Spanish Flu" (caused by an (H1N1) virus, may have caused 20–50 million deaths in 1918–1919. Other pandemics occurred in 1957–1958 (the "Asian Flu" caused by an (H2N2) virus and in 1968 the "Hong Kong Flu" caused by an (H3N2) virus, approximated to have caused 1–4 million deaths each. A more recent one, the first influenza pandemic of the 21st century occurred in 2009–2010 and was caused by an influenza A (H1N1) virus; colloquially called ‘Swine Flu’ with deaths in the UK of 457 (1). It was the first pandemic for which many member states of the WHO had developed comprehensive pandemic plans describing the public health measures to be taken, aimed at reducing illness and fatalities. Many countries drew up plans of action but failed to put down and maintain implementation resources, notable UK, Europe and the Americas were caught wholly unprepared, they had to scramble as the dangers became manifest to react. Although there have been ascribed pandemics, as above, they were really only important to countries of the ‘modern’ world with the ability to registered their passing. Perhaps there were others not so important globally, in historic times, unless there were indications of dramatic population collapse (as in the ‘black death’ plague?) and notably may have been less important to those ‘modern’ cultures of the deaths occurring in (un)developing countries and disconnected historic times.

What marks the 20th/21st century named pandemics out is their rapid transmission, spread, infection presentation, survivability or deaths and it is a form of disease that is out of the ordinary, occurring in a short period of time. It is also possibly new and for which a nation (or world) is unprepared and or of such notoriety it gains obligatory governmental action aided by screeching media hype ‘for something to be done’. More than anything else it is the transmission speed to infection to deaths ratio that raises alarm if it is a new strain; that seems to be the point at which serious attention is given to actions needed to combat the disease.

The associated main trigger to this latest one this time Covid19 is the fact that this is a new crossover coronavirus with unknown trajectories and no cure. This has led to globally 4.5m deaths that are attributed to Covid19 out of world infection cases noted thus far at 219m; which puts it at a mortality rate of less than 2%?. The highest rate of death is within the USA at 703k (Infected cases 439m with mortality rate of 6%). This is followed by Brazil with 598 deaths, (infecting 21.5m with 3.6% mortality; India 449 deaths (infecting 33.9m. mortality of 1.3 %) and the UK with 137k deaths, (infected 7.93m with 1.8% mortality).

There is though, throughout the world, a degree of under reporting of infections, over application of cause, compromised associated health issues and differences in qualitative accounting so the mortality rate will also be variable and depended on the resilience of the populations in prepared or unprepared countries. However with a less than 2% death rate to infection globally, it probably is not of the scale of historic periodic “pandemics” deaths but it is new species virus to invade humans which makes its occurrence significant. As a new ‘pandemic’, it is now being attacked with government sponsored exceptional rapid development of new treatments not available 10 years ago at the time of the last ‘pandemic’. Such new treatments that are available may curtail its ongoing rampage yet; failing an unlikely definitive cure.

The success in developing a number of treatments, within a year is fortuitously remarkable, helping to mitigate the number of deaths directly related to Covid19 within developed countries leaving those unvaccinated taking risk but more importantly it does leave undeveloped countries exposed, without a volume vaccine, to possibly mutate a new strain to emerge out into the world again, in this one can see succession problems.

Given the comparatively low rate of deaths to Covid19 (average 2%?) from this pandemic and the huge effort put into tackling it, it hardly, based on other historic diseases, is analogous to the extraordinary attention being given to it compared to established diseases and deaths. Yes it is new, it has a disputed peculiar source and it mutates quick but the extraordinary global harm and the reactionary measures to it may have been misplaced if judge on the basis of deaths to economic cost. Tens of thousands of people die each year, regularly from a number of other established diseases, in numbers that are not screamed out every night in media and which deaths exceed the deaths attributed just from Covid19. Why is this tolerated? Why has there been no comparative balance?

As for this overrated(?) pandemic it does seem that not enough people are being killed by it compared to others of the past, how else can one explain the expressive vitriolic incidence of ‘anti-Vaxers’ and their inexplicable distrustful beliefs, without any foundation, and resistant to getting the ‘jab’. Anti Vaxers seem not to care that apart from providing some protection to a sever Covid infection strain that could, without the vaccine, leave them with ancillary physical problems or it kill them or pass a strain they have incubated onto someone else. What they do not probably know is that having the vaccine would improve their brain power / intelligence quotient; (if only) or their opposition may simple be that they do not witness any personal close proximity to the disease, or a death, or alternatively in dispassionate numerical terms not enough are killed around them. Thus they remain unafraid to the danger. How long would this relax ambivalence stance last if there were a 30% death rate to infection to occur, as some past ‘pandemic’ diseases have done? And this is disregarding an unknown lurking zoonotic coronavirus or a more virulent form of something like Ebola, Marburg, Hantavirus pulmonary syndrome or contracting ‘uncommon’ Anthracis (2% to 92% fatality).

It is abundantly clear that this fortuitous age with the ability to discover, trace and profile a new outbreak of a disease and rapidly challenge its course of infection with the aid of some treatment / vaccine, is something the ‘developed’ countries have become capable of doing with some speed which would not have happened without the huge ‘upfront’ financial clout of public money laid onto the scientific community and pharmaceutical production / delivery systems. But the less resourced countries are at a great disadvantage and the onus is to insure that they are helped. If assistance is not provided a reservoir of potential mutation remains, much larger that the risk posed by the Anti Vaxers.

It is important that the arrival of any new disease, one that may have its origin from a zoonotic source, a coronavirus, is taken seriously for it is likely to be one that the human population has not had any natural resistance to. However what makes outbreaks notable is, as above, its novelty, spread, speed and percentage of deaths to infections and the extraordinary measure taken to try to limit that “unnecessary” death rate. Yet some sense of proportion must be taken in the overweening efforts latterly thrown at containment and solutions to avoid such deaths as in Sars-Cov-2 (Covid-19) ‘pandemic’. Which using the current expenditure and resources as a measure have been astonishing if not bizarre if compared with other excepted diseases that are plagues in their own right; none of which resulted in the NHS becoming The ‘Covid NHS’ side lining all other ongoing illness and disease that cause, overall, more deaths annually! And this is just in the UK, other developed countries to a lesser extent fell into the same resources hyperbole entrapment prioritising novelty casualty from un-preparedness over complacency of known extant causes of deaths. Perhaps this slanted criticism sounds too extreme but once some measure of trajectory and infection to actual Covid deaths could be modelled, many people that caught the disease did not die; those that did, in the main may have had a genetic predisposition or underlying existing cause caught in the 28 day categorisation. However caution is still required for its mutation potency is still in doubtful play and lifting all restrictions may be desired for economic reasons or be too pre-emptive, another two years might provide the answer. But given the regular annual deaths from other diseases which afflict the world and are not given the same notoriety as WHO pandemics; does cause one to ask what volume of deaths are important to gain the same extraordinary attention as this disease.

For example: in the UK a recent report indicates that there are around 48K deaths each year from Sepsis, a disease that suffers from a prognosis difficulty of being identified early enough to begin a simple treatment; why?

Also in the UK some 135K people die each year from cancer; it has the lowest treatment rate in the developed world: Cerebrovascular disease takes 21K and Dementia – Alzheimer accounts for 50K deaths each year.

Each seasonal flu year, 10K – 25K deaths happen and are accepted as normal. How can the current 140K deaths over two years to the UK Covid 19 compare with the estimated 250K> as above and many more that die each year without the daily media dramatisation?

The trend for the six leading disease causes of deaths in the UK had been reducing since 2001 to 2011 but has since slowly increased; it may be taken as a change in age demographics but also a potential indication of a restricted application of resources since 2008/9. (2)

In all other countries a similar sample of causes of deaths might be drawn that could fall into a comparable or more extensive listing as known causes of death, yet none of these causes of death are persistently and with extensive media coverage put to the populace as has been done with Covid, why not? And of course famines are not named ‘pandemics’ yet happen at regular intervals in the world and at times deaths are into the million+.

How much more could be done to help resolve the hidden ‘endemic pandemics’ of the annual killings from the accumulation of known tolerated disease, many of which could be mitigated against if the same forceful concentrated application of concerted technological funding and politicked willingness were to be applied? Would the populace stand for a daily to annual summary of common deaths and not demand greater investments and change to pharmaceutical selective investment control, at the very least it may be a step to saving the pandemonium of the ‘Covid NHS’ and GP practices being forced to ignore the usual unwell ‘service users’.

It may well be argued that with this pandemic the world has been very lucky. Many countries were unprepared (with some exception) they initially were slow to act, its virulence was manageable, huge resources were directed at it and mitigation processes were possible. The mutation direction and impact of it is hopefully easing to allow some element of a ‘new normal’ business to resume. Although it is still expected that if “the big one” hits, a new disease arriving from an unknown source, the world political administration will be better prepared to act in concord but given the current issues of congruent malaise pressuring the developed countries, one cannot see a much better outcome. Well if it happened; it is not likely to be a tale of ‘survival of the fittest’ or seeking ‘heard immunity’ nor will it be the weird ‘Anti’ information that people will worry about, they will see the “bodies piled high” as BoJo and his ilk wants, perhaps with himself atop. Humans haven’t really changed GodAllahTetragrammaton it will be bedlam.

Renot

(1) World health Organisation

(2) ons.gov.uk/causes of death

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