By Abel Merawi
April 8, 2020 (Ezega.com) -- Facing reality is not always easy, yet it is necessary for survival. There are some facts we try to avoid for we fear the changes that accompany them. There is a philosophical scenario used to examine how people deal with reality; it runs as follows: Imagine yourself in bed surrounded by nothing except the deep darkness and windy rain outside. Suddenly, you heard footsteps lurking and stealthily stepping closer. You are gripped with utter dread as your mind rushes to assign meaning to the sounds you heard. Will you comfort yourself saying it was just a dream? Will you pretend it was the sound of wind and rain? Or, will you call it by its name and admit there is someone outside – most likely a burglar? In a logical world, you would have to first check and identify with caution the source of the footsteps. Once you know it is a burglar, you would have to take measures such as calling the police or defending yourself using all your means. Thus, denial or pretension leads to disaster while accepting reality and taking the proper action gives you a better chance of success. The same is true of pandemics.
The struggle for survival is an integral part of our species, and since the old days, we have struggled with plagues. Like a burglar at night plagues have robbed us of our lives when we least expected it. At times we pretended; we assumed pandemics are the works of evil spirits or punishments from God. This was a popular assumption before we discovered germs. On other occasions, we denied; we argued that it was just a lie. We see this when world leaders like President Donald Trump call climate change a Chinese hoax. Finally, in our successful days, we faced the reality of plagues and took measures to defeat them. It is this realistic approaches against plagues that we will currently discuss. Our global struggle against this novel coronavirus requires knowledge of the best practices from the past.
We can broadly classify our measures as Pharmaceutical and Non-Pharmaceutical Interventions (NPI). When we attempt to find scientific solutions such as cures or vaccinations, we are using Pharmaceutical Interventions. On the other hand, when we take measures such as quarantines and social or physical isolation, we are using NPI. Both approaches have been used in the past with varying degrees of success. While hoping for a scientific solution for COVID-19, we will begin with past scientific solutions and primarily focus on the NPIs since they apply to our case.
When scientific solutions are found, they eradicate the plague for all of humanity. Smallpox had been a deadly plague, especially in the 15th century, killing three out of ten victims, an astounding ratio. It was in 1854 that a British doctor named Edward Jenner developed a vaccine by using a milder virus called cowpox to develop immunity for smallpox. This was the first epidemic that ended through a vaccine. After much effort, in 1980, the World Health Organization announced the eradication of smallpox from the world. Cholera was a deadly plague in the 19th century, which spread fast because people wrongly assumed it was airborne. Thanks to the British doctor, John Snow, the real cause was discovered to be contaminated water. Though it still occurs in third-world countries that lack clean water, it is safe to say we won the battle. Doctor David Heymann in his article, ‘Past as Prologue?’ states that the immunization program successfully vaccinated 80% of children in the world by 1990 against tuberculosis, diphtheria, pertussis, tetanus, measles, and polio.
Scientific solutions do not always exist, and in the meantime using NPI proves effective. Perhaps the first evidence of social distancing is in 541 A.D when the Plague of Justinian killed from 20-50 million people. As the history professor, Thomas Mockaitis states people avoided the sick and eventually the survivors developed immunity. The use of quarantines is associated with 14th-century plague called Black Death, which killed around 200 million people. The major Italian port city of Venice enacted a law stating that sailors must remain 40 days (Italian word, ‘quarantino’) before entering the city. Similarly, England introduced the first law in the 1500s to isolate the sick. The application of NPI has been effective in controlling the spread of plagues, which is why we still use it.
Currently, most countries are using various NPI and the effectiveness depends on a number of factors. In his work ‘Contemplating Pandemics’, Howard Markel, (M.D., Ph.D.) argues that after studying patterns of handling plagues for 16 years, he has found some reoccurring issues to consider. These are: (1) the perception of the people, (2) the economic cost, (3) the movement of people, and (4) the media coverage. Markel claims that the way these factors work together potentially determine the effectiveness of NPI. For instance, if people feel the disease is not dangerous, they will not be willing to implement the health and social procedures declared during a plague state of emergency. In other cases, when politicians or the media downplay a pandemic to protect the economy, the result will cost both life and more finance. Markel states that quarantine, closing schools, closing entertainment venues, wearing face-mask, public health education and all the other measures have been used in 1918 during the outbreak of Spanish Flu, especially in America. The countries or cities that effectively implemented NPI have managed to save more lives.
Until now, the countries that effectively mitigated the spread of COVID-19 are those with citizens that understand the gravity of the situation. In turn, people’s level of understanding increases when the media serves as a genuine source of information backed by experts. Furthermore, it is the countries that place life over finance that seem to be mitigating the spread. This translates into limiting the movement of people despite the financial cost. Finally, public health laws without public health education are most likely to fail. Returning to our initial point facing reality is the only way to handle it. In the past, people assumed cholera was airborne, and it was only when people knew the truth about contaminated water that the plague finally ended. Now too, COVID-19 is real. This novel coronavirus is not a punishment from God just as the Syrian War wasn’t the Lord’s wrath. It is a virus and thankfully we know many things about how it spreads. We don’t have scientific solutions yet. Therefore, our only hope is strictly implementing the non-pharmaceutical measures.
Abel Merawi is Addis Ababa-based contributor for Ezega.com. He can be reached through this form.
Other articles by Abel Merawi:
History of Pandemics in Ethiopia
Human Struggle Against Pandemics: Historical Perspective
You Can Make a Difference
Rule of Law for a Free Society
The Origins of Law
Determinants of Market Value: Part II
Determinants of Market Value: Part I
Your life Matters Too
Manifestations of Artistic Expression
Achievements vs Natural Accidents
The Grip of Sacrifice
Injustice is Never Justifiable
Education Demands of the Future
Job Security, Life and the Unpredictable Future
The Shift From Racism to Culturism
Sacrificing Meaning for Power?
Culture and Market Forces
Seeking Cosmic Justice
National Myths: Makers and Destroyers of Nations
Are We Truly Free?
Maturity: The Prerequisite to Freedom and Democracy
Loyalty to Truth, Not to Group
The Value of Work
The Flaws with Ethiopian Political System
Intellectuals and the People
Where Are Our Pathfinders?
The Allegory of the Cave and Its Lessons to Leaders
The Truth Behind Humanity
The Seven Virtues
The Seven Deadly Sins
What is the right thing to do?
Building National Identity
Adey Abeba and the Spirit of Change
Living the Truth as a Human Being
Hubris - The Tragedy of Not Learning from Others
The Era of Group Mentality: Us vs Them
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