Till a few weeks ago, pandemics were limited to end-of-day-like scenarios in cinema and alarmist fiction. Nobody could have imagined that a virus — an entity without a life of its own — would shut the world down, force almost a third of humanity to stay indoors and make people shiver with the fear of a deadly disease. But, COVID-19, a word that means death and illness for each one of the 7.30 billion citizens in the world, has achieved the unimaginable — it has turned humans into prisoners of unknown destiny. As India, like most countries in the world, completes a long period of lockdown, The Federal revisits the biggest story of our times and tries to make sense of the surreal events that have unfolded around us since March. We look at how life has unfolded in a pandemic, what it has told us about ourselves, our country, society, religion and government, and what can we expect from a post-COVID world, if it exists. Today, we look at the beginning of a pandemic that shows no signs of abating.

COVID-19: A deadly game between a virus and humans without one clear winner

Uploaded 13 May, 2020

The COVID-19 pandemic has spread fast, taking just about two months to make a round of the globe and make landfall in every continent except Antarctica.

Sandipan Sharma

December 10 was a normal day for Wei Guixian, a 54-year-old shrimp seller at the Huanan Seafood market in Wuhan. The business was brisk and everyone around her was excited about the upcoming lunar holiday in China.

When she developed a cold in the afternoon, Guixian visited a local clinic, took medicine for her flu-like symptoms and went back to work. Within days, Guixian was to become the source of an illness that would infect millions, kill thousands, lead to a global panic and bring the world to a standstill.

Nobody knows how Guixian got the illness that was to put the Huanan Seafood market on the global map and make Wuhan a household name. Many theories trace the illness to bats — the biggest reservoir of viruses in the world — and through an intermediary, probably pangolins, to humans. Others believe the virus accidentally leaked out of a laboratory in Wuhan when an intern got infected with it and the passed it on to her boyfriend, starting a chain of illness that has now turned into a pandemic — an illness that spreads across the world.

Pandemics were unknown to the world till a few centuries ago. And epidemics were unknown till 12,000 years ago, when humans lived as hunters and gatherers. But, the discovery of agriculture and domestication of animals changed everything.

The earliest available evidence of an illness that affected a large number of people was first recorded by the man whose name is synonymous with medical science — Hippocrates. In the 5th century BC, Hippocrates noticed that the Greek city of Perinthos was in the grip of an illness that led to sore throat, running nose, fever and difficulty in breathing. Though a vast majority of people recovered from the illness, a small number of patients died. Hippocrates coined the word epidemic —literally ‘upon the people’— for this illness. Reminds you of COVID-19, right?

Though epidemics of cholera, malaria and plague were common, a flu outbreak that began in the spring of 1918 is believed to be the first recorded pandemic in history.

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The 1918 pandemic, popularly but wrongly called Spanish flu (ispanka), hit the world in three waves. The first of these, in March, was mild and most people felt mildly sick and recovered. But, the virus that caused it became more virulent by August and returned with a vengeance, felling millions of people across the globe. By the time the third wave had receded, a third of the population had been infected and more than 50 million people had died, most of them in the 20-40 age group.

The trajectory of the illness now sounds familiar. It started with a sore throat, mild fever and headache. In some people, it went on to cause pneumonia and, subsequently, death. Almost all the deaths were caused by inflammation of lungs — a result of build-up of fluids and destruction of tissues — caused by a cytokine storm, or opportunistic bacterial infections. Those with comorbidities like diabetes, tuberculosis and heart disease suffered the most.

Viruses (literally poison-like) were unknown to the world till 1918. Medical experts believed the pandemic was caused by some bacteria that lived in the nasal cavity of humans. Others believed it was a curse sent from the stars — influenza, again — and was a result of a lethal miasma that had arisen from bodies of soldiers killed in the First World War. So, some people shut their doors and windows to keep the miasma out, others prayed to the stars and some doctors prescribed aspirin and other prevalent medicines to beat the illness. Nothing worked.

The biggest contribution of the 1918 flu is that it gave rise to the concept of social distancing and the strategy of lockdowns and quarantines. As the disease raged through the world, people were encouraged to stay home, wear masks and the ones infected with it were locked up for forty days, a quarantina — thus the word quarantine.

The COVID-19 pandemic has spread faster, taking just about two months to make a round of the globe, and make landfall in every continent except Antarctica. If the 1918 flu was spread by soldiers returning home from the War, the current epidemic has been literally borne by airplanes on their wings.

Not much has changed since the 1918 pandemic in terms of the measures adopted to contain the illness — a strategy based on social distancing, quarantine and lockdowns is still the first line of defence. Yet, there has been a major change.

In 2020, we know the illness is caused by a virus with spikes that attach to human cells and then hijacks the hosts system to make copies of itself. We know that the virus spreads through droplets and fomites — infected surfaces. We know that anybody with hands and a mouth is susceptible in the absence of immunity to the new virus. So, we know that washing hands with soaps and alcohol-based santisers, disinfecting surfaces and wearing masks can curtail the spread of the virus till a vaccine is found to build immunity.

By the time a cure is found, a vaccine is discovered and herd immunity develops, the virus may have killed thousands of people, infected millions and destroyed businesses and economies across the world. Yet, this is just a warning, a sign of more deadly pandemics that await us.

The 1918 flu was the result of a virus that jumped from humans to pigs and then came back in a lethal form. In 2010-11 this virus mutated again to kickstart a pandemic popularly called Swine Flu, even though pigs had originally got it from humans.

Today, thousands of viruses are scattered in a wide range of hosts —horses, wild ducks, fowls and bats. Scientists believe bats alone are host to hundreds of viruses that have coexisted with them for thousands of years. Like the latest coronavirus that probably jumped from bats to pangolins and then humans, these lethal viruses are waiting for the right intermediary to invade humanity.

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Epidemiologists believe there could be at least four pandemics in this century as viruses continue to evolve because of the constant interaction between various species. Factors such as environmental degradation, global warming — it is making viruses adapt to higher temperature — and prevalence of live markets for meat mean the next big killer virus is just around the corner.

Only two things can avert another massive pandemic — one, coordinated efforts to check the incubation of new viruses; and two, a vaccine that is effective against a large number of viruses that may attack humans in the future.

The battle with COVID-19 is just the beginning of a war that would decide the future of humans. And, if it wants to win, humanity will have to do much more than it did in the first few weeks after Guixian, the shrimp seller from Wuhan, now believed to be patient zero of this pandemic, reported a mild illness.

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