Naked Science Forum
Life Sciences => Physiology & Medicine => COVID-19 => Topic started by: garyshavit on 28/04/2020 16:22:15
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Dear Naked Scientist;
We are all stuck in this global pandemic. What should the governments of the world do to avoid it happening again?Since the first cases of airline hijackings in the 1970's, and especially after 9-11, governments have taken increasingly stricter measures to ensure air travel safety. On 9-11, 3000 people died. This month, we see have seen more than that many deaths every day.
Of course, there are issues of personal freedom, cultural norms and national autonomy at stake. But could/should/would an international program that included:
1) Closing wet markets. (Like the one in Wuhan, but there are many more around the world and not just in China.)
2) Changing livestock farming in all countries to lessen the crowded conditions that breed diseases that have crossed over to humans. (I am not a vegetarian, so I am not looking at this as just a moral issue.)
3) Checking the temperature of all air passengers, and not allowing sick ones to board. (Or insisting that they wear masks and gloves.)
4) Bringing back the almost obsolete practice of entry visas into countries, but with 'certificates of health'.
It would seem to me that it would be a shame for the world to have gone through all this and not take actions to prevent a similar tragedy in the future.
Regards
Gary Shavit
Ramat Gan Israel
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Bringing back the almost obsolete practice of entry visas into countries, but with 'certificates of health'.
How would that work?
It's not generally possible to tell if someone is carrying a virus bt has not yet developed symptoms.
You could, of course, quarantine everyone who travels for a couple of weeks. That wouldn't be popular.
One thing we could do is improve forward planning.
So, for example, if the panel of experts convened to look at pandemic risks says that we need to stockpile gowns, and the government doe s not stockpile them, we should never vote for that government again.
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Epidemic disease can't always be predicted or avoided, but it can be minimised.
There's nothing new about quarantining travellers
The practice of quarantine, as we know it, began during the 14th century in an effort to protect coastal cities from plague epidemics. Ships arriving in Venice from infected ports were required to sit at anchor for 40 days before landing. This practice, called quarantine, was derived from the Italian words quaranta giorni which mean 40 days.
Sadly, that quote is from the US Centers for Disease Control and Prevention, whose director was recently sacked by Satan for telling the truth. However
With rapid international travel and a slow-incubating disease like COVID, the genie is out of the bottle before it is identified, but it isn't difficult to identify and quarantine recent travellers from the origin zone (every airline retains its passenger manifests) and trace and isolate their subsequent contacts. Even a 50% hit rate is better than nothing.
Ban all but emergency flights in and out of the hot zone, and keep the emergency crews in separated accommodations.
Statutory local lockdown around the point of origin and any subsequent outbreaks should be imposed and publicly announced as soon as there is a suspicion of a dangerous infective agent.
Whilst strict and rapid quarantine will impose maximum inconvenience, it will only affect a small number of people who can be well serviced in their isolation and quickly compensated for the aggravation. sh1t happens. Far better than faffing about asking for general public cooperation, tolerating millions of minor infections and thousands of deaths, and allowing the economy to fall off a cliff because they don't.
Overreaction is essential. Underreaction is fatal. Like the Chief Medical Officer said, "If at the end of it, people say 'what was all the fuss about?', we will have won."
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They were discussing quarantining travellers on the Today programme this morning. It's not practical: IIRC they cited 130 million travellers, so with 14 nights quarantine, that's 1.8bn bed nights. Even if you could spread demand evenly over the year, you'd need a quarantine centre with 5 million beds.
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I don't know how these things could be implemented and I am not saying that every one of my points need to be, or should be implemented. I am not qualified to do so. I am asking what targets should and/or could be set to prevent future pandemics. For example, 25 years ago, I would not be able to imagine how passengers could be prevented from taking liquids on board with them. But it's understood now as a standard limitation for traveling by plane. I just think that we we would be grossly negligent not to consider making changes now to prevent, or at least lower the consequences of the next pandemic. 800 years ago the black death plague killed a third of the population of Europe. 100 years ago, some 10 million died of the Spanish flu. 60 years ago 100 thousand died of the Asian flu. We learned from those disasters. I am wondering what we can learn from the Covid-19 pandemic.
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In a few words: scale down, just scale down.
Ajust culture...some things (customs/habits) dont belong in the 21st century anymore.
We just have to start behaving towards Nature...
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They were discussing quarantining travellers on the Today programme this morning. It's not practical: IIRC they cited 130 million travellers, so with 14 nights quarantine, that's 1.8bn bed nights. Even if you could spread demand evenly over the year, you'd need a quarantine centre with 5 million beds.
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Suppose we had an outbreak in London. On an average day about 100,000 people leave Heathrow. They all spent the night somewhere before travelling, about half having driven in from outside the quarantine area. So we prevent anyone entering or leaving and just have to accommodate 50,000 people, all of whom already have accommodation somewhere because nobody else is arriving to take up their hotel rooms or live in their homes.
At the same time we issue worldwide advice to track and trace anyone who left London in the last 5 days, say, and insist that they be isolated for the next 5 days. They will be distributed all over the world and presumably have travelled to some form of accommodation. If we trace contacts we will probably end up with about 2,000,000 travellers isolated for a few days worldwide, which is orders of magnitude short of a disaster. And a lockdown in London, which is what we have anyway.
The historic quarantine requirement, which still applies to sea travellers, is to anchor offshore and stay on the vessel for the quarantine period. No reason why arriving air passengers should not stay on the plane in the first instance, until enough caravans, tents or accommodation within the arrivals area can be arranged. Then test and release anyone who is not infectious, and treat the infectious or infected on site. Better yet, divert all incoming flights from a known infected area to a single airport. Stansted has always been the airport of choice for hijacks for police operational reasons, with other incomings diverted to Luton or Southend whilst the place was in lockdown. Norwich might be better for quarantine but I'll leave the details to those in authority.
If you have a 100% effective lockdown, you can gradually reduce the radius around each discovered center of disease, and thus minimise impact without losing control. Problem is that if you start with no control, as in the USA and to some extent in the UK, you can't establish it later - the system is inherently divergent.
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I'm not sure if just scaling down will be enough. Plagues and pandemics wreaked havoc in a very much scaled down world of the past. What I would like to know is which of our 21st century habits we need to change. For example, since John Snow in the mid 19th century we have learned to keep our water supplies clean to avoid cholera. What steps do we need to take now? The current pandemic was caused by a zoonotic virus transmitted around the world by air travel. It seems logical to me that animal/human contact and air travel should be looked at from a scientific and medical viewpoint to find how to make these vectors of infection more safe.
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It seems logical to me that animal/human contact and air travel should be looked at from a scientific and medical viewpoint to find how to make these vectors of infection more safe.
Correct you are...and (wrong vocabulary, sorry) but THIS is what I meant by "scaling down"...easing off the travel, the excess, the waste...
I think we're on the same page, here...
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Whilst there are good reasons for eating less animal meat and certainly reviewing the sources, monitoring and preparation of what is eaten, restricting air travel is not an obvious tactic.
Assuming we don't want to ban flying altogether, who should be allowed to fly and why? You might argue that business travel is essential, but the first UK COVID cluster was around a guy who had been in Singapore on business when he contracted it. Indeed Wuhan isn't many people's idea of a holiday destination - I guess at least 50% of the western outbreaks can be traced to business travel. Freight crews are on the move all the time - maybe only a few per aircraft, but a huge amount of movement in terms of person-miles. And don't forget that Spanish Flu was spread principally by the US Army leaving Europe en masse (admittedly on ships, not planes) - do you want to restrict military movement?
How frivolous is holiday traffic? Never mind the occasional weekend in Torremolinos, but mass migrations for Thanksgiving, Christmas, Chinese New Year, various pilgrimages....It will take a very long time to return to 18th century village life, even though (there being no alternative) it was demonstrably effective against the Plague and BlackDeath
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Banning flight...in a fuzzy way, will end up in the mass migration you talk about...personally (nut, dont shoot me over this) I feel that aside from goods and services...nothing even should cross borders...
Let's be honest. I have a colleague...she wants to "lick" everything. She collects "destinations seen"...the more exotic, the better. To what end?
Why go skinny-dippin' in the Ganges? To brag about it?
Let the Ganges be.
Scale downthe madness...
(my take on this, opinions are exchanged here, not enforced...)
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Why go skinny-dippin' in the Ganges?
To catch diseases you can't get in the Thames.
Buzz Aldrin used to round off his lectures with a tale of a dog that ran out of a house and barked at him as he drove to work each day. He wondered what would happen if the dog caught up with the car, so one day he stopped. The dog ran up to the car, peed on the front wheel, and walked home, satisfied. "Well folks, we've pissed on the moon".
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Old fasioned windows - you remeber the type that open.
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Spanish Flu was spread principally by the US Army leaving Europe en masse
I thought that the Spanish flu was initially spread through US Army bases (in the USA), and then entered Europe with the infected US troops?
It was first reported by the Spanish press (US and most European countries were at war, and had strict press censorship).
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You are right!
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I think that the discussion is getting away from my original point. I think that governments should be thinking about what measures should be taken to prevent the next pandemics. Medical experts in the field should be drawing up proposals to be implemented once we get over Covid-19.
I think that two root causes to the problem are:
1) The raising and marketing of animals for food (where viruses enter the human population)
2) Infected people traveling by air (where the epidemic becomes a pandemic)
Of course, governments have political and economic considerations. But I would like to hear the scientific solution.
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I think we have covered the scientific solution.
To prevent an infection becoming pandemic you have to identify and contain it, and treat it if you can.
Problem with a novel virus, whether zoonotic or a mutation of an existing pathogen, is that the time it takes to develop, test and manufacture a diagnostic, vaccine or antiviral agent is significant and may not be effective anyway, so you have to contain the vector.
Where the vector is clearly human, containment is actually the quickest and easiest thing to do, but democratic governments don't have the cojones to do it, and communist governments don't have the cojones to admit to a problem, until doing nothing becomes an embarrassment.
Stalin said "one death is a tragedy, a million deaths is a statistic". The scientific response should be to prevent a tragedy escalating to a statistic, but politicians only respond to statistics.
In the present scenario, air travel isn't the only problem. Holiday migration within China is mostly by rail, so although it was a bit late, total lockdown was the only effective solution.
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It's interesting that people seem to think that epidemics and pandemics only happen to people.
https://www.bats.org.uk/about-bats/threats-to-bats/white-nose-syndrome/white-nose-syndrome-in-europe
Should we stop bats flying?
What about frogs?
https://www.newscientist.com/article/2220158-deadly-frog-fungus-now-thrives-where-we-thought-it-couldnt-survive/
Are they being reckless in social distancing?
Humans may be a bit more susceptible to pandemics than most other animals, but the fact is: pandemics happen.
So what we ought to do is ensure that we have sensible healthcare systems in place to look after us.
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Apart from sea mammals and migratory birds, most animals have a fairly restricted speed and radius of travel. Whilst it is possible for a disease to spread to the entire population, in order to do so it needs to remain infectious but nonlethal until the vector has reached a new group, and even this is rare as most groups repel newcomers.
The definition of pandemic is "spread across several national borders" so on the one hand it is meaningless for any other species (as they don't recognise human borders) or unlikely (for those animals with a restricted habitat). It is arguable therefore that pretty nearly all pandemics are caused by humans either acting as vectors or positively moving livestock (or, in the case of swine vesicular disease, infected ham sandwiches) around. Hence the import ban on almost all fresh food and plant material carried by air passengers. I've had a tiny pine tree twig confiscated at the Canadian border even though it was a Canadian pine, presented on a Canadian plane, alongside a transatlantic Christmas dinner!
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Banning flight...in a fuzzy way, will end up in the mass migration you talk about...personally (nut, dont shoot me over this) I feel that aside from goods and services...nothing even should cross borders...
Let's be honest. I have a colleague...she wants to "lick" everything. She collects "destinations seen"...the more exotic, the better. To what end?
Why go skinny-dippin' in the Ganges? To brag about it?
Let the Ganges be.
Scale downthe madness...
(my take on this, opinions are exchanged here, not enforced...)
I'm glad to report that hospitals/medical teams are now making significant progress in treating Covid.
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Until broad spectrum influenza vaccines are developed with widespread inoculation, epidemics will just be part of life on the planet, like destructive weather. At some point in the future we may see a global 'herd immunity' develop but until then I think the measures taken today are fairly 'cutting edge'. Some of the personal actions that are being highlighted like washing your hands and not sneezing and coughing on other people isn't 'new wisdom' and those 2 things are really the best manifestation of situational awareness in self defense from viruses for the general public. I do think we are seeing a level of unwarranted hysteria at this point (we have had worse epidemics in the last decade that didn't trigger the measures taken with this round), its pretty clear the prediction model we decided to factor for was the wrong one but I think we should accept the people at the tip of the spear are working in good faith unless proven otherwise. The problems we face now is the result of some bad actors, not failures in science.