COVID19 DAY 10&11

SURVEILLANCE AND CONTAINMENT OF THE SPECKLED MONSTER

Europe and the United States of America continue to be the hot-spots of corona virus as the number of people infected by this deadly pathogen has reached one-and-quarter million and the number of deaths has touched 65,000. Going by the numbers, the situation in India does not seem to be as alarming and many are hoping for an early calling off of the lockdown that has brought the country to a halt. However, this may be deceptive as recent statistics reveal that the speed with which people in India are getting infected is accelerating. Be that as it may, the world seems to be in for the long haul and it doesn’t look like the virus is going to go away anytime soon. Three months have gone by but scientists are still racing to find a vaccine. Many experts have estimated that it may take as much as 18 months before the vaccine becomes available. So, what will the world be like in the meantime? And how are we going to take care of the situation till then and even afterwards with this deadly infective virus around.

It is possible that the recent outbreak has been the result of complacency, particularly on the part of countries that have been long industrialised and have excellent health care systems. It is also a reminder to the less fortunate countries whose health care systems are not much to write home about. Maybe we have lost the touch as it has been nearly half a century since the last great campaign to get rid of another deadly killer disease – small pox – was undertaken. Maybe Indians will do well to recall the strategies adopted with the help of the World Health Organisation to eliminate small pox that had achieved such great success.

The strategy adopted at that time is known as “ring vaccination” or “surveillance and containment” as it was officially called. This in effect was like ring fencing a forest fire in which a band of trees is cut down around those that are on fire to stop it from spreading. And mind you this had to be adopted after mass vaccinations had failed to wipe out the disease. A little less than 200,000 cases had still been reported from 8,000 villages in 1974. So, 150,000 trained field workers fanned out to India’s 575,721 villages and 2,641 towns and cities, according to records of the massive campaign donated to the University of Michigan Library, USA, by Dr. Lawrence Brilliant, a member of this large team.

Dr. Brilliant’s own story is worth recalling though. Relating it in a TED talk, he said that soon after graduating in 1967, he came to India “like everyone in our generation.” There he ended up in a Himalayan monastery where the Guru predicted that he would help eradicate small pox. So what is the mantra that Dr. Brilliant discovered to contain small pox? “Early detection, early response.” He said that “small pox made its last stand in India” but his mantra meant that there would have to be wide surveillance. This became possible due to the full backing of the government which made money and a large team available for the WHO team.

Dr. Brilliant, however, found a strange thing. “Every time we did a house-to-house search we had a spike in the number of reports of small pox. When we didn’t search, we had the illusion that we had no disease.” Often there was under-reporting perhaps due to economic reasons or stigma or simply religious beliefs. (Utkarsh, a final year journalism student has written a piece in his blog ‘Decoding the Social Stigma’ on stigma that is accompanying the current COVID19 pandemic in India  available at the following link: https://truthadvocator.home.blog/2020/04/04/decoding-the-social-stigma/ . “It was the largest campaign in United Nations’ history till the Iraq war,” recalled Dr. Brilliant in a lecture delivered in 2006. More about Dr. Brilliant in the next entry.

A Cartoon from the 19th century from the anti-Vaccine Society(Roots of Progress)

Here I would like to mention the good work done by Jason Crawford, https://rootsofprogress.org/smallpox-and-vaccines   apparently an American on uncovering not only the progress of developing a vaccine for small pox but has also mentioned some of the controversies involved in his blog ‘Roots of Progress’. He has also used an excellent cartoon on the vaccination effort by doctors in Europe which I have reproduced here. Like the COVID19, the small pox virus (variola) can strike anyone. It had no respect for weak or powerful, rich or poor or even for religious persuasion. Small pox has claimed the lives of many high and mighty like Ramses V, a 12^th century B.C. Egyptian Pharaoh. According to Jason, it struck George Washington and Abraham Lincoln, though both of them survived it.

Edward Jenner is credited with have developed the vaccine for small pox through the cow pox, a less virulent strain of the same disease. But inoculation was known to people in Asia and Africa for a long time. It was noticed that those who survived small pox never got it again. So, people took the liquid from the body of a person who had the disease and injected it in their own bodies. They developed the same symptoms but in a milder form though some also died. But those who survived got immunity for life. This process was known as inoculation. Jenner and other Western doctors then refined the vaccine. But on one matter, I disagree with Jason when he claims credit for the West and capitalism for all the great developments of recent centuries. The West was prompted by selfish motives to colonise large parts of the world but for which large numbers of indigenous people, as he himself admits, would not have been wiped out because of diseases imposed on them by their aggressors. And the latest pandemic is clearly the result of that very capitalism that promoted globalisation after 1991.