MANY pandemics and epidemics have occurred throughout the history of mankind, from biblical times to date. We have lived to tell the tale in the Aids pandemic and our cousins in the Congo and in West Africa have lived to tell the tale of the last Ebola epidemic.
Whether by coincidence or by design, pandemics that have threatened to wipe out the whole world in a sci-fi-like fashion have, unfortunately, visited our planet every century (100 years) at least in the last 400 years.
In 1720 there was the deadly bubonic plague which started in Marseille (France). It is estimated that it killed well over 100 000 people.
In 1820 the first cholera pandemic killed well over 100 000 people in Asia hitting hardest Philippines, Thailand and Indonesia.
The influenza pandemic caused by H1N1, beginning in 1918 and reaching its zenith in 1920, killed between 50 and 100 million people worldwide and was probably the worst recorded in human history.
The first cases of the influenza epidemic in Southern Rhodesia, as Zimbabwe was known, occurred amongst the railway staff in Bulawayo about October 9 1918, the disease having appeared in epidemic form in South Africa in the previous month. The disease came to Africa with soldiers returning from the World War I fronts in Europe.
Bulawayo itself was rapidly infected and from there the epidemic rapidly spread to Kwekwe, Mvuma and Harare via the railway line. It soon engulfed communities that were not linked by the railway line, including Nyanga and Chipinge at times decimating whole communities. It is not known exactly how many people died of influenza in Zimbabwe, but upwards of half a million deaths were recorded in the Eastern Cape province of South Africa.
What is Covid-19?
Emerging and re-emerging pathogens are global challenges for public health.
Coronaviruses are enveloped RNA viruses that are distributed broadly among humans, other mammals and birds. They cause respiratory, enteric, hepatic and neurologic diseases.
Six coronavirus species were previously known to cause human disease.
Four viruses, known as 229E, OC43, NL63, and HKU1, are prevalent and typically cause common cold symptoms in immunocompetent individuals.
Two other strains , Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are zoonotic in origin and have been linked to sometimes fatal illness.
SARS-CoV was responsible for severe acute respiratory syndrome outbreaks in 2002 and 2003 in Guangdong. MERS-CoV was responsible severe respiratory disease outbreaks in 2012 in the Middle East.
The seventh coronavirus, SARS-CoV-2 (Covid-19) is responsible for the current severe respiratory disease outbreak that started in Hubei, China, and has now become a world-wide pandemic. Its reservoir is unclear, but likely zoonotic possibly bats or pangolins.
Given the high prevalence and wide distribution of coronaviruses, with their large genetic diversity and frequent recombination of their genomes, coupled with increasing human–animal interface activities, novel coronaviruses are likely to emerge periodically in humans owing to frequent cross-species infections and occasional spill-over events.
The attack rate of Covid-19 is 30-40%, and its reproductive number (R0), meaning the number of people an infected person will infect, is three. Though the case fatality rate worldwide is 4%, it is almost double at 7,2% in Italy.
The median incubation period is five days and 97,5% of those who develop symptoms will do so within 11,5 days of infection.
Using conservative assumptions, 101 out of every 10 000 cases will develop symptoms after 14 days of active monitoring or quarantine.
There are stark differences between Southern Rhodesia in 1920 and Zimbabwe in 2020, yet there are striking similarities. The only mode of transmission from overseas were two steam ships and a steam train from Cape Town to Bulawayo and then Harare. Now we have numerous daily flights from everywhere in this global village.
There were not any health facilities to talk about then and yet our health facilities now are not anything to talk about either following many years of neglect. Most hospitals have no equipment or its obsolete, at the very least. They do not have running water or piped oxygen, drug stores are dry, laboratories are just nominal, a ventilator is a tourist attraction and the health workforce is demoralised, deflated and demotivated. Their wages are deplorable and they do not have basic personal protective equipment. Yet there are on the frontline.
Of the 85 000 Covid-19 infected in Spain, 14% are health workers who acquired it at work. More than 60 doctors have died in Italy from Covid-19 acquired at work. The threat is very real to our health workers. There is not even a place for them to get treatment if they contract Covid-19 at work and nobody has talked about life insurance either.
There is need for everyone to put their hands on the deck if we are to emerge from this pandemic. We need all to practice the preventative measures that are well publicised, including social distancing and the lockdown. Above all we need to roll out tests to all and sundry. This is the time to revamp, re-equip and retool our health facilities.
Dr Mungwadzi is a specialist physician and consultant at the University of Zimbabwe College of Health Sciences. He writes in his personal capacity. — firstname.lastname@example.org