The heralded pandemic

SARS-CoV-2

The November 2005 issue of Scientific American published an article signed by W. Wayt Gibbs and Christine Soares titled Preparing for a Pandemic. The article had the following subtitle-summary:

One day a highly contagious and lethal strain of influenza will sweep across all humanity, claiming millions of lives. It may arrive in months or not for years--but the next pandemic is inevitable. Are we ready?

Fourteen years later, the pandemic is here, although the authors were mistaken in one detail: they thought it would be caused by the influenza virus, but it was actually a coronavirus. These viruses belong to two different families:

• Orthomyxoviridae: includes four genera of influenza viruses (A, B, C and D) plus other three that infect salmon, mosquitoes, ticks and other animals. These viruses have as genetic material one or several negative RNA molecules, with a total of about 13,500 bases, encoding 11 proteins. RNA is called negative because it must transform into its complementary before it can express itself inside a cell.
• Coronaviridae: includes numerous species classified into four groups (alpha, beta, gamma and delta). These viruses have as genetic material a single positive RNA chain, with between 26,000 and 32,000 bases. RNA is called positive because it can express itself directly within a cell, without having to become its complementary chain, like that of the influenza virus. These viruses produce diseases like SARS, MERS, and COVID-19. The name COVID-19, by the way, does not apply to the virus, but to the disease it produces: it stands for COrona-VIrus-Disease-19. The virus is called SARS-CoV-2.

In the article published in 2005, the authors considered various possibilities for containing the pandemic, relying mainly on the possibility of using drugs and vaccines, which in the case of influenza would have been feasible. Actually, being a previously unknown coronavirus, neither drugs nor a vaccine were available. Under these conditions, the authors of the article make the following reflections:

According to public health experts, the location and isolation of [the infected] would never be enough to stop the [disease]... Based on the experience of past pandemics, experts estimate that once a new strain of the virus appears... it will go around the world in two or three waves, lasting several months each, to reach its maximum intensity in each community within five weeks of arrival...

The WHO brought together a group of experts... in Geneva in March 2004, to determine what medical actions should be undertaken. They concluded that exploration of travelers entering a country with symptoms... does not guarantee public health benefits (although it could increase population confidence). They also questioned that the investigation of fever cases, the provision of information telephones... would delay the spread of the disease... They recommended the use of surgical masks for the sick... and the health personnel in contact with them. For healthy individuals, hand washing offers greater protection than wearing face masks in public spaces... The ban on public gatherings... and other "social distancing" measures should be applied depending on the nature of the pandemic... The possibility of closing educational centers may be considered.

The attached figure shows the result of a simulation of the disease spread, discussed in the article and applicable to the United States of America: on the first day, the disease would infect about 40 people; after 60 days the maximum extension would be reached, with more than 3% of the population affected. Four months later the remission of the wave would end, which would have affected about 33% of the population. About six months after the start of the first wave, the second wave could begin, which would be much less harmful, since a significant part of the population would already be immunized. It is known, from studies carried out in other diseases, that this produces a herd immunity effect, so it is not necessary to vaccinate (or immunize in another way) the entire population, for immune individuals protect the others by decreasing significantly the number of candidates to spread the infection.

Not a bad prediction, to have been made fourteen years ago. May this pandemic be a humility cure, precisely when doctors and the media were announcing that we will soon live 200 years, or even reach immortality (υβρις -> Aτη).

The same post in Spanish
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Manuel Alfonseca