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Understanding pandemics as we battle Covid 19

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Coronavirus disease 2019 “Covid19” is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), according to the world health organization the disease, The disease was first identified in December 2019 in Wuhan, the capital of China’s Hubei province, and has since spread globally, resulting in the ongoing 2019–20 coronavirus pandemic.

As of 2 May 2020, more than 3.38 million cases have been reported across 187 countries and territories, resulting in more than 239,000 deaths. More than 1.06 million people have recovered. As of the same date “2 May 2020”, Rwanda has recorded a cumulative 255 cases with 120 recoveries and no death.

M28 investigate website reported that the government of Rwanda through its ministry of health have invested a lot in creating awareness on symptoms of the virus and containing the spreading through different measures including a total lockdown, which is expected to end 3rd May.

“The common symptoms of this Virus include fever, cough, fatigue, shortness of breath, and loss of smell and taste” said Dr Daniel Ngamije, the minister of health in Rwanda.

On 14 March 2020, the Ministry of Health in Rwanda reported the country’s first case of COVID-19, an Indian citizen, male. According to the officials, the transmission is believed to have occurred abroad as this patient arrived from Mumbai, India on 08 March 2020, according again, the patient had no symptoms upon arrival in Rwanda and reported himself to a health facility on 13 March, where he was immediately tested.

On Saturday 14th March, president Paul Kagame advised Rwanda to remain calm and focus on simple but effective measures that are key to keeping each other and everyone safe.   “As the world faces the COVID19 pandemic, our thoughts and prayers are with the victims, families and their loved ones. We wish strength to the health workers on the frontlines and quick recovery to all patients,” Kagame said, he also added on that “As always, we will overcome these difficult times through solidarity and working together. This will require the discipline Rwandans have always shown in confronting challenges and getting good results.”

On Monday 4 May 2020, people are resuming work in Rwanda after a month and 13 days of total lockdown. According to the minister of health, health guidelines have to be taken serious by the citizens

“The virus is primarily spread between people during close contact, often via small droplets produced by coughing,sneezing, or talking. The droplets usually fall to the ground or onto surfaces rather than remaining in the air over long distances. People may also become infected by touching a contaminated surface and then touching their face,” Said Dr Ngamije, he also added that people should maintain social distancing, wearing of masks, washing hands and avoid touching their faces.

Throughout history, diseases have plagued the mankind, the Neolithic Revolution, which was marked by a shift to agrarian societies, preceded by hunting and gathering communities, brought about increased trading activities. The shift created new opportunities for increased human and animal interactions, which in turn, introduced and speed up the spread of new diseases. The more civilized humans became, the more the occurrences of pandemics was witnessed.

This led to outbreaks that left an indelible mark in history due to their severity. 

Three of the deadliest pandemics include the Plague of Justinian (541-542 BC) that killed about 30-50 million people, Black Death (1347-1351) that killed 200 million and Smallpox (1520 onwards) that killed 56 million.

The most notable major pandemic in the modern history was the Spanish Flu of 1918-1919. Over a century later, the world is grappling with the effects of the ongoing COVID-19 pandemic that has currently infected millions people and killed over 239,000 up to now

China and viruses

The Peoples Republic of China (PRC), is a country in East Asia and is the most populous country in the world, with a population of around 1.4 billion people. It is also one of the world’s first civilizations.China is the third-most biodiverse country in the world after Brazil and Colombia with over 34,687 species of animals and plants. It is home to at least 551 species of mammals, 1221 species of birds and 424 species of reptiles and 333 species of amphibians; most of which are consumed as food. The Chinese authorities alerted the World Health Organization, WHO on December 31 last year of an outbreak of a novel strain of coronavirus causing severe illness. It was subsequently named SARS-CoV-2 and is now known as the causative agent of COVID-19. The origin of the virus was the city of Wuhan in China.The effects it has left in its trail have caused different countries to take extreme measures in a bid to curb the spread of the virus. This is, however, not the first time China has been the origin of a viral outbreak. The Asian flu (H2N2) virus emerged in East Asia, triggering a pandemic in February 1957, It was later traced back to China with a stop in Singapore. It then spread to Hong Kong and to coastal cities in the United States in the summer of 1957.According to the USA Centers for Disease Control and Prevention, CDC, the number of deaths caused by the virus stands at 1.1 million people worldwide including 116,000 in the US. A vaccine was developed and the flu tapered off in 1958.

The Hong Kong flu (H3N2) outbreak occurred in Hong Kong, China, between 1968-1969, killing an estimated 1 million people globally. It is said to have evolved from the H2N2 strain of influenza that had caused the Asian flu. It occurred in two waves, and in most places, the second wave caused more deaths that the first. A vaccine was later developed against the virus but it became available only after the pandemic had peaked in many countries.

In 1997, human infections with Bird flu (H7N9) were first reported in China. It is a zoonotic disease (one that passes from an animal or insect to a human), which infects humans after exposure to infected poultry or contaminated environments. Rare instances of person-to-person spread were been identified in China. Since then, annual sporadic infections have been reported outside of Mainland China, Hong Kong and Macao, but all the cases have occurred among people who had travelled to China before becoming ill. The current risk to the general public’s health posed by the virus is low but exposure to infected poultry pauses the risk of it spreading to neighboring countries. There have been six waves of the epidemic over the years with the last one being in 2017.

Recently in 2002, a viral respiratory disease caused by a coronavirus called Severe Acute Respiratory Syndrome (SARS-CoV), was reported in Asia.  It is thought to be an animal virus from an as-yet-uncertain animal reservoir, perhaps bats, that spread to other animals (civet cats) and first infected humans in the Guangdong province of Southern China. According to National Foundation for Infectious Diseases, NFID, coronaviruses are a large group of viruses that cause diseases in animals and humans. They often circulate among camels, cats, and bats, and can sometimes evolve and infect people. They are named for the crown-like spikes on their surface.

Human coronaviruses were first identified in the mid-1960s. The CDC states that there are seven coronaviruses that can infect people. The SARS epidemic from China affected 26 countries and resulted in over 8000 infections in 2003. Some of the affected areas included Toronto in Canada, Hong Kong Special Administrative Region of China, Chinese Taipei, Singapore and Hanoi in Vietnam. SARS also had influenza-like symptoms including fever, malaise, muscle pain, headache, diarrhoea, shivering, coughing (initially dry) and shortness of breath. Severe cases often evolve rapidly, progressing to respiratory distress and requiring intensive care.

Given the history above and the current situation the world is experiencing with the COVID-19 pandemic, what does China hold in terms of future outbreaks?Dr Eddy OkothOdari, a senior lecturer and researcher of Medical Virology in the Department of Medical Microbiology at the Jomo Kenyatta University of Agriculture and Technology (JKUAT) while speaking to AUC pointed out several factors.

“Potential for a pandemic would depend on various socio-economic and geopolitical factors attributed to a country or region. Most pandemics that have emanated from China have been viral in nature and have occurred because of such viruses crossing species from animals to humans. Viruses’ crossing from animals to humans is not a strange phenomenon. However, we have to appreciate that most of these viruses, which eventually end up in pandemics, have been traced to the “Wildlife Markets” (wet markets) in Southern China. The activity of trading in wildlife is unique to that region. China being an economic hub where a lot of businesses take place, many people travel to and out of China and therefore I would imagine that any outbreak occurring in China would easily and quickly spread to other regions compared to if such an outbreak would occur for example in an African country.”

In the paragraphs above we talked about the Spanish flu, but how does the Spanish flu compare to the current COVID-19 pandemic?The Spanish flu pandemic of 1918 is sometimes referred to as the mother of all pandemics. It affected one-third of the world’s population and killed up to 50 million people, including some 675,000 Americans. It was the first known pandemic to involve the H1N1 virus. The outbreak occurred during the final months of World War I.

It came in several waves but its origin, however, is still a matter of debate to-date. Its name does not necessarily mean it came from Spain.Spain was one of the earliest countries where the epidemic was identified. Historians believe this was likely a result of wartime media censorship. The country was a neutral nation during the war and did not enforce strict censorship on its press. This freedom of the press allowed them to freely publish early accounts of the illness. As a result, people falsely believed the illness was specific to Spain and hence earning the name “Spanish flu”.

Initial symptoms of the Spanish flu included a sore head and tiredness, followed by a dry hacking cough, loss of appetite, stomach problems and excessive sweating. As it progressed, the illness could affect the respiratory organs, and pneumonia could develop. This stage was often the main cause of death. This also explains why it is difficult to determine exact numbers killed by the flu, as the listed cause of death was often something other than the flu. These symptoms are very similar to those of the ongoing COVID-19 pandemic.

For decades, the Spanish flu virus was lost to history and scientists still do not know for sure where the virus originated. Several theories as to what may have caused it point to France, the United States or China. Research published in 1999 by a British team, led by virologist John Oxford theorized a major United Kingdom staging and hospital camp in Étaples, France as being the centre of the flu.

In late 1917, military pathologists reported the onset of a new disease with high mortality in the overcrowded camp that they later recognized as the flu. The camp was also home to a piggery, and poultry was regularly brought for food from neighboring villages. Oxford and his team theorized that a significant precursor virus harbored in birds, mutated and then migrated to the pigs.

Other statements have been that the flu originated from the United States, in Kansas. In 2018, another study found evidence against the flu originating from Kansas, as the cases and deaths there were fewer than those in New York City in the same period. The study did, however, find evidence suggesting that the virus may have been of North American Origin, though it was not conclusive. Multiple studies have placed the origin of the flu in China. The country had lower rates of flu mortality, which may have been due to an already acquired immunity possessed by the population. 

The argument was that the virus was imported to Europe via infected Chinese and Southeast Asian soldiers and workers headed across the Atlantic. However, the Chinese Medical Association Journal published a report in 2016 with evidence that the 1918 virus had been circulating in the European armies for months and possibly years before the Spanish flu pandemic.COVID-19, on the other hand, was first discovered in the Wuhan province of China late last year. There has been no argument against this so far. Research is still ongoing as to whether it was passed on from bats or the newly found connection to pangolins.

Back to the covid 19 worries and for cussing in east Africa, truck drivers have turned into a threat.  The Uganda’s health minister, Dr. Jane Ruth Aceng while on an interview on a local television argued that the increase in Uganda covid cases were fueled by truck drivers, recently the minister of health in Rwanda Dr. Ngamije Daniel argued the same thing on a local broadcaster.

The government of Rwanda and that of Uganda have taken different measures to contain the spread of the virus by these truck drivers including escorting those in transits and as of Rwanda, those that are to designate in the country are handed over to the Rwandan drivers. However, there remains a huge threat as other neighboring countries fail to take the virus serious including Burundi and Tanzania.

It is alleged that Tanzania is currently giving out fake data on the pandemic were as Burundi is even having an ongoing presidential campaign which pose a serious threat.

Some regional countries like Burundi, Uganda, and Tanzania, have not taken serious measures like Rwanda, but according to some regional experts, it because of the political balance of upcoming presidential elections in those cited countries.

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