Media Blog Reflections on a pandemic Eight years ago, we devoted an entire magazine to zoonotic diseases. I could pretend this was incredible prescience, but in reality it wasn’t – according to most people with an international medical perspective there was a commonly held belief that a pandemic of some kind was ‘overdue’. Viruses are more prevalent in larger populations, and ‘cross-overs’ more likely – hence quite rapid reaction from the global health community to outbreaks of viruses like SARS, AIDS, MERS, Hendra virus and bird flu. Nobody knew what virus would strike humanity, but medical experts knew something would appear sooner rather than later, most likely a flu or coronavirus. They just weren’t sure when. Like many of the topics in our Geographer magazine, however, it was both timely and timelessly informative and told us many things… It told us that the more we encroached into wildlife areas and killed and ate wildlife, the more chance we had of viral transmission. AIDS, for example, was probably transmitted to humans through butchering a chimpanzee in the Cameroon or DRC in the 1920s. It informed us that bats and similar ‘older’ species, which have lived with some of these viruses for longer than humans have existed, can carry viruses which we could find very harmful, so we should respect them and their habitats. Viruses need to mutate to fully take off in the human population, because they in effect adapt over time to the precise conditions presented by the human body. Viruses are short-lived so can mutate and evolve much more quickly than their hosts, going through several generations in the lifetime of a host. Viruses are also a permanent part of life – in fact, they probably drove evolution in many cases, favouring species which had adapted to survive them or individuals who were immune or less affected. Many of the significant evolutionary step changes in history were driven by viruses. And they explain why the predominant species on our planet aren’t all asexual: having to find a mate forces greater genetic diversity which makes our offspring more adaptable and better able to defend themselves against viruses. Humans can catch viruses from animals, and always have. 60% of human infectious diseases probably began in this way. But it’s only when they successfully adapt to humans that they really become a problem. Like influenza. Trump famously likened Covid-19 to the flu. Whilst on almost every level he is wrong, he also chose an incredibly poor analogy: influenza began as a disease of wildfowl, crossed over into the human population, where it could mutate into at least 144 variations, and was responsible for more than 50 million deaths in 1918, whereas Covid-19 has killed a little over three million people worldwide in its first year or so. It was called Spanish flu, not because it came from Spain, but because Spain was not involved in WWI and so the name was seen as less inflammatory than picking any of the countries that were active protagonists. Another thing the magazine in 2013 made clear is that flying is the main way that viruses now get around the world. If a pandemic was going to spread it was going to be by plane, and the only way to predict its spread was to map the volume and frequency of passengers flying between different locations around the world. By extension, the best way to stop the spread would be to stop flying into a country, or at the very least demand testing and quarantine for anyone flying. This is just common sense. If Ebola had broken out in a place that lots of people fly to and from, we would have a far more serious problem with it. Instead it has largely remained contained in west Africa. AIDS was thought to have stemmed from Cameroon, but it was decades before it found its way abroad. Covid-19, on the other hand, broke out in the epicentre of world trade – China – and aviation made the spread both rapid and global in nature. Those countries that clamped down quickly on international travel tend to be those which have fared best. In the UK, which didn’t, there were reports of over 200 new cases a week arriving into the country through foreign travel. The fact that this was an incredible risk should not be surprising – we ask our school children to sit in a class with the windows open. On a plane, 500 people sit in close proximity, breathing the same air. It only takes one or two people to carry the infection onto a flight for half the passengers to leave with it when they get off. Even a year into the pandemic, we still seem loath to properly action this. The other common factor in countries which have handled the pandemic better is robust testing, tracing and isolating infected individuals. The UK was slow, reluctant and inconsistent in this. I’m not sure even now if our test and trace systems work, after a year of lockdown. It is this failure to act quickly and decisively that has led to us simultaneously having one of the longest periods of lockdown, and one of the worst death rates of any country in the world. Scotland has fared slightly better than the rest of the UK. Maybe this is because we have some rural areas and less obvious population densities. Or maybe it is because we more closely followed Scotland’s political leadership, which advocated for a stronger response than the UK as a whole. But the death rate in Scotland in the spring was 113 deaths per 100,000 population against a UK average of 162 deaths per 100,000 population. At the UK average, Scotland would have seen around 8,850 deaths, not the actual 6,181 – an increase of more than 40%. Lockdown has saved lives. Scotland’s lockdown has saved more lives than the rest of the UK’s. But the UK has one of the worst global death rates in the world, so that isn’t much to celebrate. And whilst some of our media are quick to blame the spread on the Brazil and Indian ‘variants’, they have been largely silent about the British variant which is worrying large parts of Europe and the rest of the world. People are scunnered with lockdown and the many and various restrictions. They jar with our sense of rights and freedom, and have led to many of us becoming anxious and isolated. The wealthier have tended towards boredom, the poorer towards hunger, and it has exposed the inequalities in our society like nothing before. Those in the front line have borne the brunt of the anxiety and are most at risk of infection. It’s a high cost to demand from those invariably on the lowest wages. Any frustration we have should not be directed at medical advisors trying to prevent more people dying. Our death rate is not higher, nor our lockdown longer, than almost every other nation on Earth because of our medical workers. It is because we failed nationally to act sufficiently quickly, to heed the various warnings, to be stringent when we required to be, and to isolate the virus before it got out of hand. With a burgeoning global human population, we need to be more open and honest about what worked and what didn’t. We need to take the time to learn the lessons from our own response and others. We are not out of the Covid-19 woods yet, and are unlikely to be for some time. And the risk of another potential virus is never far away.