Author: Sachit Swaminathan

Do you remember the days of 2020? Do you remember the uncertainty, the anxiety, and the constantly changing advice? Do you remember waking up every day, checking the news hoping for something better, but just seeing bad news after bad news? Perhaps, one of the most disheartening aspects of it was the expectations of scientists vs. what actually happened. At every turn, the virus proved more mysterious, complex, and unpredictable than what was anticipated. Every time, we thought that it was over and that we could declare mission accomplished, there was always something unexpected waiting for us. Taking a look back at some of these different moments during the Pandemic, my hope is to depict how the virus surprised us at every turn, and the lessons that we can take away for the next major Infectious Disease Outbreak.

The first surprise that the virus threw at us was that the majority of us believed that our vaccines produced something known as sterilizing immunity. This was the ideal scenario because it meant that not only did the vaccine reduce the incidence of symptomatic and severe disease. However, it also reduced the incidence of infection and how frequently it was transmitted. This meant that, even if someone could not or chose not to get vaccinated, they would effectively be protected because the people around them could not spread the infection. This would decrease the overall community burden of Covid, along with the number of hospitalizations and deaths. Initially, it seemed like our vaccines had the potential to do this. For instance, there were studies in early 2021 showing that “The Pfizer vaccine reduced asymptomatic cases by 89.4%, and symptomatic cases by 93.7%”(Israeli Studies find Pfizer Covid-19 Vaccine reduces transmission). Similarly, many Israeli studies in the early part of 2021 observed the phenomenon that “Vaccines reduced the viral load in the respiratory tract of infected individuals, compared to unvaccinated people who were infected”(Israeli Studies find Pfizer Covid-19 Vaccine reduces transmission). Additionally, as Israel and the United States begun vaccinating their population, cases dramatically decreased. For instance, from January to May, Covid cases in Israel decreased from “1000 million per day to less than 3 per million”(What pushed Israel out of herd immunity? Modeling Covid-19 Spread of Delta and Waning Immunity). Unfortunately, these early signs of optimism were misplaced, and it clouded our judgement and took our eyes off the ball for the challenges that were about to come next.

Around the same time that the incidence of Covid was decreasing in first world countries like the US, Israel, and the UK, the situation was extremely dire in India. In India, the number of infections were significantly increasing, along with the number of hospitalizations and deaths. The cause was not known yet, at the time. However, in April 2021 in India, “56-65-year-olds were spending an average of 13 days in the hospital”(Covid-19 Mortality in the Delta Wave in India: A Hospital-Based Study from Ramanagara District, Karnataka). Additionally, “77-84.62% of individuals in hospitals were completely out of breath, and WBC count was significantly elevated in over 40% of cases”(Covid-19 Mortality in the Delta Wave in India: A Hospital-Based Study from Ramanagara District, Karnataka).  In other words, there were early indications that there was something going on in India that was causing the pathogenicity of Covid to increase, and a significant number of people to get Covid to become seriously ill. To some extent, it was even more than what was seen during the initial Covid wave in New York or during the 2020 winter Covid wave in the United States. This was corroborated by the number of individuals “…needing significant levels of Oxygen”(Covid-19 Mortality in the Delta Wave in India: A Hospital-Based Study from Ramanagara District, Karnataka). Perhaps the largest red flag and warning sign in this situation should have been the fact that most of the population in India had already been infected, and supposedly developed immunity. According to some studies, “55% of India’s population may have been infected by January 2021″(India says it contains spread of COVID-19, no new cases in fifth of country). This only further proves that a new, pathogenic variant that was clearly immune-evasive, and especially adept at penetrating immunity induced by natural infection had arisen and would prove a significant threat to the United States, where so many people had still not been vaccinated. Indeed, the story of what happened in India repeated almost exactly in the United States 2-3 months later.

So, America experienced the catastrophic effects of the Delta variant surge and then believed that everything was over. Surely there was enough immunity in America, so everything would be okay now, right? Unfortunately, the virus was still not done with us. Not only did our cases end up at a higher baseline than they were prior to the Delta surge. However, we then had a new variant arise in South Africa, which was good at evading all the immunity obtained from the Delta Variant, and previous variants. Specifically, “The reinfection rate of individuals who had been infected by other variants was up to 56% according to studies done by Qatar”(Protection against the Omicron Variant from Previous SARS-CoV-2 Infection). On the bright side, there were some positives on the horizon, though. The variant seemed to induce clinically milder symptoms and may have carried a lower risk of Long Covid. The variant also seemed to confer stronger protection to previous variants, suggesting that it was favored to be the dominant variant. For instance, studies showed that after having the Delta Variant, “Many individuals had a 6-fold increase in neutralization ability/capacity”(Omicron infection enhances Delta antibody immunity in vaccinated persons). This was unique to the Omicron variant, as other variants did not appear to provide such a broad immune response, especially to variants that were so dissimilar to it. This raised the hope that Omicron could signal a start to a more stable state with Covid because Omicron would be able to block reinfection, and infection, even if Covid experienced a significant number of mutations. Plus, the lower pathogenicity of Omicron would give it a survival advantage across populations, given that it would be less likely to kill its hosts. All that being said, while this prediction turned out to be somewhat true and the pandemic has remained stable after that point, with deaths and hospitalizations staying relatively stable in the US (albeit at a high level), and all subvariants being offshoots of Omicron, the 2021 winter Omicron wave caused a high rate of hospitalizations, deaths, and cases, even if it induced immunity in the process. 

So you might be wondering, what exactly was the point of going down memory lane with Covid? What was the point of discussing all these events? What I hope that you gleamed from this article is that while the Covid-19 Pandemic had an end of sorts, and while we appear to be out of the unstable, uncertain phase of the Pandemic now, America’s response fell quite short in many ways. Any future Pandemics could be made worse, and if we do not focus on how to significantly improve our response, the level of suffering that we undergo then could be made way worse. For one, we needed to be way more proactive, not reactive. We needed to stop hoping that Covid would end by itself, and we needed to actually take the steps to end it. We needed to tightly restrict travel from other countries and put a lot of security measures in place to prevent variants from coming to our country. Similarly, we needed to distribute the vaccine much more equitably and put a much more all hands-on deck effort in getting the world vaccinated by early 2022. It would not have been easy, but it could have been done. Additionally, we needed to keep slight restrictions in place until the world was vaccinated, like having a Federal Mask Mandate to keep cases as low as possible, while vaccinating the world. Finally, with the level of genomic analysis that we have available in today’s day and age, we should have worked on predicting worst case mutations that Covid-19 could undergo and created backup vaccine formulas based on those mutations to have immediately ready the second that we heard of these new variants. All of that would have minimized the level of hospitalizations, deaths, and disruption that society had to undergo throughout this pandemic. So, if nothing else, I hope you as a reader takeaway one point from this article: We needed to do way better in our response, and we are lucky that this was not way worse than it already was!

Sources:

Lubell, Maayan. “Israeli Studies Find Pfizer COVID-19 Vaccine Reduces Transmission.” Reuters, Thomson Reuters, 19 Feb. 2021, www.reuters.com/article/health-coronavirus-israel-vaccine-int/israeli-studies-find-pfizer-covid-19-vaccine-reduces-transmission-idUSKBN2AJ08J/.

De-Leon, Hilla, and Dvir Aran. “What pushed Israel out of herd immunity? modeling covid-19 spread of Delta and waning immunity.” medRxiv, 2021, https://doi.org/10.1101/2021.09.12.21263451.

At the Atlanta Science Festival, me and my team members, Ashmita and Claudia, had the pleasure of getting to talk about Heat Stroke to a large audience of individuals and explain the seriousness of it, and why it’s so important to pay so much attention to it and take so much initiative to prevent it. Not only did I enjoy this experience because it gave me experience speaking in public in front of a large group of family members! But, in doing so, I myself actually became more interested in the topic and its political, social, and economic implications. Being a Biomedical Engineer, this topic also hit close to me as it reminded me of a pressing global problem, where the solutions still have significant limitations in their capabilities and how accessible they are all around the world, an issue that I commonly learn how to tackle throughout my degree. In this post, I hope to do two things. I hope to share the information and insight I learned about heat stroke with those who were unable to come to the Atlanta Science Festival. Second of all, I hope I can share with you some of the ways I have thought about solving this pressing problem of Heat Stroke and my thought process to go about solving it!

First of all, many of you are probably wondering, haven’t we all dealt with Heat Stroke? After all, Atlanta is perpetually hot all the time! Heck, it’s just the beginning of May and it already feels like it’s 140 degrees. However, as miserable as that might have been, I promise you that that was not Heat Stroke! What you likely dealt with was Heat Exhaustion, which is extremely uncomfortable, but I promise you that it is not nearly as bad as Heat Stroke! With Heat Exhaustion, at least your homeostatic mechanisms are still working. You know your Homeostatic Mechanisms, the ones that ensure that your body is still in balance, even with changes in the environment to prevent you from developing diseases or dying?! Do you remember how, for instance, when you have gone and exercised quite a bit or you have been outside in the hot sun for some time, you have sweat quite a bit? These are examples of your homeostatic mechanisms kicking in, so you do not have a detrimental response to these environmental changes. The problem, though, is that like everything in life, these mechanisms designed to protect you can fail. Eventually, the hypothalamus, which is responsible for maintaining this homeostasis gets worn out. When that happens, you are basically exposed to this significantly increasing temperature, without any defense mechanism to fight back (Garcia 6). At that point, you are essentially overheating like a computer which is something that can lead to significant consequences, including death, which I will discuss as we go forward!

So now that you know the difference, the next thing that you are probably doing is, what can we do to better deal with the increasing incidence of Heat Stroke in our society? First of all, healthcare providers in our society have to do a better job of treating Heat Stroke with the same level of urgency as other critical illnesses and have to treat it more like diseases, such as Appendicitis, where you will immediately die if you do not get the necessary surgery. This is extremely similar to that. In the case of Heat stroke, not getting treatment immediately can lead to muscle, kidney, heart and even brain damage. The other side of this argument is that more effort has to be taken by the individual to prevent the detrimental consequences of heat stroke and take early action before it is too late, and there are significant, everlasting effects. Simple steps may seem inconvenient, but they can ensure prevention of the worst outcomes from heat stroke. For instance, steps, such as drinking enough fluids, looking out for health related problems with medications, applying sunscreen, and avoidinging overworking in the heat can go a long way. Additionally, significantly more funding has to be spent by the government in investing in the protective equipment necessary to effectively prevent heat stroke as investing money in vaccines, and treatments for other diseases. While two solutions, besides just protective equipment, Neck Fan and the Ice Pack, have gone a long way in attempting to prevent and mitigate Heat stroke by helping to constantly blow cold air around a person’s neck, so as to help that person cool off and bring their body temperature down and reducing body temperature by promoting the contraction of blood vessels; thereby, ensuring that joints are less stiff and that muscle spasms are less likely to occur, these solutions have limitations in the long-term. Eventually, an issue will arise with long-term use of these interventions and something more will need to be done to prevent a significant rise in temperature in just a short period of time. This is especially true for individuals who are in jobs that exposes them to significant amounts of heat on a chronic basis (Kim 4). Additionally, while current PPE are effective in preventing certain infections, they also add to the problem of heat exhaustion and heat stroke (Steps to Put on Personal Protective Equipment (PPE).” World Health Organization, World Health Organization).

This is where research from Georgia Tech and other universities in this area has come to extremely significant use in helping to create longer-lasting and more effective solutions. The solution from Georgia Tech researchers resulted from a way of thinking that was completely outside the box of the problem, but got to the heart of what was necessary! Tech researchers have found that with the creation of a sensor system, through the utilization of a cloud based sensor system, not only can heat stroke be treated effectively, but its incidence can be significantly reduced to begin with (GTRI Helps Develop Wearable Sensor System to Prevent Heat Injuries among Soldiers). Trust me, this technology is way too much for me to understand! However, the gist is that researchers will be able to obtain information about changes in soldiers’ temperatures over significantly large distances. Too large of a heat increase in too short a time will still be a problem. Make no mistake! However, the hope is that if a rapid heat increase is detected before it becomes an extreme issue, a soldier can get the help that they need to prevent complications (Foy 2). This is especially true with the use of local networks, which should be able to tell a soldier whether there are any soldiers in close proximity to them that can assist them. In the long-term, I hope that I can build upon this work to create an internal cooling mechanism to bring down the temperature and a method to help predict baseline normal temperature, based on the thickness of the suit and the environment an individual is working in. For now, though, I hope I have at least been able to better provide insight into why Heat Stroke is such a big problem and why it is one that both more individual and societal effort is needed to solve!

Citations:

1. Akins, Anna. “GTRI Helps Develop Wearable Sensor System to Prevent Heat Injuries among Soldiers.” Institute Relations, https://gov.gatech.edu/node/515.
2. Cecile Garcia, Operations Manager. “Feeling (Not so) Hot: Heat-Related Conditions and Illnesses.” Blog, Joffe Emergency Services, 14 June 2019, https://blog.joffeemergencyservices.com/event-medical-services/feeling-not-so-hot-heat-related-conditions-and-illnesses. 
3. “Steps to Put on Personal Protective Equipment (PPE).” World Health Organization, World Health Organization, https://www.who.int/bangladesh/emergencies/coronavirus-disease-%28covid-19%29-update/steps-to-put-on-personal-protective-equipment-%28ppe%29. 
4. Kim, Siyeon, et al. “Frequency of Firefighters’ Heat-Related Illness and Its Association with Removing Personal Protective Equipment and Working Hours.” Industrial Health, U.S. National Library of Medicine, 4 June 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546580/. 
5. Foy, Kylie. “New Device Detects Heat Strain in Military Trainees.” MIT Lincoln Laboratory, https://www.ll.mit.edu/news/new-device-detects-heat-strain-military-trainees.

Imagine that you’re a Georgia Tech student. Your day starts at 8:25 AM, with your first class, Systems Physiology, which you know you have a weekly quiz in. You wake up at 8:05 AM, and by the time you finish brushing your teeth and changing into your clothes, you see that is 8:10 AM. Your class is not nearby. These are not the times of virtual classes after all! You have to make it all the way across campus, and you have barely any time to do so. You can’t take the bus because the bus is running late. So, you are unfortunately left with only one choice, to run quickly to class and skip breakfast, or eat breakfast, miss your quiz, and hurt your grade. Which do you pick? The answer that many students at Georgia Tech would pick would be to skip breakfast. After all, your stomach can wait right? Your hunger can wait? So what that you don’t eat for a few hours, what is really the worst that can happen? Eventually, skipping breakfast leads to skipping lunch because you are too busy throughout the day to eat lunch, and eventually, next thing you know, you’re skipping dinner because there’s no time to eat any dinner. You have that test to study for that’s happening in the morning that you need to ace, and you can’t even waste a second taking a break to eat. This is unfortunately the reality for many Tech students, and college students, in general, and I hope to tell you today why this reality is so dangerous and the significant harm that it can cause.

Sure, one or two days of late eating or skipping meals may not harm you. Heck, even if you do it for a few months, nothing might happen. However, what I am here to tell you and what I hope to instill in your minds today is that this is not something that you will get away with over the longer term. Contrary to what you may have been told, your digestive system is not ironclad. Just like other parts of your body, your digestive system is prone to diseases and issues. You just don’t realize it because, well, how could you? When your digestion is working as it should, you are less inclined to pay attention to it because you are not in a constant state of pain or distress. It is only when things go wrong that you start to realize how truly important eating properly is, and the impacts of not eating properly. Over time, not eating properly can wreak havoc, not just on your digestive tract, but ultimately your entire body. In fact, not eating properly can be a risk factor for many chronic diseases in the digestive tract and throughout the body that can ultimately increase the risk for cancers, autoimmune conditions, tissue damage, etc. if they continue long enough.

Perhaps, one of the most devastating consequences of chronically undereating, caused by skipping meals is the development of a condition called Gastroparesis. Gastroparesis is a condition that is caused, when the stomach empties significantly more slowly than it should. Think of it this way, normally when you eat something like a sandwich, over 90% or so of that sandwich should be gone from your stomach within 4 hours. Put another way, if someone were to take a look in your stomach after four hours, they should see almost none of the sandwich there. Contrast that to someone with Gastroparesis, where, even after 3 to 4 hours, a noticeable amount of that sandwich may still be remaining in that person’s stomach (perhaps, even as much as 40% to 50% of the meal, or, in some cases, even more). Now, you might think, surely it’s not that big of a deal that your stomach takes longer to empty? What’s the worst that’s going to happen? You’re going to feel a little more full for a little more time, so what? Unfortunately, the symptoms are usually much more severe than this and most people feel much more uncomfortable than just feeling full for a longer period of time. When the stomach does not empty as it should, many people can feel nauseous, have stomach pain, feel like their stomach is overly stretched for long periods of time, etc. (Gastroparesis).

Additionally, the discomfort of Gastroparesis does not just stop with the symptoms of the disease itself. Many people who have Gastroparesis are at risk of developing a significant complication known as a Bezoar. This is when undigested food matter essentially forms a large clump in your stomach or your intestines and effectively blocks the flow/passage of other food or fluid (Palchaudhuri 26). One example is a Phytobezoar, which is made up of matter from cellulose and other cruciferous vegetables that are poorly digested in those with impaired gut motility. There are other types of Bezoars, but the key theme with all of them is that they can be life threatening if not addressed immediately because they can prevent the delivery of nutrients to your tissues. Gastroparesis can also affect your blood sugar levels. You may not think about it, but, usually, when you eat, your stomach moves food to your small intestine throughout the day, keeping rises and falls in your blood glucose levels extremely stable. However, for someone with Gastroparesis, when food that is stuck in the stomach for so many hours suddenly moves to the small intestine all at once, all that sudden absorption of large quantities of food can cause such a significant and rapid increase in Blood Glucose levels. This can have extreme complications, such as causing Ketoacidosis, and causing rapid cell shrinkage, due to a person’s blood becoming significantly more concentrated than it was before(Shakil and Church 1699).

So now that you have heard so much about Gastroparesis, you are probably wondering, how does skipping meals cause Gastroparesis? How does my stomach suddenly lose its ability to digest food properly, just because I skip meals? Well, it turns out that the answer is actually much more logical than you might think. Just like other muscles in your body, the muscles and nerves in your stomach need to be used periodically in order to effectively work. Just like other muscles and nerves in other parts of the body, the muscles and nerves in the stomach atrophy or weaken when they are not being effectively used. For example, have you ever seen the movies about children who were in wheelchairs all their life, and then suddenly tried to walk? Did you notice how it took these children a very very long time to learn how to walk afterwards? Similarly, have you noticed how when you lift weights at the gym, you build muscle, but after a period of time, when you stop working out, you end up losing all that muscle? This is a natural consequence of muscle atrophy. Believe it or not, the same thing happens in your stomach. Moving food is essentially the work out for the muscles in your stomach, and if they stop getting this work out, they get weaker and weaker (Santonicola and Gaglidari 10). To an extent, these muscles can become stronger again by being used again, through eating properly, but it is a slow and difficult process and it is one that I don’t think anyone should have to go through, especially for something this preventable.

So why did I tell you all this information about a random health condition? Well, my intention was not to scare you, but rather just to convey that taking care of your physical health is just as important as success and grades. These days, so much stress is put on our age group to meet certain expectations that I think we forget the importance of taking care of ourselves sometimes, and that is really a significant problem in and of itself. The incidence of many diseases in young people are rising, especially in the western world, and one significant factor is that, these days, young adults are so stressed out that they do not take the time to put as much effort into their health or their physical and mental well being, as they do their success. So, I hope with this post, I have emphasized that not taking care of your health can have significant consequences and is just as important as being successful in school and other facets of life.

Citations:

Chawla, Rajeev. “Gastrointestinal Complications of Diabetes.” Complications of Diabetes, 2012, pp. 100–100., https://doi.org/10.5005/jp/books/11685_10.

Do you remember those early days of the Covid-19 Pandemic? Schools were shut down. Zoom meetings were the norm. Graduation parties, birthdays, and weddings all felt like another era. But, worst of all, the number of people who succumbed to this virus and lost their lives was just horrific. More people died from Covid than during 9/11 or World War 2. Those people were brothers, sisters, mothers, fathers, aunts, and uncles. Each of them meant something special to someone else. We put our hope in the scientists and researchers, and don’t get me wrong they were amazing! But every step of the way, the virus stymied and defied even the best scientists. Scientists initially thought that once vaccines came along, our relationship with the virus would be significantly different. They thought that by summer 2021, life would return entirely to normal and that Covid would be a thing of the past. However, the virus turned out to be much more formidable than many of them imagined, and in some ways, even now, the world does not have a good handle on this virus, and we are still living by its command. There is no ability to clearly tell what is going to come next. Some suspect that there will be another winter wave, but that the impact on hospitals will be significantly lower than the last two years. Others think that there will not be a winter surge at all. The most pessimistic of experts, though, suggest that hospitals could be in for a tough few months as we head into the holidays. But, if you want to hear the even more sobering news folks, keep this in mind. This will not be the last pandemic that shakes up the world like this. In this post, I hope to inform you about why we should not be complacent into thinking that this was a one time tragedy, how we keep making ourselves more and more prone to pandemics, and what we might be able to do to better be prepared.

So you might be wondering, what type of virus is fit to become a pandemic? When do we know that we’ve got a pandemic on our hands? To put it simply, a pandemic is a worldwide epidemic. An epidemic is when there is the exponential growth of a disease in a certain country. A pandemic is when a disease has been able to grow exponentially in multiple countries. This concept of exponential growth is key. There have been so many diseases that have spread to multiple countries. SARS spread to about 30 countries. Ebola spread to 7 countries outside of the continent of Africa. But do you know what the difference was? Do you know what the saving grace was? Countries were quickly able to get a handle on who was carrying the disease and who was sick, so they could isolate them before they were able to spread it to anyone else. You can think of diseases like SARS and Ebola like the villian, Lord Voldemort from Harry Potter. Voldemort was cruel and terrible, but he made it clear from day one that he hated Harry, and that he would do whatever it took to kill him. SARS and Ebola were like that as well. They were extremely nasty illnesses, but it was extremely clear when someone had it because their peak viral load or the time that they would be most likely to transmit the infection to other people would be when they were having symptoms. Covid-19; however, was completely different. Most of the spread occurred when people did not even know that they had the virus. There were people walking around, who were positive that felt perfectly fine. For god sakes, some of them did not even have a runny nose! This raises the question, how do you fight something when you do not even know what you are fighting? How do you fight off an enemy, when you do not even know that that enemy exists? This is precisely where the problem laid. By the time, health authorities figured out that a person had the virus, he/she had already passed it to 4 other people, and those 4 people had passed it to 4 other people, and so on. You can quickly see how 1 infection can become a 100 and a 1000 in just the course of a few days. Plus, to add to the issue, no one had any preexisting immunity to this virus. So, we were essentially facing an invisible enemy without even any armor. Plus, Covid was also deceptive, where, even when a person had symptoms, those symptoms coincided with other diseases that we have learned to accept as part of our daily existence. All this created the perfect storm for a devastating global pandemic. So, to recap, there are really three things that increase the risk that a virus will have the capability to cause a pandemic. First of all, it has the capability to spread in a way that cannot be easily detected/kept up with. Second of all, the symptoms that it causes are not easily distinguishable from other diseases. But, third, and most importantly, no one in the population has any form of immunity to it.

Assuming you read that, you’re probably wondering, “Okay, I understand that certain viruses are capable of causing pandemics, but how do these powerful viruses even make it to the human population in the first place? How are they even spread to humans in the first place? Where do these viruses originate from? I can understand the curiosity. It seems mysterious how a virus that did not even exist before 2019 suddenly made its way to humans. However, I’m here to tell you that the answer is not as mysterious as you think. The answer to that is simple! Covid likely came from an animal reservoir. You might be thinking, “Wait, how? We don’t even have that much contact with animals on a daily basis?” What you have to remember, though, is that it only talks one source of contact. All it takes is one unlucky encounter, and the virus can jump to humans. Given the wrong circumstances, it is possible, and then once that human spreads it to another human, you have begun the stage of community transmission. In fact, recent research has even shown that there are multiple stages of zoonotic transmission, where in each stage, the viruses involved not only get better in transmitting from animals to humans, but also get better equipped to stay in the human population. For instance, research by Brian Pike and others suggests that there are about five stages of zoonotic transmission. According to them, viruses that are in stage 1 are solely present in humans, while diseases viruses that are in stage 5 are solely present in animals. Put another way, stage 1, a virus is solely present in animals. When that virus has gained the ability to jump to a human, it is in stage 2. However, that still does not mean that it is time to be concerned yet. Viruses at stage 2 are still not guaranteed to cause a pandemic because they are not able to transmit readily between humans. They have just been passed on from an animal reservoir. When you reach stage 3 and 4; however, things are much more concerning. At stage 3, the virus is not only present in humans, but it has actually gained the ability to spread from one human to another. Put another way, it has become fit enough to spread between humans. Stage 4 takes it up a notch because the frequency of this human to human transmission only increases, as the virus transmits more and more periodically from person to person, without even the involvement of an animal host. For instance, if you think about the Influenza virus, it is a stage 4 virus because it is transmitted significantly on a periodic basis during the winter between humans, and there are no animal reservoirs involved (Pike et al., 2010). Think about it, you do not get the Flu from an animal! You get it from another person. Additionally, this other fact comes to mind. Viruses that are in stage 4 are more and more likely to mutate. This also helps to explain how the Covid Pandemic kickstarted itself. Initially, Covid may not have been the most fit. However, by continuously spreading from person to person, it reached a point where it essentially begun to learn how to become smarter and more fit so ask to skirt any developed immunity and infect more people at once. Viruses obviously cannot mutate to obtain an advantage if they are not able to replicate, which also sheds insight as to why stage 3 and 4 viruses are significantly more dangerous and more prone to cause pandemics.

You have probably reached the point, where you’re thinking to yourself, Sachit, this is great information, but how is any of this important? How is any of this remotely optimistic or positive? Why am I telling you all this information? What I am here to tell you is that this information, while stressful and terrible, is actually extremely positive. Given that so many pandemics start when a virus is transmitted from an animal to a human, this also shows that we are not helpless and that there are many ways that we can help to prevent future pandemics. Many of them unsurprisingly come down to changing the way our relationship with the environment works. For instance, according to research done by Brian Pike, HIV became such a significant problem for the human population because of the significant amount of primate hunting and butchering that was going on in the early 20th century. Perhaps, even more surprisingly, the researchers found that there were a group of viruses that had not even been previously found to have had the ability to infect humans that humans had antibodies too. For instance, one of the most noteworthy facts that the researchers found was that there were individuals, living a Cameroonian village who had antibodies to the Simian virus. This is usually a virus that only affects monkeys, so the fact that it had obtained the ability to affect humans was astounding (Pike et al., 2010). SARS was thought to have arose from bats in a wet market that were captured. The H1N1 Pandemic, also known as Swine Flu was thought to originate because different flu viruses, typically only found in pigs essentially recombined to form a super fit strain that could infect humans. Guess how humans came into contact with pigs? Well, the answer is that it was the same way in individuals in the Cameroonian village came into contact with monkeys. It was through hunting them and butchering them. Sometimes, though, contact may not even come through hunting and capturing a given species. Contact may occur in circumstances in which an individual does not have any control. For instance, Lassa Fever is a devastating disease that spreads between humans who are in close contact with rats. Hence, many individuals who are in a situation where they live in crowded, congregate housing conditions are at significantly increased risk of catching a disease like Lassa Fever (Pike et al., 2010).

So, you might be thinking the solution is to just prevent human contact with animals, and that that will solve the problem. However, I want to tell you that that view fails to look at the full picture. There are other factors that make pandemics more likely to occur, other than just what I talked below. Activities that we do as humans, such as cut down trees may not seem harmful to us, but they kill species, and impact the diversity of our environment. This makes it much more likely for the perfect storm to occur for a virus to cause a pandemic. Have any of you seen the movie Contagion? Do you remember the ending scene where trees were cut down in the Macao forest, causing bats to fly out in droves? Pigs were exposed to the feces of these bats, causing them to become infected with the virus, and then when humans decided to butcher the pigs, they were exposed. It seems like an extremely far-fetched event, and it seems like something that would be unlikely to happen. However, the things that humans did ended up making something that was far-fetched all the more set to happen. If you don’t believe in movies, I can even give you a similar example of something eerily similar that happened in real life. In 1998, deforestation occurred, which caused a full livestock of pig to be exposed to fruit bats. Once a group of farm workers in Malaysia were exposed to these specific pigs, that was it. The situation was finished! (Pike et al., 2010).

Reading all this, I hope you understand, when you ask the question, who is responsible for a pandemic, there is no one answer to that question. No single person or group of individuals is responsible for a pandemic happening.  Instead, what I hope you have gained from this post is the understanding that there are truly things that we can do to not only reduce the risk of another pandemic occurring, but ultimately make the impact of the next one much lower. For instance, trying to encourage communities that participate in hunting a lot to use best hygiene practices, such as cleaning injuries, scratches, and bites with soap can go a long way. Additionally, if someone does have an injury, avoiding contact with an animal via hunting or butchering can also go a significantly long way (Pike et al.,2010). Similarly, not chopping trees and putting the health of the environment over the health of corporations likely will help to serve us in the long – term. However, it is understood that not every cause is preventable. In the cases where contact between animals and humans is not preventable, such as in congregate settings, there is no easy solution. However, perhaps maybe some sort of genomic surveillance can be instituted to monitor what types of viruses are most likely to spread in such populations on a daily basis. Maybe vaccines can be formulated and administered ahead of time, and given to these populations based on which viruses are most likely to spread in a given community at a given time. At the very least, what needs to be understood is that doing nothing is not going to get us anywhere. Pretending like we, in some way, as humans did not contribute to the Covid – 19 Pandemic and that it was out of our control is ridiculous. There are practices that we can institute right now that will reduce the likelihood that this will happen again. What those things are are not entirely clear, yet, but if we come out of this crisis as sitting ducks, we are making ourselves ground zero for an even more horrible pandemic in the future. Most of all, I hope this post equips you with information as to what you can do as an individual to make the next pandemic less likely because as much as we don’t like to hear it, all of us are at fault in some way or another! We need to stop pretending like we have control over Mother Nature. Mother Nature has control over us!

References:

Pike, B. L., Saylors, K. E., Fair, J. N., LeBreton, M., Tamoufe, U., Djoko, C. F., Rimoin, A. W., & Wolfe, N. D. (2010). The origin and prevention of pandemics. Clinical Infectious Diseases, 50(12), 1636–1640. https://doi.org/10.1086/652860