By Chitra Ahanthem
Isn’t it interesting that even as technological, scientific and medical advances are now able to ward off various diseases and infections, some find a way of making their deadly presence felt? The latest public health scare is currently the Ebola outbreak of East Africa, which the World Health Organization (WHO) has declared as an international health emergency. Mention may be made that it is only for the third time that WHO has declared a public health emergency of international concern, after the H1N1 outbreak, commonly called swine flu that broke out in 2008, and the ongoing polio outbreak in Asia, Africa and the Middle East. The other side of development and progress is that geographical boundaries open up and there is more interpersonal interactions that fuel the growth of the spread of infections. To cite an example, when an epidemic of plague or cholera or such broke out in a particular town or village in an earlier era, the most that the infection could travel would be to towns or villages or cities in the immediate surroundings. But the same outbreak now in this time and age of increased person to person interactions and more people being congregated at markets, airports and train stations mean that the spread of infection is increased manifold.
Another very interesting feature with viral outbreaks is that they are most deadly at its break out point and time and then go into a stupor, waking up again in either a more deadly version or a weaker strain. This happened with the H1N1 virus that took a heavy toll in terms of public health leading to a huge medical scare that eventually led to the imposition of strong medications as a generic treatment measure with no importance given on its life threatening side effects with no mention yet again on the fact that a majority of people infected by swine flu recovered without any medical treatment. I still remember the knee jerk reactions around me when lab tests confirmed that I was positive for swine flu and yes, I still have the medicines that were given to me: the ones that I refused to take because I felt that it was risk worth taking. But no, it was not easy to take that stand since the large scale fear prevailing then was that swine flu was infectious and the mortality rates were reported as being high. Of course, what made it easy for me to decide was largely the condition of the isolation ward at the hospital where I had gone to give my sample (the room had live vermin and germs that came out of the bathroom!) and then the volume of resources that I had access to (mostly online) with regard to the nature of swine flu and its implication on the human body.
What is happening now is that with more infections taking place all around us (due to more people being interconnected), there is first and foremost a tendency for a large scare that in turn creates pressure on health and state authorities to respond to the situation. It happened when the first cases of HIV/AIDS were being reported in the country: largely considered to be of foreign origin, the Ministry of Health actually sent out a directive that entry of foreign nationals would be curbed! The fall out of a public health emergency and the scare that follows it, the risks and trails undertaken by health workers along with the economic sidelight that pharma companies enjoys: all of these and more have been well portrayed in Steven Soderbergh’s acclaimed film that came out in 2011, ‘Contagion’. The film largely captured various nuances of the swine flu and earlier SARS outbreak and featured a fictional viral pandemic, the mad rush to ascertain its origin, the politics behind finding a cure and then deciding who gets the medicine first before it would get on the public domain. A viewing of this film would be largely educational as it narrates quite well the various push and pull factors that come into play when a global pandemic strikes. And call it a continuation of the debate over whether life imitates fiction or fiction imitates life for the questions that this 2011 film threw up is still relevant today with reports of yet to be approved medicines for the Ebola outbreak being a good therapy but unavailable to all outside of the well to do nations.
When international health agencies come in with declarations of emergency etc, it means that governments tend to wake up though sometimes not in the best way as happened when HIV/AIDS was reported or even with the generalizations in the wake of the swine flu epidemic. But one aspect of viral infections is that it can be prevented or made weaker by one basic act: that of washing our hands and keeping them clean. This is easier said than done since the amount of interaction with people and things that are touched by different people (starting from doors and furniture to vehicles, utensils and buildings) is mind boggling. Then again, the entry of hand sanitizers in the consumer market today bodes well for people who want to keep away viruses, which are on the look out for a potential victim. And now, shopkeepers stocking hand sanitizers can thank me if their stocks of the same fly away from their shelves!