For the last few weeks the eyes of the world have been fixated on a new coronavirus causing the illness COVID-19. Newspapers and screens are saturated with pictures of deserted cities, closed borders, healthcare workers in spacesuits, hospitals being erected in record time and stranded cruise-ships.
One hopes that the virus will be contained, and that life will return to normal. But what if that is not the case? What if living with COVID-19 is the new normal?
Officials wearing protective attire work to diagnose people with suspected symptoms of the new coronavirus at a hospital in Daegu, South Korea.Credit:Yonhap/AP
We are not suggesting that this is what will happen. But as the virus spreads to countries where three-quarters of the world lives, it becomes increasingly likely. Fortunately, mankind can learn to live with such challenges.
Every year, for decades on end, we have been visited each winter by the influenza virus (the flu). WHO estimates nearly a billion of us (likely 400 million children and 600 million adults) get infected with the virus each year, with 3-5 million having a severe illness resulting in 300,000 to 600,000 deaths. This is not just a challenge for the developing world.
In Australia itself each year more than 100,000 flu infections are diagnosed, resulting in over 2000 hospital admissions and 400 deaths. You probably did not even make a special note. The borders stay open, the hospitals manage, trade flourishes and life goes on. This is not to overlook the cost and anguish but simply to highlight that human life coexists with viruses.
Will COVID-19 become a regular killer like influenza? The answer will depend on how widely it spreads. Scientists measure the spreading potential with a number called R0, which is the number of people on average that one person with the virus infects. For influenza, this figure is around 1.5, for measles it is 10-15. For COVID-19 it is estimated to be between 2-3.
While this number may seem low, the hundreds of cases on the Diamond Princess cruise ship docked off Japan cautions one about how widely and quickly the virus can spread amongst people living in confined spaces. With case numbers and transmission increasing across Asia, and now showing up in far off countries like Iran and Italy, many experts predict that COVID-19 might be here to stay.
What might that mean for Australia? Australia has had fewer cases than other countries in our region, pointing to the effectiveness of early diagnosis and containment strategies employed. The harder question is how Australia should respond if the disease starts taking wings in the wider regions around us.
Quarantining cities, travel bans and trade lockouts have provided our public health system some time to prepare, but such bans can only be observed for so long. A nation like Australia with international connections cannot protect itself by isolation. What then, might be the way forward?
With modern medicine and public health measures we have learnt to live with emerging viruses. The transition will not be easy – will come at a cost of life and livelihood. But we managed to control SARS; we developed new treatments and vaccines for Ebola and have changed HIV, a potentially life-threatening virus, into a chronic manageable infection. With good hygiene, a reasonably effective vaccine and medications and a prepared medical system, we have learnt to live with influenza. Thus, should it come to it, we will find a way to live with the COVID-19 virus – just as we have managed with the others.
The "normalisation" of SARS, HIV, Ebola and Influenza have all required substantial investment from governments, philanthropy and the private sector. They have required strategies to strengthen public health systems in all countries – rich and poor.
Furthermore, the money and the talent to tackle these viruses did not come from one country or one sector. Instead, it took a co-ordinated global effort, and so it will be with COVID-19. Therefore, it is critical that we don't scapegoat a region; or stigmatise a people; or burn the very bridges we will need to respond and manage the shared global challenge that COVID-19 is.
Professor Shitij Kapur is Dean of the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne.
Professor Sharon Lewin is Director of the Peter Doherty Institute for Infection and Immunity.
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