Doctor Explains What You Need to Know About Pandemics

Video Credit: WIRED
Published on March 6, 2020 - Duration: 10:53s

Doctor Explains What You Need to Know About Pandemics

As more coronavirus cases appear outside of Asia, Dr. Seema Yasmin breaks down what you need to know about pandemics.

Doctor Explains What You Need to Know About Pandemics

- The new coronavirus, SARS-CoV-2,and the disease it causes, COVID-19,is spreading across the globe.And as more cases appear outside of Asia,you're probably starting tohear the word 'pandemic.'- The risk of a globalpandemic is very much upon us.- [Reporter] Global pandemic.- Could become a pandemic.- [Reporter] With thepotential to become a pandemic.- Let's unpack whatthat word actually meansand how you can protectyourself going forward.[light ambient music]So, what is a pandemic?Simply put, a pandemic is adisease that spreads globally,crossing international boundariesand affecting a large number of people.To put that in context,here are a few other helpful definitions.So, firstly, we have thisdefinition of an endemic disease.That means a disease that's occurringat a steady, predictable rate.Then you have outbreak,which means a diseasethat's spreading well aboveand beyond endemic levels.An epidemic, on the other hand,is an outbreak that's spreadto a large geographical area.Keep in mind that one diseasecan change status over time.Now, going back to the P-word,the classical definition of a pandemicdoesn't say anything atall about disease severity.It's really all focusedon geographic scale.So far, the World Health Organizationhasn't referred to this as a pandemic--- Our message continues to bethat this virus has pandemic potential.- Although many epidemiologists,myself included, are treating it as one.The spread of this new virus, SARS-CoV-2,is likely past the point of containment,and that's the first thing you try to dowith a potential pandemic.It's what China was trying todo with massive quarantines,the likes of whichwe've never seen before.But once you're past thatpoint of containment,you need to quicklypivot to another focus.Instead of trying to stop a diseasethat's already spread tomany different countries,you need to focus on slowingthe spread of infection.To do this, you have to properly isolatepeople who are infectedand try and quickly developtreatments and vaccines.It looks at least sofar with this new virusthat the death rate is a lot lowerthan other severe coronaviruses.That doesn't mean manypeople haven't died.We've seen thousands of deaths.But the overall death rateis closer to around 3%for this new virus,whereas the death ratefor SARS was around 10%,and for MERS the death rate was over 30%.Now, just because this new virusdoesn't seem to have as high a death rate,it doesn't mean that weshouldn't have a plan.So, how do we protect ourselves right now?I know this sounds really pedestrian,but trust me, one of thebest pieces of adviceis to wash your hands withsoap and water regularly,have good cough hygiene,so cough into your elbow,cough into a tissueand then throw it away,and also get your flu shot.I know people are kinda overhearing about the flu at thispoint, but the reason I say itis that if you get sick with the flu,it massive increases your riskof getting a second respiratory infectionlike the new coronavirus.Also, you can practice what'sknown as social distancing.That means simply limitingyour exposure to other peopleby working at home, for example,or if you're in public,maintaining a distanceof three to six feetbetween you and others.I'm getting a ton of questionsabout masks, understandably.So, here's what you need to know.You need to wear a maskif you have symptomsof respiratory disease,symptoms like coughing,or if you're lookingafter people who are sickand have those symptoms.You also need to know howto properly use a maskand be aware of thingslike once a mask is moist,it's not as effectiveand needs to be replaced.Wearing a mask without full knowledgeof when and how to wearit can be dangerousbecause it gives peoplea false sense of securityabout how protected they really are.If you do need a mask,health authorities recommenda regular surgical maskbecause that preventsdroplets from other peoplecoming into contact withyour mouth and nose.And if you have symptoms,it prevents those dropletsfrom you reaching others.An N95 mask is recommendedfor healthcare workerscaring for sick people whenthey're doing proceduresthat bring more fluid upfrom inside a person's lungs.That's more dangerous,so that's why an N95 mask is recommended.Bear in mind that with masks,it's not one-size-fits-all.You wanna make sure thata mask you're wearingreally is right for youand really is working.One way to do this,ideally you get fit-tested,but also when you put an N95 mask on,you can do a seal testwhere you breathe hardand you feel to see whether any airis escaping around it or not.A question I get asked a lotis should you wear a mask ifyou don't have any symptomsjust to be really, really safe.The answer I normally give is nobecause if you wear a mask unnecessarilyor you stock up on a ton of them,you're just contributingto the mask shortagesthat we're already seeingand taking away resources frompeople who truly need them.So, for now, take advicefrom what your local healthofficials are saying.I think what history tells usis that pandemics areinevitable and to be expected,and that's why we really needsolid pandemic preparednessplans at national levelsand also at family and community levels.To understand just whatpandemics are capable of,let's look at a fewexamples from human history,starting with perhaps themost infamous pandemic,the Black Death or the bubonic plague.Now, this pandemic got itsname from its symptoms,specifically lymph nodes thatbecame blackened and swollenafter bacteria entered through the skin.Lovely, I know.Now, this isn't the firstpandemic, by any means,but it's certainly one of the deadliest.It lasted from around 1346 to 1353and resulted in the deathsof somewhere between 75 million peopleup to 200 million people.It's mostly associated with Europe,but it's thought tohave originated in Asiaand then spread across that continent,as well as possibly Africa.There are a few theoriesabout how the disease spread to humans.Some scientists say itcould've spread to usdirectly from rats.Others say there's some evidencethat it was actually spread byfleas that lived on gerbils.Let's fast-forward to 1918,and here we run into theSpanish Flu pandemic,which infected one in threehumans alive at the timeand killed about 50 million globally.It's only called Spanishbecause Spain was notinvolved in World War Iand it was neutral.Therefore, it did nothave news censorship.So, when this outbreak arrived in Spain,that's when it got press coverage,whereas in France and other countriesit was not mentioned in newspapers at all.The Spanish Flu killed really quickly.There were approximately 25 million deathsin just the first five or six months.Part of the reason for that thoughprobably had to do a lotwith poor living conditionsat the time and the fact thatflu makes you susceptiblefor other infections likebacterial chest infections,and back then there were no antibiotics.And unlike what we're seeing today,where it seems that older peopleare more vulnerable todeath from COVID-19,at least based on preliminary data,Spanish Flu was different.It was wiping out youngand healthy adults.Then there's the HIV/AIDS pandemic.HIV quickly spread fromCentral and Western Africato every continent on theplanet in the early-1980sand it's killed morethan 30 million peoplearound the world.It's also the first pandemicfor which there's been global activismand the very rapiddevelopment of treatments.It went through the whole spectrum,from being an outbreak toan epidemic to a pandemic,and now many people saywe can call HIV endemicin some parts of the world.Thanks to advances in medical technologyand the AIDS activists,HIV should be a chronicmanageable conditionthat you live with your whole life,although ideally we'd have avaccine and a cure for HIV.Next, we have the SARS pandemic,which went from 2002 to 2003and was also caused by a coronavirus.Remember, that's awhole family of viruses,including four coronavirusesthat cause the common cold,as well as this new coronavirusthat causes COVID-19.SARS likely jumped fromcivet cats to humans in Chinaand then spread to otherparts of the world.Back in 2002, Chineseofficials had a delayin sharing data about SARS.And in the response, theWorld Health Organizationupdated the internationalhealth regulations,basically to compel all 194 member-statesto get their act togetherand meet specific standardsfor detecting, reporting,and responding to outbreaks.These new plans for a morecoordinated global responseto pandemics came into effectwith the 2009 Swine Flu pandemic,which was caused by a new H1N1 flu virusand killed between 150,000 toaround half-a-million people.It spread really widely.It was seen in both Northernand Southern Hemispheresbetween April and September of 2009,which means it also spreadoutside of the normal flu seasons.We've learned from previous pandemicsthat people can either dayfrom the disease at handor develop immunity to that disease.And that means that as thedisease continues to circulate,it won't have that same devastating impactthat it did the first time around.One example of this is the H1N1 virusthat caused the 2009 flu pandemic.That virus is now a common flu virusthat circulates worldwide, butit doesn't cause a pandemic.So, how does a pandemic end?Virologists estimate that this new viruswill likely stay in Chinaand continue to seed othercountries and the worlduntil maybe it just becomes as commonas the other four coronavirusesthat cause the mild common cold.Some people are even starting to call itthe fifth coronavirus, somaybe that will be its story.It goes from COVID-19, whichcaused this terrible situation,to the fifth regularcoronavirus causing the cold.Some virologists even predictthat maybe 40% to 70% ofadults around the worldwill become infected with the new virusbefore this is all over.But many scientists still saythe vast majority ofthose who become infectedare more likely to have amilder version of the disease.What we have on our sideversus those poor peoplefacing the Black Death, for example,is we have the capacityto more quickly developtreatments and vaccines.A COVID-19 vaccinecandidate could be readyfor early phases ofsafety testing in April.And if that goes well, testing could beginto see if the vaccineactually prevents diseaseby the late summer.But, reality check,it would still be 18months at least after thatthat any vaccine wouldprobably be available.So, yes, you'll behearing the P-word a lot,but remember, definitions of pandemicfocus on geographic spreadand do not focus on severity of a disease.

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