Annals of Clinical Cardiology

EDITORIAL
Year
: 2021  |  Volume : 3  |  Issue : 1  |  Page : 1--2

When will this pandemic end?


Govindan Vijayaraghavan 
 Department of Cardiology, KIMSHEALTH, Trivandrum, Kerala, India

Correspondence Address:
Govindan Vijayaraghavan
Department of Cardiology, KIMSHEALTH, Trivandrum - 695 029, Kerala
India




How to cite this article:
Vijayaraghavan G. When will this pandemic end?.Ann Clin Cardiol 2021;3:1-2


How to cite this URL:
Vijayaraghavan G. When will this pandemic end?. Ann Clin Cardiol [serial online] 2021 [cited 2021 Sep 27 ];3:1-2
Available from: http://www.onlineacc.org/text.asp?2021/3/1/1/319498


Full Text



History repeats.

There is a lot to learn from history to avoid mistakes. History of wars is taught in detail in all the military schools so that they can plan future strategies. To answer the question when this pandemic will end, it is pertinent to see what happened during the Spanish flu which had taken the lives of millions all across the world and affected 500 million people all over the world in 1918 and 1919. The flu in 1918 had killed many people in the United States who were in their fruitful years of life, and consequently, it cut down the average life expectancy in the US by 12 years. The H1N1 strain that gave rise to the Spanish flu withdrew into the background and continued as a seasonal flu. There were three distinct waves of the pandemic in 1918. It started at the peak of the world war in the spring and became deadly during the fall, killing many civilians and military personnel in Europe and America.

The Spanish flu started as a bird flu having an entirely new viral strain that transmitted to humans soon before 1918. The first ones to isolate and sequence the genome of the flu virus were Jeffrey Taubenberger and his team in the late 1990s. They extracted the viral RNA from postmortem samples of the lung from American soldiers died in 1918, and another from a lung preserved in Alaskan permafrost for nearly 100 years. Laboratory tests of the reconstructed 1918 virus show that in its original form, the virus novel-encoded proteins had made it 100 times more lethal in mice than today's seasonal flu.

Fifty to hundred million of people were killed by the Spanish flu between 1918 and 1919, tens of millions were killed because of seasonal flus and various pandemic outbreaks and all these deaths can be attributed to the single and accidental emergence of the 1918 virus. One branch of the 1918 virus indelibly migrated to pigs and evolved into swine flu that was seen in pigs every year in the US, and after 1918, it spread worldwide. If an animal has been Infected with two various influenza viruses simultaneously, for example, one from a bird and another from humans, these two genes of the 1918 flu (H1NI virus), exchanges genes with another bird flu becoming H2N2 pandemic, which has claimed a million lives across the world. We still have remnants of the 1917 flu pandemic and its variants which are supposed to have caused the 2020 pandemic, with lots of differences in its microbiology, presentations, and complications which has baffled the scientific community. We should not forget the altered versions of the same flu in the winters of 1919–1920 and 1920–1921, but they were far less deadly, similar to the seasonal flu. The combination of 1918 flu with bird flu or swine flu gave birth to a powerful new pandemic strain, which affected us in 1957, 1968, and 2009.

A new virus with the potential of high transmissibility among humans was reported in December 2019 from Wuhan in China. The WHO issued two alerts in December 2019 and January 2020 and declared the viral infection as public health emergency of international concern. Later the International Committee of Taxonomy of Viruses named this virus severe acute respiratory syndrome (SARS)-CoV-2 on the basis of the phylogenetic relationship of the coronavirus that had led to the SARS outbreak in 2003. This virus was named the COVID-19 following the guidelines of the World Organization for Animal Health and the Food and Agricultural Organization of the United Nations. This virus created a rude shock for the whole world by December 2019. More people were affected in more than 210 countries, causing more than 2 million deaths and are still raging on. From the very beginning, warnings were issued that human-to-human transmission of SARS-CoV-2 could result in a pandemic-like situation. The high infectivity, droplet mode of transmission, the long incubation period as well as the long viral shedding period, along with the quick transmissibility pattern globally traumatised most of the countries. Human behavior did affect the pattern of involvement and control of the disease. Educated and intelligent individuals stick on to COVID-19 precautions such as physical distancing, hand washing, and mask-wearing. However, the public at large are not adequately concerned in these measures or in frequenting crowded places. Maskless crowds and group gatherings always resulted in outbreaks and strict lockdowns were required in many places against public opposition.

Will the coronavirus go away in the summer? People felt that the initial caution and care resulted in the reduction of number of patients and mortality. Regrettably, a significant increase of COVID-19 cases in summer months in the US made it clear that we were in for a second wave of the disease. Other respiratory illnesses, such as colds and influenza (flu), are very common in the colder months. With the onset of the fall, we saw a dramatic increase in COVID-19 across the U.S. In colder months, people tend to congregate indoors and it work as a risk for further transmission of the virus. In India, state elections and the once in 12 years religious festival Kumbhamela resulted in unprecedented crowding with a spike that we never anticipated with mortality of patients in the younger group which shocked the nation. Now India is tightening up the restrictions and imposing lockdown in many states which has paralysed the country with the hope that the second wave may not last long. What is still troubling most of the workers is the inability to predict the end of this pandemic. Will it slowly become less infectious and lethal. Or do we have to face a third wave of infection? The aggressive vaccination drive in many countries like U.S.A, Israel, and the many European countries and the development of herd immunity may help us to control the pandemic. The herd immunity is a farfetched idea where 70% of the population should develop immunity by disease or vaccination. Mass vaccination is the only answer, and in many countries, this could be achieved in the near future. However, when this could be achieved and the pandemic will become a seasonal illness preventable by annual vaccination is becoming a distant dream!