A new coronavirus has received considerable attention in the
past week. The virus has only been
identified in less than 20 people so far, but of the first dozen in Saudi
Arabia, half died and the remainder had significant morbidity. Now a report from the UK highlights relative
ease of infection upon exposure UK
coronavirus study.
Whether it is the fun or the fear that emerging pathogens
represent, they are one of the reasons why public health professionals have an
assured degree of employment. Germs
survive by adapting to their environment.
Selective propagation favours those germs that can readily move to new
environments and hosts, can thrive and multiply on their hosts, and are less
likely to cause the host to die.
Highly mobile hosts facilitate dissemination and spread of
such germs. Humans have modified the
natural ecology by condensing global travel times to hours from days and weeks
– hence broad dissemination of novel and emerging pathogens becomes a real risk
of our technological advances. (the second of the main reasons why public
health has an assured future – new technology).
The major point of this discussion is what are the
appropriate actions in preparation? We
have multiple jurisdictions who are redundantly closely observing this and
other emerging pathogens. Their
perceptions tend to be comparable, but occasionally interpretations differ and
one jurisdictions/organization/society acts autonomously leading to a
“spiralling” of responses. Trimming
some of the duplicity might lead to greater efficiency, more focused response
and better coordination (contrast the Canadian and American responses to pH1N1
for a study in efficiency, and no, Canada’s performance was not the more
stellar)
The augmenting “spiral” response is rather than retaining
logical sense based on evidence, global recommendations for something like surgical
masks as respiratory protection, become N35 respirators in some centres, and
then specific professions adopt even higher protection like self contained
breathing apparatus. Professional
demands for equity drive responses to the highest common denominator, not the
most efficient.
The lack of evidence often drives up the precautionary
response, compounded by the inevitable changing understanding of the science
which conveys a message of distrust and fuels public and professional
hysteria.
Let us hope that this coronavirus quietly disperses faster
than its cousin that prompted the SARS scare.
Conversely, we need to be prepared to grapple with a range of moderate
to severe pathogen outcomes and current public health infrastructure in North
America has probably slipped below the needed surge response capacity, in part
in an effort to reduce duplicity because we have this tendency to want to do
things within jurisdictions and not trust our national or international leadership
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