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Opinion | The Wuhan virus at our doorstep? Plagued, again

It’s clear that the virus emerged after its likely host animal, the bat, was displaced from its ecological niche. The prevention of such outbreaks from time to time must focus on letting other creatures retain their habitats. (Photo: Ruters)Premium
It’s clear that the virus emerged after its likely host animal, the bat, was displaced from its ecological niche. The prevention of such outbreaks from time to time must focus on letting other creatures retain their habitats. (Photo: Ruters)

In the 1500s, the response to plague was meta-magical. In 1896, it was preventive. Now, for the 2019-nCoV, it should be pre-emptive and anticipatory

By now, the facts are common knowledge. The question is: Will it get me?

I speak, of course, of 2019-nCoV, the Wuhan plague. I use the last word advisedly. Messages ping metronomically to tell me what I should do in case somebody sneezes near me and how to prevent the virus dripping down to my lungs. Mumbai is 2,700 miles away from Wuhan, but people have bought surgical masks by the kilo. Googling what kind of mask can protect you gets 86,600,000 results in 0.57 seconds.

The Wuhan disease, not yet a pandemic, is already a plague. In quiet times, plague is a specific disease caused by Yersinia pestis. However, when a disease explodes into being, kills instantly and rampages across continents, rational definitions fail. It becomes a plague.

In 2020, our view of this latest plague is still medieval European, despite the brilliant, near-magical science that has put a face on the virus and even sequenced its genome. The WHO advisory is no different from what any small European village might have enforced during the Black Death. Two words—avoid and isolate.

Wuhan is under lockdown.

In that European village, conditions were pretty similar. Quarantine was imposed. The sick were isolated, with or without caregivers. Then, supplies ran out. Things spiralled out of control. Sickness decimated the village. Borders were breached, fugitives trapped and punished.

Closer to our time, in my own city, look what happened in 1896, when plague was considered incurable—just as viral diseases are today. Control measures were exemplary. Citizens were urged to report signs of illness. They were forcibly and publicly examined for signs of plague. Soldiers broke into homes to detect concealed cases. They fragmented the population at gunpoint, divided them initially by location, then by community and religion into plague camps. Mumbai was isolated by land and sea. It was, even by 21st century standards, a most scrupulously enforced quarantine.

Did this prevent the spread of plague? No. It went on to become a pandemic. Within the quarantined city, corpses choked the streets. Those plague camps became the model for detention camps in the Boer War and, soon after, the concentration camps of Nazi Germany.

In 1896, the bacterium of plague had just been isolated, the first vaccine was being tried out, and a curative serum was feverishly sought. A few months into the outbreak, the science was already accomplished.

In Wuhan, the first 2019-nCoV patient was seen on 12 December 2019. By 3 February, there were 20,438 confirmed infections, with 420 dead. The genome of the infecting virus, read early on, shows it’s a close relation of the Severe Acute Respiratory Syndrome (SARS) virus and matches a similar strain in bats.

In 1896, the term zoonosis was rarely used. The host-vector-human chain of transmission of plague was only established in 1898 by Paul-Louis Simond. Today, more than 60% of communicable diseases are zoonoses. Zika fever was thought negligible for 70 years when—bam!—it manifested as the horrific Zika Congenital Syndrome.

In 2002, SARS emerged in Fóshān City, Gangzhou Province, China, and over the next year spread through 20 countries. More than 8,000 people suffered. SARS had a fatality rate of 9.6%. The first victims were animal handlers in the Gangzhou market. The SARS virus was identified in 2003, and the palm civet cat, common merchandise in that market, was pinned down as the host. Two years later, Chinese horseshoe bats were found to carry the virus.

Bats are now regarded as the reservoir host, both for SARS and for MERS-CoV, which emerged in Saudi Arabia in 2012. The intermediary host for MERS-CoV is the camel. Whatever the intermediate host animal for Wuhan’s 2019-nCoV, its likeliest reservoir host is the bat.

It is beyond question that this epidemic, like SARS and MERS-CoV, emerged when the virus was displaced from its ecological niche. When the bat habitat is threatened, the virus switches to a new host. From this intermediary host, it infects human beings. Keeping the bat secure in its habitat is the logical solution to blocking this disease.

In the 1500s, the response to plague was meta-magical. In 1896, it was preventive, inaugurating the century of vaccines. In 2020, it should be pre-emptive and anticipatory. Surveillance should focus on sensitive ecologies. All encroachment should be actively resisted. Crowded markets, like one in my neighbourhood, that sell seafood, live chicken and freshly butchered meat are crucibles for zoonoses. The caves in the hills around me are thick with bats, and these are fast disappearing.

Illness is a private experience. It shrinks the world. Wuhan is at every doorstep now. Our response should be dictated by that experience and not by public policy. We cannot protect ourselves from 2019-nCoV by avoiding and isolating China. Why not be pre-emptive and start right here instead? Give the bat a thought. Stop a hill from being blasted. Don’t cut down that tree.

Ishrat Syed and Kalpana Swaminathan are surgeons who write together as Kalpish Ratna. They are the authors of ‘The Secret Life Of Zika Virus’ and ‘Synapse’

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