What has COVID taught us in the last eight months ? One lesson is that the fear is deadlier than the disease

It was (it still is) an unprecedented public health crisis. It started as a small outbreak in Dec 2019 (though similar cases did occur in Nov) and in no time it became a global concern. It spread fast.

Misinformation and rumours spread faster. Fear of this deadly disease was deadlier. Misinformation and rumours started replacing truth with stories. The power of social media, in no time created an Infodemic. By January end, the world was on a oneway street to panic and despair.

The panic-stricken world seemed to be staring directly into a certain human extinction. City after city in Europe and North America had their health infrastructure overwhelmed. Countries after countries therefore, took recourse to the Chinese model of locking down and by the end of March the world was locked down.

Sweden was an odd country out, relying on what has been a time-tested method of infectious disease control- testing, treating and isolating till development of herd immunity or vaccine. It allowed children to go to school, kept public transport and restaurants and gyms open. April through June, the pandemic razed and the critics bayed for the blood of Anders Tegnell, Sweden’s chief epidemiologist.

Its death numbers per million population were comparable to rest of Europe but significantly higher than neighbouring Denmark and Norway. By August however, the situation was firmly in control. While all European nations (including Denmark and Norway) saw a second surge in deaths September onwards, Sweden has seen no such trend and the death curve remained essentially flat.

Brazil was another country where the leader was a staunch lockdown antagonist. The entire world was aghast as he rode an open truck, mockingly coughing and cheering the crowd. The disease surged taking its toll to alarming numbers. Argentina and Peru were the neighbours to contrast who followed the world and imposed lockdowns. Up to June and mid-July, it appeared that Brazilians were paying with their life the price for his folly. Now, as on 26 Oct, the numbers speak a different story though. Per million deaths in Brazil (738) with the curve almost flattening compare favourably to Peru(1031), or Chile (727)or Argentina (637) where the disease is still razing.

Back home, when one of the harshest lockdowns was clamped, neighbouring Pakistan openly declared its economic compulsions against a strict lock down. As the stringent Indian lockdown was eased in June, the number of cases surged till its peak on September 15 when it started coming down. As the tally card reads now, deaths per million population in India stand out at 86 compared to 30 for Pakistan, 35 for Bangladesh and 25 for Nepal.

Island countries like Australia and New Zealand, shut themselves up completely and together with disease control measures in their small communities, achieved an effective early control only to witness an upswing as the guard was lowered.

So, what have we learnt about the pandemic so far?

1 Lockdowns do not work: : Looking at the numbers in geographical pockets it is obvious that the disease has an almost predictable curve. From the point of geometrical progression (read community transmission) it takes a certain time (depending on the geographical spread and population density) before it peaks and then declines. Larger spread out countries take longer time whereas smaller ones took less time. Even in a seemingly uncontrolled USA, individual cities and states had the peak and decline that was no different from the rest.

2 Numbers peak and then decline: We did see the number of new cases rise (The second wave) and in certain countries the numbers far exceeded the first wave. As we braced for a dreaded rerun on cemeteries and crematoria, to every one’s relief, that does not seem to be happening. The proportion of serious cases needing critical care support and consequent deaths remains low. This has been observed all over.The obvious explanation is development of immunity. Behind every tested and detected case there are scores of undetected individuals who contract a subclinical (asymptomatic) infection that results in development of protective antibodies conferring immunity. Over a period of some weeks the antibody levels come down, the immune function taken over by T cells (a subtype of lymphocytes).

Though we do have sceptics who do not subscribe to development of herd immunity.

3 There is development of immunity with infection: With the world gripped in helplessness, the scientific community with support of industry worked overtime to discover or invent a cure and a vaccineand a profit oriented pharmaceutical industry rushedto market drugs to be used prematurely.

Hydroxychloroquin was the first, followed by Doxycycline, Remdesivir, plasma therapy, Ivermectin and several others. They were hailed as magic bullets only to be consigned to the scrapheap of misplaced hope.

4 It is good to wait till froth settles: Political leaders declared effectiveness of treatment with scientists kowtowing, watchdog institutions like WHO and FDA made questionable announcements, governments paid no heed to experts of eminence and relied more on eminence of experts who had no expertise in virology and epidemiology.

5 Trust Science but not blindly: COVID is an abbreviation of Coronavirus induced ‘disease’. Disease word rightly is Dis-ease, meaning a lack of ease or being unwell.

Since an overwhelming majority (more than 90% of those who are counted as cases of COVID do not develop any dis-ease; it is therefore all about the result of a test called RT- PCR, a positive report implies infection by the virus.Thus, as on date, out of 43 million recorded cases, nearly 38 million cases actually did not develop any symptoms at all.

While being observed as a positive case, any symptom they developed has been attributed to the virus. There is a running joke in the medical fraternity now which holds, “other than pregnancy and fracture Corona virus can cause anything.”

What remains intriguing is why certain geographical regions have suffered more than others? If we go by the count of death per million for comparison, in south American countries the figures are in excess of seven hundred, in Western Europe between five to seven hundred (except Spain where it is higher) and in the Indian subcontinent- in spite of a less developed medical infrastructureless than a hundred.

Within India the figures for states like Maharashtra are much higher than that of the Bimaru states. Various theories have been put forward like innate immunity, cross immunity with tuberculosis and Malaria, level of hygiene and sanitation (in an inverse relation) etc.

The other question begging for an answer is the magnitude of mental agony. While certain numbers got infected, suffered and died, there were far more serious psychological consequences consequent to lockdown that tantamount to a non-judicial incarceration besides the agony of loss of livelihood and income.

While a rough data will be compiled of suicides and divorces, it is well known that behind every suicide there are hundreds of those who pulled back from the brink. Similarly, there are divorces and marital discords which do not end in divorce.

The numbers who suffered from depression will never be known. Death and physical illness may be easy to count, but such an exercise for mental suffering is almost impossible. The numbers of those whose world will never be the same again will never be known.

Like all bad times, this too shall pass. At the end of all this when the world, nations, governments and the societies will sit to take a stock, there will be good decisions to cite and the bad ones to lament.

There will certainly be a long queue for accolades and bouquets by credit seeking heroes; while we will also keep looking for villains to be made accountable for the wrongs on the debit side.