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Vet Advice: Pandemic amnesia

Rarely is there perfect information about emerging disease

Face the North Wind is the compelling true story of cousins Fred Darbyshire and Ed Theriau, two young men from Sturgis, Sask., who ventured 1,000 kilometres north to Wollaston and Cree Lakes by canoe and dog team in search of fur. For 25 winters they survived on bear grease, caribou, fish and tea in the bitter cold of winter, often sleeping outside in a down sleeping bag under a tarp. I knew Ed well and he often talked about the horrible winter of 1919 and the tragedy faced by a band of 17 Chipewyan families at Wollaston Lake. Only six individuals survived the Spanish flu, the rest either dying directly from the deadly virus, or by starvation because they were too ill to hunt.

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When COVID-19 started its rampage across the globe I thought of the evenings spent with Ed in his retirement sipping Scotch, neat. Ed could hardly hold a tumbler with fingers permanently flexed from polling canoes against river rapids, and was barely able to stub another cigarette into ashtrays brimming with butts.

By the summer of 1919 the flu pandemic had started to ebb. The highly virulent H1N1 virus, initially shared between birds, pigs and humans, had started to run its course, but not before millions died (some global estimates range as high as 50 to 100 million), with a fifth of the world’s population sickened. The death toll from H1N1 surpassed total fatalities in both World Wars.

This year is the 100th anniversary of the Spanish flu’s end. I find it striking that the centenary of one of the most devastating events in human history has been allowed to pass thus far with little public reflection of any kind. In the midst of all this is a monumental struggle with the global pandemic of the novel coronavirus which causes COVID-19. Author Laura Spinney writes in her new book, Pale River, which is a modern account of the Spanish flu crisis, that “the flu re-sculpted human populations more radically than anything since the Black Death.”

The world awaits the final outcome of COVID-19 while it assaults humans everywhere in the absence of effective therapeutic drugs, vaccines and sound medical strategies.

I have often said that the real predators of the 21st century will be the microbes, many which emerge unexpectedly from animals, zoonoses that infect humans, mutate, and then gain the capacity to be transmitted between people. At this point, zoonotic disease rides on the back of modern society: global travel, free-wheeling international commerce, and the belief that science and money can compensate for the lifestyle changes modern society imposes on itself.

We forget about the dreadful impact of microbes over time: that humans are transformed immunologically, ecosystems are altered, diets include animal protein we have never eaten before, and lifestyle habits are permanently altered. New viruses fall from the trees we shake.

Emerging disease and novel pathogens, many coming from animals, are pervasive. We cannot live on top of one another and strive to become a part of a global community without becoming prey for new disease. Potential pandemics in both humans and animals will become part of the “new normal” if humans continue to do what we are presently doing. China, with a human population of 1.4 billion, many crowded in cities, continues to represent a potential pandemic generator.

Examples of serious emerging and re-emerging diseases, many on the cusp of becoming potential pandemics (animal and human) in the span of a single lifetime include: reoccurring variants of influenza in humans, chickens and pigs, African swine fever, SARS, Ebola, HIV, Nipah virus, Zika virus, West Nile virus, Chikungunya, dengue, Rift Valley fever, foot-and-mouth disease and Marburg virus.

“Two fundamental characteristics of microbes allow them to circumvent our attempts to control them. Whereas human generations occur approximately every two decades, those of microbes occur in minutes, allowing them to rapidly replicate. Microbes also can mutate with each replication cycle. Their ability to replicate and mutate gives them the advantage of selectively circumventing human interventions, be they antimicrobials, vaccines, or public health measures.” (Robert H. Ebert Memorial Lecture Emerging and Re-emerging Infectious Diseases: The Perpetual Challenge; American Association of Medical Colleges delivered by Dr. Anthony Fauci in 2005.)

Elizabeth Prescott made a series of interesting and important points in her paper The Politics of Disease: Governance and Emerging Infections (2007).

The responsibility for timely and proportional response to infectious disease falls to those with the power to harness the processes.

Co-ordination of activity between national and international actors is a reflection of the capacity to govern.

Failures in governance in the face of infectious disease results in challenges to social cohesion, economic performance and political legitimacy.

Emerging and re-emerging disease are highly variable in pathogenic characteristics and each creates unique political challenges. The history of past outbreaks becomes extremely important.

In the face of figures like 25 per cent unemployment in a country representing the world’s greatest economy and trillions in financial aid, it seems unbelievable that we forget or look away. Yet we do. Perhaps it’s because a disease has no ultimate prize to win and celebrate. In her book, Spinney reflects that war has victors; pandemics leave only the vanquished. Silence about public horrors permits human societies to cope with recovery and progress. Spanish flu has been consigned to the footnotes of history because its onslaught did not occur in public but in private, behind closed doors in millions of homes.

Rarely is there perfect information about emerging disease. Tolerance for uncertainty and trust in the aptitude of public health officials, including both medical and veterinary forces, by political authorities is critical to an appropriate response.

— Dr. Ron Clarke prepares this column on behalf of the Western Canadian Association of Bovine Practitioners. Suggestions for future articles can be sent to Canadian Cattlemen or to the WCABP.

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Dr. Ron Clarke

Dr. Ron Clarke prepares this column on behalf of the Western Canadian Association of Bovine Practitioners. Suggestions for future articles can be sent to Canadian Cattlemen ([email protected]) or WCABP ([email protected]).

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