Daily Times

“History never repeats itself. Man always does,” rightly said, Voltaire. Man is always condemned to repeat it by forgetting the lessons taught through previous experiences be it in the case of waging deadly wars or more recently not learning from the perilous history of pandemics. The same is the case with Coronavirus Disease (COVID-19), which many epidemiologists believe to be progressively similar to the last century’s deadly pandemic of Spanish flu (1918). Even during the past times, social and physical distancing had been suggested as one of the most prominent public health interventions against infectious disease pandemics. It has also proven beneficial for the COVID-19. These restrictive measures have been necessary to slow down the spread of the virus and have already saved tens of thousands of lives. However, they cannot last longer owing to adverse social, psychological, and economic consequences of increased lockdown. Therefore, it is necessary to relax restrictions and reintroduce lockdown measures in phases, not at once; following the “strategic reduction of contact” policy to “keep the curve flat.”

Strategic reduction of contact means allowing some social contact while keeping the risks of transmission very low. As tested in some countries, this new approach is highly effective for effective social distancing that can reduce adverse socio-economic and psychological consequences of complete lockdown and social isolation. Additionally, some form of contact reduction along with relaxed measures is necessary for the longer run, possibly, until a vaccine is developed and widely available to at least 60 per cent of the population, keeping in view the reproduction number (R0 of the SARS-COV-2 virus). However, it is unfortunate that our government is set to announce an early victory against COVID-19 and has ended lockdown in nearly every part of the country. Smart Lockdown has been implemented in some of the areas but it has been also ineffective. It should not be limited to residential areas only but needs to be extended to workplaces, markets, schools, religious places, and in mass gatherings.

Similarity with the second wave of the Spanish Flu 1918

Similarly, the recent reckless attitude of the public towards following SOPS and enjoying post-lockdown celebrations reminds me of the summer of 1918 when the first wave of the deadly Spanish Flu pandemic was over and the number of cases sharply dropped. Considering it to be an end to the pandemic, most of the people in outbreak countries came out of the homes and started celebrating on the streets. However, they did not know that even a small negligence can be life-threatening. Mass gatherings during the celebrations proved perilous and the highly transmissible virus struck again in late August with an even far deadlier form that knew no age and killed everyone, including young, old and all those in the middle; taking the death toll to around 25 to 50 million people with over 500 million cases. The Spanish flu also followed the same path as COVID -19. It started in late winter, peaked in spring and its first wave ended in early June; making people falsely believe that the pandemic was over and the severely affected countries started celebrating and avoiding basic preventive measures like social distancing, etc.

The deadly pathogen reverted in late August and human history is witness to the perils of the 1918 Spanish flu pandemic. Similarly, for COVID-19, the epidemiologists and the health organisations are speculating a seasonal impact of the CoVID-19 transmission. The journal of infectious diseases opines that the virus may have seasonal effects and could go higher in the winter season as human coronavirus and Influenza peak during cold seasons.

It is necessary to relax restrictions and reintroduce lockdown measures; following the “strategic reduction of contact” policy to “keep the curve flat.”

Let us learn from history!

Therefore, it is high time to learn the lessons from the Spanish Flu pandemic and do not let history repeat itself once again. Because we are far away from announcing a complete victory against the mysterious member of Coronaviruses’ family. No one knows how it behaves and it can be far deadlier than Spanish Flu in its second wave. Therefore, it is okay to celebrate the end of the lockdown but simultaneously maintaining social distancing and following preventive measures are necessary. However, in the case of Pakistan, the government has eased down lockdown measures without ensuring standard operating procedures by people at various places. It is all right to relax lockdown during this time, as we cannot afford more lockdown due to the psychological and socioeconomic consequences of the pandemic. But is highly important that the government should be very strict in following SoPs to ensure limited or no transmission of the virus.

Additionally, testing capacities should be increased and healthcare staff should reach to the suspected cases to test more people per day. As per the data shown in NCOC, the daily testing has fallen to 22,000 with a laboratory capacity of over 70,000 tests per day. Those who are positive should be followed up and contact tracing should be properly done to identify the contacts. However, contact tracing seems difficult in the case of Pakistan keeping in view its fragile healthcare system and inadequate surveillance activities in rural areas. To solve this problem, the government should train the polio vaccinators who are about to start the nationwide Polio Vaccination campaign on July 20. They should be equipped with COVID testing tools and they can easily test a high number of suspected cases along with their normative work.

Moreover, as the borders have been opened, it is necessary to strengthen “Point of Entrees” and all people should be tested while going out or coming in. Lastly, the tertiary healthcare system has been strengthened and the hospitals are capable enough to clinically manage CoVID-19 patients. However, infection prevention and control measures are still needed to avoid nosocomial infections.

Therefore, it is necessary to practice preventive measures until the announcement of the vaccine. COVID-19 vaccine is humanity’s only hope to reduce the causalities of the pandemic.

The writer is a Research Fellow at the World Health Organisation Headoffice, Chevening Alumni and former scholar from London School of Hygiene and Tropical Medicine