S.G.VOMBATKERE | 7 JUNE, 2020
At global centre-stage, “Corona” is one of the most commonly used words worldwide, and the volumes of information and misinformation on it have caused doubts and fears among the public. This article discusses the fear that Coronavirus and Covid-19 have induced in society, and therefore begins with facts.
Viruses and bacteria
(1) Viruses outnumber cellular life at least 10:1, and drive global biogeochemical cycles. They are part of cellular life on Planet Earth.
(2) There are about 220 species of viruses which are known to infect humans, and around 320,000 viruses which infect mammals. Every human is host to millions of viruses – some are beneficial, others can cause disease.
(3) Millions of virus varieties are bacteriophages – they “eat” bacteria. Some bacteria are harmful, but others (e.g., Lactobacillus) are essential for humans to digest food and live.
(4) Every virus mutates, changing its ability to reproduce in its host.
(5) Humans and animals have been exchanging viruses on a day-to-day basis for millennia. We routinely exchange viruses with each other even as we breathe or speak.
(6) Viruses spread – DNA viruses (pox viruses) replicate directly in the host, and RNA viruses like Coronaviruses, attach to the host cells to replicate.
(7) There are several Coronaviruses – we are concerned with SARS-CoV-2 detected in 2019, which causes Covid-19.
Facts and fears
Coronavirus is highly contagious. It can enter the human body only through the mucosa, the membrane lining the inside of nose, mouth and eyes. It cannot enter through the skin of the hands, etc. Coronavirus is contained in tiny droplets when an infected person sneezes, coughs or speaks loudly. If these droplets are inhaled by another person before they fall to the ground or onto door handles, etc., they enter the body through the mucosa of the nose and infect him.
Hence the need for all to wear masks – an infected wearer’s mask prevents spread of infected droplets and an uninfected person’s mask prevents their inhalation. Droplets can remain on, say, a door handle for a short time. If such a surface is touched by hand, Coronavirus can get transferred to the skin of the hand/fingers, where it will be harmless, unless the hand/fingers touches the edges or inside of nose, mouth or eyes which have mucosa. All this is equally true of the common cold virus.
Most Corona-infected persons develop mild-to-moderate symptoms and recover without hospitalization. Many remain asymptomatic. Thus, Coronavirus is not a big killer of humans. There are far bigger killers of humans, as shown by WHO and IHME (Washington). Neglecting those larger causes of deaths and focusing on Corona/Covid-19, fails the test of proportionality.
In the absence of a cure for Covid patients, or a vaccine for populations, the threat of Covid spread necessitated imposing physical distancing between people through a lockdown. It was accompanied by government-initiated, wide-reach advice, instructions and orders to create awareness about Coronavirus and Covid-19, and control its spread. Constant repetition concerning maintaining 1-metre inter-person distance, wearing masks, washing hands (soap-n-water, 20-seconds, etc), hand-sanitizers, sanitizing door handles using chemicals, etc., has resulted in many people getting paranoid about touching anything. Many carry hand-sanitizer bottles around with them, and use them or wash hands dozens of times every day. All this has created fear about contracting Covid-19, and has assumed dimensions of paranoia, when only doctors and health workers on duty need to take such precautions.
Unfortunately, governments were initially quite oblivious or uncaring of the fact that these measures are unaffordable, impractical and impossible for the vast majority rural and urban poor who live and work in congested places and/or have no easy access even to drinking water.
The 4-hours short-notice “social-distancing” lockdown severely impacted the lives and livelihoods of hundreds of millions of rural and urban Indians. It caused panic-purchase of supplies for subsistence. It resulted in unexpected, spontaneous exodus of millions of workers out of urban areas who, together with many more millions of urban and rural poor, were more fearful of hunger and starvation, than about Corona-related disease and death. Fear ruled.
Migrant workers, urban slum dwellers, rural landless, etc. are undergoing the psychological trauma of uncertainty regarding the immediate future for themselves and families. This is accentuated by the physical trauma of hunger and exhaustion, and fear of experiencing demeaning and insulting police violence. Fear, again.
The Covid fear has had social repercussions. People of some Bihar villages refused entry to their own returning migrants, fearing that they bring Covid. Nurses living in paying guest accommodation and working in a hospital in Bengaluru, were forced to vacate by the owner, because he feared infection.
The catchy phrase “war against Corona” prompted Union Health Minister Dr.Harshvardhan to declare that India is doing better compared to other countries on all parameters in its fight against Covid, and we should be able to “win this decisive war” in a few weeks. But the situation has only worsened. Declaring war on Coronavirus has had the unfortunate fallout of increasing Corona-fear among the public.
Without criticizing the “war” phrase, we need to understand that Coronavirus is here to stay, and we will learn to live with it like earlier generations have been living with so many other “killer” viruses and bacteria.
Experts say that in coming months and years, the majority of population will get infected by Coronavirus, and develop immunity to it, helped by an immunization (vaccination) program, and its spread among the population will be limited by “herd immunity”. In the meantime, Covid cure and vaccine will be developed. Thus, people have little to fear if normal precautions are observed just as we do for common cold, and can resume work in accordance with governments’ regulations and directions.
Disease, cure and fear
Humans have begun to “cure” diseases ever since societies neglected the wisdom that the body itself does the “curing”, and that the medicine-doctor combination only assists the natural curative/healing process. (Ayurveda recognizes this). People have always searched for means to reduce or eliminate pain using herbs and other substances or methods. Over millennia, this has extended to avoiding pain and prolonging life. Implicitly, the fear of death as an “unknown” exists in most societies.
Among humans, only societies which we label “primitive” understand death as an event in life. Even people who understand the inevitability of death, either fear death as an unknown, or without fearing death, fear the pain and suffering that can precede death. Either way, it’s about fear.
The healthcare sector
Regarding Corona in particular but life in general, noting that the words “us” or “we” refer to humanity as a whole, and that we discussants are a minuscule minority of India’s 1.3-billion and 7.6-billion humanity,
(1) Most of us are fearful of illness and death, pop pills with or without medical prescription, have routine health checkups, and consult specialist doctors within a health system which manages illness/disease or life-threatening trauma, with little or no focus on health and healthy living,
(2) We attempt to add years to life (statistical longevity) using medication, with little regard to the quality of life, and
(3) Societies and their leaders fail to view social health holistically, in the sense that creating a healthy society will result in individuals enjoying physical, mental, social and emotional health, and that emotional good health will remove fear of death and of dying.
Notwithstanding the present understanding of health or healthcare, the state of the healthcare sector can only be rued. Witness: Public health (protein deficiency, anaemia, malnutrition-underweight-stunting, public hygiene, non-Corona disease, etc.) and public health systems (PHCs, hospital beds, doctor-nurse-medicine-equipment availability, etc.). All this, with parallel but unaffordable multi-specialty corporate hospitals linked with pharmaceutical, diagnostic & therapeutic bio-engineering, medical education, insurance and banking industries. Today, we fear contracting disease by going to a public hospital, and fear expensive treatment in a corporate hospital leading to economic ruin. Yet again, fear.
Overcoming Corona-fear begins with acceptance that Coronavirus is here to stay. Humanity will develop herd immunity and co-exist with it, as it has been doing with other viruses and bacteria over millennia. Of course, we will continue to use available technology to minimize suffering, enhance cures and prevent Coronavirus spread, but that should not divert attention and effort from other issues affecting social health.
A healthy society in which “the mind is without fear” would link people-centric economics with social justice, and peace and harmony within and between societies, and all life on Earth. It would consist of largely self-sufficient, sharing-and-caring, vibrant communities, never lacking food. Inevitable disease and death would not be feared, but also not accepted when it is a result of injustice, inequality or malafides.
Building a healthy society may appear far-fetched, but it is doable, even if time is running out and there is worldwide absence of requisite leadership.
Major General S.G.Vombatkere, VSM, (Retd) focuses on development and strategic issues, using cross-discipline study and systems thinking.