Invisible enemies confront us

More than 15% of the world's population is stricken with a contagious and virulent infectious disease. At least 2% of those infected die. In a matter of months more than 20 million catch the disease and close to 500,000 die. In countries like Australia and New Zealand more than 15% of the population are ill and for a number of months life virtually grinds to a halt.

Businesses, factories, shops and schools are all closed down. Hospitals are over-run and community halls, schools and race courses converted into temporary hospitals. People are ordered to wear masks in public and to avoid crowds. People also go out of their way to avoid "strangers" and shun conventional medicines, seek out popular cures and secrete themselves away in their homes avoiding contact with their neighbours.

Cities and suburbs seem strangely quiet and few buses, trams and cars rarely seen. Strict quarantine is imposed on all international arrivals and state borders formally closed. Bitter disputes emerge between local, state and national governments as to how best to confront the epidemic.

This grim scenario may seem fanciful but it is actually what has happened a number of times over the last 200 years and may well reoccur if not with the coronavirus that is currently sweeping through China, then with some other severe infectious disease which we are sure to experience over the next two decades.

The current outbreak of coronavirus has focused world attention on the possibility of a pandemic spreading all around our world with the number of cases increasing every day. So far there have been more than 28,000 cases and 565 deaths, the majority in China. In addition cases have now been discovered in at least 23 other countries.

Many countries have now suspended flights to China and rushed to get their citizens out. Australia has quarantined about 300 evacuees on Christmas Island, Britain dozens of people at a hospital in NW England and the USA has house almost 200 evacuees in a Reserve Air Force Base in California. In China close to 60 million people remain in lockdown.

With coronavirus what we are currently witnessing is not one epidemic but two. The first is an epidemiological epidemic or an epidemic of cases and deaths. The second is an epidemic of human behaviour marked by fear, hysteria and panic which in time threatens to overwhelm the epidemic of cases and deaths. In all of this governments and the media play an important part.

SARS and earlier pandemics like Plague and Polio indicate to what extent epidemics can disrupt normal life and produce a crisis of confidence. What we need to better understand is how people handle fear in their lives and particularly the deep-seated fear they have about infectious disease, contagion and exposure. As well, we have always expressed doubt about official government policies of isolation and quarantine leading to a widespread belief that Governments cannot really protect us during epidemic crises.

There is nothing new about the link between human movement and the spread of infectious disease. In many ways the history of infectious disease in Australia and New Zealand is the history of human migration and movement. Over the last two decades the enormous growth of the numbers of people who daily cross international borders and the rapidity of their travel has transformed the migration scene and the spread of infectious disease.

Today roughly 700 million people cross international borders every year, most by air, and there has been a dramatic increase in the movement of refugees, foreign students and military personnel around the world. In a time of such population movement infectious disease agents are easily transported across national and international borders, in people, their baggage, in animals and food stuffs as well as in the bilge water of ships.

The Coronavirus which threatens us at the moment is a contagious viral disease apparently nurtured among wildlife in natural disease reservoirs and this has most probably been the case for centuries. It is only when humans disturb or intrude on such reservoirs that they run the risk of infection. If nothing else this current outbreak reveals that humans and the microbial world are locked in an ever escalating battle and that despite our immune system and our ability to develop new drugs the microbial world always seems to mutate, adapt and change to threaten us.

Critically we continue to under estimate the importance of the biophysical environment and in particular the relationship between animal and human health. We also continue to believe that we are the dominant species in the world. Nothing could be further from the truth. The microbial world possesses the ability to adapt and change in response to anything we might level at it.