Posted by: The Probe 9th April 2020
The word pandemic gets thrown around a lot. It seems like every flu season, we see news reports speculating whether it will become a pandemic. The reality is that sooner or later, we are almost certain to experience another devastating pandemic. This is particularly concerning given the recent outbreak of the novel coronavirus, Covid-19, in various countries across the world.
Illnesses have ravaged societies throughout history – in some instances, leading to their outright collapse. The bubonic plague wiped out a third of Europe. The introduction of smallpox and other old world diseases to the Americas resulted in an apocalyptic loss of life, with around 90% of the indigenous population ultimately decimated by the newly introduced pathogens, which led to whole communities and cultures disappearing within a century.[i]
While modern medicine and science afford us greater protection and understanding than our ancestors could dream of, we are far from invulnerable. Our capacity to develop vaccines should, in theory, limit how many will ultimately die from any novel pathogen. However, vaccines take months to years to develop and deploy, giving cold comfort to those at the vanguard of the disease. Our achievements are not making the emergence of infectious diseases any less likely. In fact, even once increased surveillance is taken into account, it has been observed that the rate at which new pathogens emerge is starkly increasing.[ii]
The global population is rapidly approaching 8 billion people. It is estimated that those currently living account for approximately 6% of all the humans who have ever existed.[iii] The majority of people now live in densely populated urban centers. London is well on the way to becoming a megacity, as its population of 9.3 million people already exceeds that of Scotland (5.4 million) and Wales (3.1 million) combined.[iv], [v] Increasing urbanisation is expected to continue, with the UN predicting that within 30 years, 68% of the global population will live in urban areas.[vi] Densely populated regions facilitate transmission events, particularly in crowded areas such as train stations (although extreme crowding can actually stall transmission after a certain point due to individual movement within the group slowing down).[vii] Increasing population density correlates strongly with the emergence of novel pathogens.ii
Furthermore, our cities are more interconnected than ever before. Today, for example, a passenger can travel from Tokyo to London in less than 13 hours. As such, carriers of a novel pathogen can come from anywhere in the world – possibly before symptoms even begin to manifest, although not necessarily before the infected are contagious.
The H1N1 virus has been responsible for two serious pandemics. The Spanish Flu of 1918-1920 famously killed more people than the World War that preceeded it. More recently, there was the swine flu of 2009. While flu kills hundreds of thousands in an average year, many who die are elderly (often from complications).[viii] H1N1 was attention grabbing because it was able to cause severe effects in younger adults and children, including acute respiratory failure in some cases.[ix] Insurance industry models put the risk of a flu pandemic on the scale of the 1918 pandemic annually at between 0.5% to 1%, essentially predicting one event on that scale every hundred years or less.[x]
Our civilisation is further increasing the likelihood of pathogens emerging through how we are shaping our environment. We know that one of the main drivers of disease emergence is when land is repurposed. Clearing land (e.g. rainforest) to make room for agriculture exposes livestock and humans to novel pathogens. While viruses and bacteria jumping species is not a common occurrence, such practises drastically increase the likelihood of it occurring.ii Climate change may also be driving the evolution and spread of diseases, with a warming climate enabling certain vector species like mosquitos to spread beyond their traditional habitats.[xi] Pollution generally has a variety of negative health consequences and in the case of H1N1, both particulate matter and ozone were associated with higher levels of mortality.[xii]
In the event of a pandemic, life cannot just come to a halt. People will keep working, and dentists and other medical professionals will need to perform treatments.
Biosafety procedures and routine decontamination and sterilization are critical to preventing pathogen transmission of all kinds. Healthcare-associated infections are a serious threat to patients at any time, which ultimately emphasises the importance of investing in high quality decontamination solutions that can help minimise the risk of disease transmission.[xiii]
The new Lisa sterilizer from W&H can complete a type B cycle in just 30 minutes and other cycles with a full load in only 13 minutes. While Lisa’s Eco Dry+ technology automatically adapts the drying time to the mass of each load, fully featured traceability options provide excellent documentation and security. The Lisa Mobile App also ensures ultimate ease-of-use, an additional means of backing up data, and real-time cycle monitoring.
Managing a burgeoning pandemic requires a coordinated response from governmental authorities and healthcare providers. However, every epidemic begins somewhere. It takes time for viruses and bacteria to achieve sustainable human-to-human transmission. Everyone has a part to play in preventing infections from spreading. By following proper disinfection and sterilisation protocols with suitable equipment, dental professionals can prevent unnecessary transmissions of infections of all sorts.
[i] Koch A., Brierley C., Maslin M., Lewis S. Earth system impacts of the European arrival and Great Dying in the Americas after 1492. Quaternary Science Reviews. 2019; 207: 13-36. https://doi.org/10.1016/j.quascirev.2018.12.004 January 31, 2020.
[ii] Morse S., Mazet J., Woolhouse M., Parrish C., Carroll D., Karesh W., Zambrana-Torrelio C., Lipkin W., Daszak P. Prediction and prevention of the next pandemic zoonosis. Lancet. 2012; 380(9857): 1956-1965. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712877/ January 31, 2020.
[iv] World Population Review. London population. World Population Review. 2019. http://worldpopulationreview.com/world-cities/london-population/ January 31, 2020.
[v] ONS. Population estimates. Office of National Statistics. 2019. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates January 31, 2020.
[vi] UN. 68% of the world population projected to live in urban areas by 2050 says UN. United Nations. 2018. https://www.un.org/development/desa/en/news/population/2018-revision-of-world-urbanization-prospects.html January 31, 2020.
[vii] Hu H., Nigmatulina K., Eckhoff P. The scaling of contact rates with population density for the infectious disease models. Mathematical Biosciences. 2013; 244(2): 125-134. https://www.sciencedirect.com/science/article/pii/S0025556413001235 January 31, 2020.
[viii] WHO. Influenza (seasonal). World Health Organization. 2018. https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) January 31, 2020.
[ix] Lee R., Phillips C., Faix D. Seasonal influenza vaccine impact on pandemic H1N1 vaccine efficacy. Clinial Infectious Diseases. 2019; 68(11): 1839-1846. https://academic.oup.com/cid/article/68/11/1839/5104116 January 31, 2020.
[x] Fan V., Jamison D., Summers L. Pandemic risk: how large are the expected losses? Bulletin of the World Health Organisation. 2018; 96: 129-134. https://www.who.int/bulletin/volumes/96/2/17-199588.pdf January 31, 2020.
[xi] Brooks D., Boeger W. Climate change and emerging infectious diseases: evolutionary complexity in action. Current Opinion in Systems Biology. 2019; 13: 75-81. https://www.sciencedirect.com/science/article/pii/S2452310018300957 January 31, 2020.
[xii] Morales K., Paget J., Spreeuwenberg P. Possible explanations for why some countries were harder hit by the pandemic influenza virus in 2009 – a global mortality impact modelling study. BMC Infectious Diseases. 2017; 17: 642. https://link.springer.com/article/10.1186/s12879-017-2730-0 January 31, 2020.
[xiii] Laheij A., Kistler J., Belibasakis G., Välimaa H., de Soet J. Healthcare-associated vieal and bacterial infections in dentistry. Journal of Oral Microbiology. 2012; 4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375115/ January 31, 2020.
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