Why flu is nothing to sneeze at

Topics Coronavirus | Ebola

Super-spreader is a term that gained notoriety and panicked currency during the 2002-04 severe acute respiratory syndrome (SARS) outbreak largely in Hong Kong, neighbouring Guangdong, and Vietnam.


Later determined to have originated from bats, this virulent “zoonotic” coronavirus was a chilling manifestation of a transmission from animals to humans with unknown consequences. Bats have been the prime culprits in a number of zoonosis events from Nipah and the haemorrhagic Ebola to Hendra (in horses), rabies and SARS.


As the Wuhan novel coronavirus — termed Covid-19 by the World Health Organisation — burned out of control in China’s Hubei province inviting draconian quarantines, travel advisories, and travel bans (for China and later Iran, Lombardy and other emerging hotspots as the virus seeped into Europe and even Brazil), the attention of health experts once again turned to bats and super-spreaders. While Italy reeled, by early March San Francisco had declared a state of emergency and New Delhi had seen its first coronavirus case.


The first recorded SARS super-spreader is believed to have been Zhou Zuofeng who was brought to a Guangzhou hospital, on January 30, 2003. He rapidly passed on the infection to over 30 caregivers and medical professionals. One of those, a Dr Liu, arrived in Hong Kong for a family event and booked into room 911 of the soon-to-be-ostracised Metropole Hotel at 75 Waterloo Road (the hotel was later renamed Metropark Kowloon and Room 911 disappeared without a trace).


The hapless Dr Liu was determined to have been the cause of as many as 80 per cent of the subsequent Hong Kong SARS cases. From that ill-fated ninth floor the virus travelled with speed and stealth to Hanoi, Toronto and Singapore.


This issue of super-spreaders was troublingly evident again when an explosive South Korean coronavirus outbreak was traced to the reclusive Shincheonji Church of Jesus in Daegu. The locus of the outbreak was determined to be a 61-year-old woman who was estimated to be responsible for over 450 infections.


Armed with the knowledge of SARS and ignorance surrounding the latest zoonotic breakout, reactions have ranged from pragmatic (washing hands regularly) to the bizarre (imbibing rassam, a spicy south Indian lentil stew to kill the virus). What is evident is that the stable doors have been closed after the horse has bolted. The virus is on the loose, a vaccine is at least a year away, genomic mutations may occur, and initial research suggests Covid-19 may not burn out like SARS.


It is very likely Covid-19 (earlier known as 2019-nCoV) will become en­demic and join the four main coronaviruses currently in circulation that account for as much as 25 per cent of colds. While a small percentage of sufferers may develop serious respiratory issues like pneumonia, the new menace appears relatively benign and so­mewhat manageable with vaccines, education, and healthy habits. As with seasonal flu that thrives in cold dry co­nditions, this new strain may subside during hot, humid, summer months, offering respite for researchers and exhausted frontline health care workers.


Some facts on the novel coronavirus: Thus far while total infections are hard to assess, Covid-19 has had a fatality rate of 2.14 per cent (of diagnosed cases) compared with the current US seasonal winter flu outbreak (0.07 per cent); SARS (9.6 per cent); Swine Flu H1N1 (17.4 per cent); and Mers (34 per cent). To put this in context the CDC (Centers for Disease Control and Prevention) estimates the 2019-20 US deaths from flu will range between 14,000 and 36,000 out of 26m to 36m infections. The best defence is frequent hand washing and perhaps a mask in crowded spaces. You cannot outrun a bug.


A serious and sustained pandemic will challenge and dramatically im­pact business practices, stock markets (American Airlines dropped 9.1 per cent and Marriott plunged 7.9 per cent in just one day, February 25), country GNP forecasts, supply chains involving China, schools, population flows (travel and migration), insurance, governance, and political models.


While the world is on high alert, worryingly this is not the case at resorts and even in high-risk urban centres (including in India) where procedures remain egregiously lax for fear of alarming guests and losing business. Many Asian hotels pressed for information retreated swiftly into the anodyne — taking “all necessary precautions”... “following official guidelines”... launching “preventative measures”... Some hotels said they were under a gag order on Covid-19. But behind the PR spin and seeming head-in-the-sand bullheadedness there is a real fear gripping the travel industry as business plummets.


So how are hotels, airlines, and countries handling this? In Hong Kong, Taipei and Singapore, guest temperature scans were de rigueur by late February with schools and several government offices closed. By early March some far-sighted hotels had installed airport-style thermal scanners to reduce inconvenience. China witnessed the complete closure of many hotels, some of which will reopen by March 10. Only a handful of hotels in Bangkok have temperature checks in place with even luxury properties in denial. The same is largely true of hotels in Phuket, Vietnam, and even Bali. Of course, this will swiftly change as events develop.


Airlines are replacing HEPA micro filters with greater frequency and introducing rigorous disinfection routines. Citing “flight reductions” Cathay Pacific closed several airport lounges and grounded half its fleet in March, while beleaguered cash-strapped Hong Kong Airlines cut staff and eliminated in-flight service on certain flights.


Singapore Airlines has reassured passengers that post flight all surfaces and devices undergo “rigorous” cleaning and the cabin air is replenished every two to three minutes (the standard for most modern aircraft).


If anything, the current Covid-19 outbreak has revealed how unprepared governments are for a full-scale pandemic. It has spotlighted how out of touch and insular hotel PR has become. It is time for governments, national health centres and the hospitality industry to come together to fashion universal protocols to put travellers at ease and dispel rumours. It is in everyone’s interest to do so. This is the only way to protect the bottom line.




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