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 Table of Contents  
EDITORIAL
Year : 2020  |  Volume : 7  |  Issue : 7  |  Page : 1-2

COVID-19: The war against the invisible enemy


1 Department of Pediatric Critical Care, Advanced Pediatric Critical Care Center, Wanless Hospital, Miraj, Maharashtra, India
2 Department of Pediatric Critical Care, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Pediatric Critical Care, Indira Gandhi Institute of Child Health, Bengaluru, Karanataka, India

Date of Submission24-Apr-2020
Date of Decision30-Apr-2020
Date of Acceptance02-May-2020
Date of Web Publication29-May-2020

Correspondence Address:
Dr. Vinayak Patki
Department of Pediatric Critical Care, Advanced Pediatric Critical Care Center, Wanless Hospital, Miraj - 416 410, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JPCC.JPCC_76_20

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How to cite this article:
Patki V, Bansal A, Basavraja G V. COVID-19: The war against the invisible enemy. J Pediatr Crit Care 2020;7, Suppl S1:1-2

How to cite this URL:
Patki V, Bansal A, Basavraja G V. COVID-19: The war against the invisible enemy. J Pediatr Crit Care [serial online] 2020 [cited 2020 Jul 14];7, Suppl S1:1-2. Available from: http://www.jpcc.org.in/text.asp?2020/7/7/1/285382

On the evening of 2019, when the first formal reporting of Coronavirus infection was done from Wuhan, nobody had ever thought that this year would bring such a huge challenge to the survival of mankind. Coronavirus disease 2019 (COVID-19) has posed a severe health problem, and that translated to a severe financial crisis in the interconnected world. It has triggered panic across the globe due to its deadly potentiality of difficult containment, frequent changes in its genomic structure, and conversion into a more deadly strain. It has left the scientists struggling to respond and develop the ways of fighting against it as a previously unknown disease. There is no clear indication that how long this pandemic will last and how much cost we are going to pay for it. Around 4.5 million people have been infected across the world by COVID-19, with nearly 300 thousand casualties so far.[1] Early hopes that the novel coronavirus outbreak would be over by mid-April–May 2020 have been dashed by the accelerating figures of death and infection increasing globally, with experts now warning that the pandemic will last till 2021.

COVID-19 brings back the painful memories of the past outbreaks of death and destruction such as the Spanish flu, Asiatic flu, H1N1 swine flu, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS). In 1918 during the waning of the first world war, the human race was hit with one of the worst pandemics the world knew. The Spanish flu deadly influenza affected about 500 million people worldwide, one-third of the world's population at that time and the disease took the lives of almost 50 million people, making it the deadliest virus outbreak in human history. Later in 1957, the Asiatic flu headed to Singapore, with a large migrant Chinese population, and reached the US, where 2–4 million people were infected. The same virus came back again in 1960 as a Hong Kong flu. In 2009, the H1N1 virus put out its ugly head again. The swine flu originated in Mexico and rapidly spread across the world. It forced the World Health Organisation (WHO) to declare the first influenza pandemic of the 20th century, with a death toll of 290 thousand people. Then came SARS in 2003, and MERS in 2012 which were also from the coronavirus family.[2]

Have we learn anything from history or we going to repeat the past again and again? Humans have succeeded in destroying the natural habitat of these viruses, but another one will reemerge and will be one step ahead of humans. Do we always need to play a game of catch up? What are those conditions which help the emergence of these viruses again and again? Changing social habits, growing populations, and better global connectivity has made it possible for the virus to be transported to the major cities of the world within a span of a day, making it much harder to contain. Influenza pandemics appear to be not a single phenomenon but a heterogeneous collection of viral evolutionary events.[3]

The coronavirus pandemic has presented the world with an invisible enemy that requires a global fightback at an unprecedented scale. While the management approaches have varied around the world to this completely new kind of war, but, the goal has been a common one – to save lives as well as livelihoods. The recent headline of GlobeandMail aptly describes this pandemic: “We are at war with COVID-19. We need to fight it like a war.”[4] In the current situation the virus is an enemy, “flattening the curve,” and “saving the economy” are the war strategy, health-care personnel is the front-line warriors, people isolating at home are the home-front warriors, people breaking the social-distancing rules are the traitors and deserters.

Why it remains a challenging task to fight the COVID-19? Because of its unknown origin, mysterious biological features, high reproduction number (R0), a long incubation period, short serial interval, and limited treatment and prevention measures.[5] What did we learn from the experiences of different countries in the world about the COVID-19 pandemic? Lack of transparency in policies, delay in declaration of emergency by the WHO, delay in travel restriction and quarantine policies, public misinformation, and limited research and development are the main factors that made the huge difference in controlling the infection and limiting the causalities.[6]

When the first case of the 2019–2020 coronavirus pandemic was reported in India on January 30, 2020, originating from China, it was a massive challenge for the country to face COVID-19 due to many hurdles such as the population of 130 million, poverty, unplanned cities, illiteracy, and an already overwhelmed health-care system. India needed to fight it differently. India could not afford to do massive testing of people because of limited recourses. India relied upon low cost but highly effective “suppressive strategy” which includes measures like hand hygiene, wearing masks, isolation, quarantine, social distancing, and community containment. India decided to screen the international travelers, screen them, and quarantine them.[7] Almost 1.5 million were screened and around 30 thousand were quarantined. Major public places were closed, followed by ban on the domestic public travel and eventually ban on international travel. On March 22, 2020, the Indian government declared 1 day “Voluntary public curfew,” an innovative initiative requesting everyone to stay at home. However, realizing the increasing numbers every day, the bold step of nationwide lockdown was declared on March 24, 2020, even though there were less cases across the country. No other country has done lockdown in such an early phase of infection, and it was proved to be the most successful step in controlling the spread of the virus. As far as the management of these patients, India was able to set up designated COVID-19 hospitals to treat them effectively. Aarogya Setu app on mobile seems to be an innovative idea to help manage the safety of individuals. Infection rates and death are much less than predicted as compared to the USA and the UK. Currently, most of the regions in India are still in Stage 2, with a few locations marked as hotspots due to evidences of “localized community transmission,” suggesting pockets of Stage 3 as well. The WHO has also praised the efforts of India in controlling this pandemic.[8]

Many questions are still unanswered as of now. Epidemics come and go but the question is, will it ever stop invading human hosts? As novel coronavirus returns to the world today with vengeance, as the number of infections grows, it remains uncertain if the worst is over or yet to come in the near future? With the lessons from the past and current knowledge from the novel coronavirus, will effective treatment or cure be soon be available? The reality that the battle between humans and deadly epidemics has been rising for centuries and that humanity is still alive today is the testimony of the fact. We have managed to respond effectively to these killer viruses but in many instances at the cost of human lives and unmeasurable resources. However throughout history, humanity has been winning the war against epidemics.[9] In the light of advancement in science and technology, the challenge for the human race is to stay ahead of the game in what is seen as the long and continuous battle against this invisible enemy.

In the special supplement of the journal of pediatric critical care on COVID-19, we have brought articles from renowned national and international authors to enrich your knowledge and updates on COVID-19 and help you in preventing and managing it in the most effective way.



 
  References Top

1.
Coronavirus Disease (COVID-19) Situation Report – 119: 2020; 2019. Available from: Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200518-covid-19-sitrep-119.pdf?sfvrsn=4bd9de25_4. [Last accessed on 2020 May 19].  Back to cited text no. 1
    
2.
Krammer F, Smith GJ, Fouchier RA, Peiris M, Kedzierska K, Doherty PC, et al. Influenza. Nat Rev Dis Primers 2018;4:3.  Back to cited text no. 2
    
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Morens DM, Taubenberger JK. Pandemic influenza: Certain uncertainties. Rev Med Virol 2011;21:262-84.  Back to cited text no. 3
    
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Yi Y, Lagniton PN, Ye S, Li E, Xu RH. COVID-19: What has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci 2020;16:1753-66.  Back to cited text no. 5
    
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Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020;76:71-6.  Back to cited text no. 6
    
7.
Sahu KK, Mishra AK, Lal A, Sahu SA. India fights back: COVID-19 pandemic. Heart and Lung: The Journal of Critical Care 2020. DOI: 10.1016/j.hrtlng.2020.04.014 PMCID: PMC7177138.  Back to cited text no. 7
    
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9.
Bandyopadhyay S. Coronavirus disease 2019 (COVID-19): We shall overcome. Clean Technol Environ Policy 2020;1-2. doi: 10.1007/s10098-020-01843-w. [Epub ahead of print].  Back to cited text no. 9
    




 

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