SARS-CoV-2 otherwise known as Covid-19 is holding over 3 billion people hostage and has infected over 2 million people and killed more than 134,000 worldwide and still counting. Scientists around the world have pointed out that increasing interaction or contact between humans and wildlife reservoirs is one of the key drivers in emerging infectious disease (EID) outbreaks. The ease of traveling anywhere around the globe in hours plays a significant role in the spread of infectious diseases. A study published on bats Coronaviruses in March 2019 by the Wuhan Institute of Virology predicted this is going to happen in China. But the early warning was ignored by the Government. Time and again in the recent past emerging infectious diseases have waged wars on humanity; Hendra virus in 1994 (Australia), Nipah virus in 1998 (Malaysia), in 2018 (Kerala), in 2001 (Bangladesh), SARS-CoV in 2003, Avian Flu (H5N1) in 2008, lesser-known Marburg Virus in 1967, MERS-CoV in 2012, Ebola virus in 2014 and still going on in West Africa. All these infectious viruses’ hosts are almost certainly known to have originated from bats and subsequently jumped to humans with or without an intermediate host (mostly civets).
This new Coronavirus, Covid-19, first emerged in Wuhan, China is known to have originated from the wet market. The first cluster of patients primarily were stall owners at the Huanan Seafood wholesale market in central Wuhan, who developed severe pneumonia. Reports soon claimed the market sold not just seafood but different species of live wild animals kept in cages stacked one above the other in a cramped space, giving the virus perfect opportunity to spillover. The firstSARS-CoV-1 outbreakin 2002-2003 (which also emerged in the wet markets in China), has created awareness among the general public about the Coronavirus group of viruses and its potential to cause fatal infections in humans. The Coronavirus family is not new to science, research on Coronavirus dates back to as early as the 1930s.
The Covid-19 has caught us off guard. It has paralysed the world’s economy, perplexed the world leaders and mobilised the scientific community to scramble for the cure. The global response to Covid-19 exposed the public health policy’s greatest failure in our generation.
This pandemic suggest that we have not learned to mitigate the threat of emerging infectious diseases. During this pandemic Covid-19 preparedness reports of Nagaland Government is something we should be very concerned about. Dovih P (2015) “Can Traditional Bat Hunts Cause Disease Outbreaks in India?” published in Economic and Political weekly recommended the need for national and regional epidemiological surveillance laboratories in biodiversity hotspots to deal with emerging infectious diseases. It also emphasised on investment in healthcare infrastructure in disease outbreak-prone areas like Nagaland. However, the state Government’s recent quick-fix corrective measures for Covid-19; “Maintaining a cleaner environment in and around the facility by painting the walls, planting trees and a good drainage system” is not good enough to contain this kind of contagious virus. Increasing investment in the health care system specifically in laboratory sciences and research facilities are the right path for the state. In this way, the state will reduce the dependency on neighbouring states for medical tests and diagnosis. It is time Nagaland Medical Directorate and the state Government understand the seriousness of investing in medical research facilities because such research saves lives. The best example can be seen from the Kerala Government’s response to the Nipahvirus outbreak in 2018 that claimed 17 precious lives. They have quickly built three medical centres that have immensely helped them in containing the Covid-19, despite being the first state hit by the virus in India. Building containment facilities,and garnering the support of scientists with large-scale DNA sequencing skills, data analysis and capacity building in scientific research are very crucial in responding to this kind of outbreak. Nagaland state though one of the oldest state in the Northeast (established more than 50 years) but lag far behind younger states in medical front. This does not reflect so well on the state Government and the Medical Directorate Nagaland without a single well-established research laboratory and a medical college. The medical infrastructure needs to align with growing demand and increasing medical cases of the state. While enhancing the medical infrastructure is an urgent necessity in the capital town Kohima and Dimapur, equal importance needs to be paid to the marginalised people living along the Myanmar borders who have very little access to medical health care. Wild animals will always have several virus circulating in their body, and animal-human contact are increasingly becoming common. Hence the US Centre for Disease Control (CDC) “One Health approach” involving experts in human, animal, environmental health, and other relevant disciplines is the need of the hour. A sentinel innovative public health surveillance system on wildlife, animal farms, and animal markets could help understand the risks and mitigate possible disease outbreaks in the future. Administrations such as forestry, animal husbandry, wildlife ecologists, sociologists, and medical health care personnel, along with experts (not necessarily from the Government sector) need to unify and rethink in an effort to combat infectious disease in humans by formulating risk-based targeted interventions and action plans.
Bushmeat hunting and close contact with wildlife is not the only opportunity for the virus to spillover to humans. With increasing human population, urbanisation, climate change, deforestation, and intrusion into wildlife habitats epidemics/pandemics will continue to increase in the future. Viruses that otherwise are restricted to their natural reservoir hosts will jump to humans upon repeated exposure. The problem is not the animal hosts. It is the humans’ activities that fuels the spillover diseases. For instance, the Nipah virus outbreak in 1998 in Malaysia that killed hundreds is known to have spilled over to humans due to deforestation and agricultural intensification for palm oil plantations. Ebola virus outbreak in West Africa is known to have jumped to humans viabushmeat hunting. Similarly, studies have claimed that HIV-AIDS is known to have jumped to humans through bushmeat hunting of chimpanzees in Africa about a hundred years ago.
There also needs to be a cultural shift in our food habits and attitude towards the way we treat wildlife. Co-existing with wildlife and keeping the ecosystem intact is the way to go to discourage infectious diseases from spillover to humans. Hopefully, this Covid-19 can help us learn enough to better prepare and quickly respond to any future outbreaks. Seeing the way emerging infectious disease is storming the world moving heaven and earth at the last minute may not help unless prepared. If we value our health, Nagas as a society deserves a health care with modern health care infrastructure and not a substandard health care system. For disease, no man is an island.
D Pilot Dovih (Researcher)
National Centre for Biological Sciences (NCBS), Tata Institute of Fundamental Research (TIFR) under the Department of Atomic Energy Government of India Bangalore, Karnataka