The Malta Independent 21 April 2024, Sunday
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Four years later: Covid-19 pandemic revisited

Andrea Caruana Sunday, 3 March 2024, 09:45 Last update: about 3 months ago

Just over a month ago the Maltese islands celebrated Carnival in its traditional manner and Easter’s sombre pomp and ceremony is fast-approaching. Years erase memories, more so bad memories. There was a time not so long ago when no more than four people could meet at a time, and when all religious activities were halted with exception for funerals; even then, under strict conditions. This was on pain of being fined, or worse, infected.

It was on 7 March 2020 that the Novel Coronavirus-2019 arrived in Malta and the country joined the world in pandemic crisis. There is no opposite word for nostalgia, the closest we may get is ‘gratitude for the present’ and in such a way we will look back to what the country, and the world, went through.

The pandemic began in Wuhan City, Hubei Province, China. At the time it was not even a pandemic, just a group of people reported to have a deceptively innocent “pneumonia of unknown [cause]”. The only difference, however, was its rapid rate of spread, as we all know, by aerosols. After developing into an epidemic in China, it then struck France next, then Germany and so on.

It arrived in Malta on the most innocent of carriers: a young girl. A few short days later, on 11 March 2020, the WHO declared it a pandemic. ‘Pan’ meaning ‘all’, ‘demic’ derived of ‘demos’ meaning people, both from Greek in short: all people. This was to last for 3 years and 3 months. Since its beginning, Malta has registered 121,405 cases, according to the latest statistics.

The first Maltese death was recorded to be a 92-year old Gozitan woman on 8 April 2020. The same statistics show that 883 people in Malta have died with the virus.

While the virus was at its peak, with all the restrictions and distress that it brought about, who would have thought that such a dark time had an end? That such a dark time was going to irreversibly change our lives and the world? Ultimately, it was not the apocalypse. Rather, the triumph of human tenacity and endurance in the face of adversity. By human innovation, the Novel Coronavirus 2019 has effectively been reduced to the same status as the seasonal flu and is currently monitored in the same way by the WHO. The virus and its entailing problems brought great strides in a variety of disciplines; from epidemiology and forecasting statistics to public health and hospital management. Necessity really is the mother of invention.

Of note, the triumph of man over the Novel Coronavirus 2019 is arguably the triumph of a woman: Katalin Karikό. A female Hungarian-American scientist with a deep fascination of mRNA, the biological unit of information that was harnessed by her and ultimately used in some way or another by big-pharma in their new pandemic-ending vaccines. What is left unknown is that Karikό contributed to humanity so greatly after many years of being crushed by her peers. Her interest in mRNA seemed frivolous to them, a scientific dead end. She was constantly refused funds and was even forced to emigrate to the U.S in the hope of seeing her research through. Finally, she was funded by a fellow scientist, Weissman, who had received a grant instead of her, yet had faith in her work. For this, after years of struggle and perseverance, Karikό and Weissman received the 2023 Nobel Prize. So, we may say that the virus that brought the male-dominated world to its knees was overcome by a woman. It may be called a great feminist victory.  

Tiny Malta deserves particular merit in this pandemic. Not only was Malta hailed as a ‘Model Country’ during the pandemic by the WHO but to this day, according to ECDC records, its number of vaccinations against COVID-19 have exceeded one million, putting Malta amongst the highest vaccinated countries in the EU.

In the same vein, of the effects of the pandemic, the ripples extended in some curious directions. To begin with there came the advent of delivered food/groceries as a normality. What began as a luxury, one may recall getting Chinese take-away once in a while on a special occasion, suddenly became a modern commodity. During the pandemic this was deemed to be the safest way to get food home, but today there is a trend in employees on the workplace ordering quickly-delivered food at now-reasonable prices, regularly.

On the cultural level, the typically Asian tradition of mask-wearing was actually adopted by some Maltese post-pandemic. It is indeed an Asian tradition according to a study by Noels et al. 2022 based on Asiatic countries’ histories of previous epidemics and the consequent policies the countries adopted. Indeed, it can be argued that the Asian countries did not have a reactive response to the pandemic like Western countries; rather, they were pro-active thanks to their pre-existing policies and prior normalization of mask-wearing. Evidence of this cultural adoption in Malta may be seen on buses, hospitals, planes etc., generally confined, highly populated areas; the elderly and some cautious people may still be seen with masks to this day. What was once seen as bizarre has now become rational and, in some cases, advisable. All this, despite the fervent anti-mask movements that spread over the world.

Looking back, with rested and curious eyes, some burning questions may certainly crop up. To begin with, why did the Novel Coronavirus 2019 travel so fast? Keep in mind that the ‘coronavirus’ is in fact a category of viruses and others of its kind existed before 2019 for example, as documented by the US CDC, those which cause Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) but these never spread at such an unprecedented rate. It is a difficult question with more than one answer.

To begin with, the Japanese RIKEN research group published a paper in 2022 claiming that minimal changes in the structure of the 2019 coronavirus made it easier for it to penetrate the human body, as we know, via aerosols. Most people know what an aerosol is now and how it may spread disease, but that was not the case back then, bringing us to a number of other, social, factors that contributed to the rapid spread. According to a study by Kejela 2020, the public’s attitude towards hygiene had to change rapidly. The outdated practices had to be brought up to date rapidly and until that was done many got infected. Hygiene now had to be observed in immense detail from activities of daily life to their interactions with other people. It was an immense paradigm shift that necessarily had to take its time.

The most striking example of this is the practice of mask wearing, which as we said, persists to this day by a minority. Yet this minority of approximately 20% mask-wearers was sufficient to decrease annual flu infections drastically according to a study by Prempeh et al., 2022. One must keep in mind that the seasonal flu is transmitted via aerosols also.

A persistent question for some may be, why was the virus so selective? Why did it kill certain individuals and give others something similar to a bad cold? At this point, one must be reminded of the fact that certain demographics have lower immunities than the average person; chiefly the elderly, the pregnant and those with pre-existing conditions. This is simply due to nature. That said, amongst ‘average’ people some had to be hospitalised and fight for their lives whilst others fared better off. We only have an answer 3 years on. According to a study by Kenney et al., 2022, involving the cooperation of Yale and Boston Universities, those who shrugged off the virus had a ‘hyper-response’ to the virus due to a more varied immune system. This is simply determined by genes. And so, arguably, it was all a matter of luck.

A cautious yet fearful question is, “Can such a pandemic happen again?” According to a study by Shi, a Wuhan virologist, in 2020, a number of coronaviruses do exist in bat caves and do hold the potential to infect human hosts. That said, according to Vaccitech’s Chief Business Officer, Graham Griffiths, the lessons learned by the pharmaceutical industry in particular, apart from our updates in hygiene, have seen the importance of faster vaccine production and, more importantly, approval by the respective regulatory boards. Indeed, in this pandemic, out of desperation, the vaccines may be said to have been ‘fast-tracked’ and cut through a lot of red tape. This was so effective that such an attitude and a consequent change in international medical policies will be kept up in quiet times and, hopefully, confer an advantage to us against the next pandemic.

Some mystery and even doubt may still remain regarding the new mRNA-vaccines. It is easy to recall the outrage and uproar that arose if one person received one brand of vaccine whilst another person received another brand, as issued by the government. That said, in the long run, it was these vaccines that solved the pandemic crisis. On the other hand, we may go to the other extreme; some of us may have heard rumours about the promising research going on to use the vaccines HIV/AIDS. Whilst we must remain cautious and not let our imagination run away with us, there is some truth to the rumours. Clark and Riddler of the NIAID are carrying out a large-scale phase 1 clinical trial on human test subjects that started in 2022. That said, a similar project called Mosaico, ahead of its time in 2019, was a failure due to the vaccine being ineffective and unfortunately, such has been the case with similar, recent projects. That said, scientists and researchers have a newfound spirit of innovation and enthusiasm to tackle the problem of HIV/AIDS with these novel tools. Ultimately, only time will tell.

Looking back to the pandemic is painful. Such a unique time must not be erased from our memory for the sake of remembrance of those who succumbed to it, had their lives changed by it or fought it selflessly on the front-lines. However, it may be useful to not remain stuck in how awful it all was. Rather, we should look forward in hope. The ripples from that terrible time have actually borne wonderful fruit, as we outlined.

Humanity did not go extinct as some feared. Instead, we demonstrated our ability to adapt, even under immense pressure. This may be solid proof of what evolutionary biologists claim sets us aside from other animals. So, we commemorate the date COVID-19 came to Malta and the ordeal that it carried with it. But we should also celebrate our triumph.

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