In the Northern Hemisphere, March is a pivotal month for the onslaught of “spring fever”. And for those of us who have been known to embrace the herd mentality of the season-ending collegiate basketball tournament in the US, it is also known as the month of “March Madness”. In this year of 2020, it seems tragically appropriate that, in this turbulent month, we have experienced yet another kind of “March Madness”. And that is the fearsome disease that we have come to know as “Covid-19”. As we come to the end of this crazy month, here are some reflections on why the Covid-19 pandemic will forever be associated in my mind with the madness of this pivotal month of March.
The warnings may not have started with the cancellations of that basketball tournament and so many other major March events, such as the Geneva Auto Show and the Mobile World Congress in Barcelona. From our vantage point in southern France, we had, after all, been following the news about the outbreak of a new virus in Wuhan, China, first reported in December 2019 (and therefore the “19” attached to the name it was ultimately given) but only brought to global media attention in the course of the massive shut-down of the Chinese New Year in January of 2020. And through the month of February, reports started trickling in of outbreaks in South Korea and Iran – and even on a cruise ship or two in oddly disparate places. The prevalent thinking, though, seemed to be that this was just another SARS or MERS epidemic – alarming indeed as they were, but each in its place far away from home – and evidently brought under control before going any further than that.
EARLY WARNINGS FROM DR. RYAN AND THE WHO
The trigger, though, seemed to be those March cancellations. They are what led me to recollect a program in Geneva that our Council for Multilateral Business Diplomacy had organized way back in 2007. It was one of our first CMBD meetings, convened to facilitate a dialogue between officials at the World Health Organization (WHO) and the business community. One of our main segments had been on emerging epidemics. SARS had been just the most recent one, but one should not forget about HIV/AIDS. In 2007. We were in the midst of the success of a massive mobilization of resources, including through the WHO, because of the AIDS pandemic but also for malaria and tuberculosis. So this additional 21st century matter of NEW global health emergencies like SARS had elevated our interest in the work of the WHO.
I don’t remember the exact words, but I vividly remember the passion in the voice of Dr. Michael Ryan, who was then the WHO’s Director of Global Alert and Response Operations. He spoke about the scientific inevitability of a global epidemic far greater than SARS or AIDS and more like the rampant devastation of the 1918-1919 epidemic that was known (albeit incorrectly) as the Spanish flu. He expressed frustration with the lack of a global consensus to prepare for this likely calamity, even at the WHO. We had listened to Dr. Ryan with a mix of disbelief and anxiety but ultimately went our respective ways without thinking any further about it.
THE RETURN OF DR. RYAN
The point here is that Dr. Ryan didn’t stop thinking about the inevitability of something like Covid-19 – or about the indifference of key policy makers to do anything about it. Of course, Dr. Ryan was not alone in this. Many other scientists – my good friend Dr. David Nabarro among them, but also Dr. Peter Piot and others who warned us about the Ebola outbreak – were speaking up. I wasn’t all that surprised to learn some time after our 2007 event that Dr. Ryan had left the WHO and its bureaucratic games.
It was only a few years after that, when the Ebola crisis proved that the WHO itself was unprepared for such a global health emergency, that the WHO Executive Board underwent a soul-searching debate to reform the WHO’s emergency-preparedness role. In the course of this mad month of March, I was looking through the WHO press releases on how well the Chinese had handled the initial outbreak of Covid-19 when I suddenly noticed that Dr. Ryan was back at the WHO. Not only that, but he had just been appointed Executive Director for the very programme on health emergencies that included this new Covid-19. What attracted him to return, I wondered.
One might note that this new Health Emergencies Programme sounds a lot like the Global Alert and Response Operations that was the title of Dr. Ryan’s responsibility back in 2007. But I had closely followed the tense debates in the WHO Executive Board on post-Ebola reforms, and this Health Emergencies Programme was indeed a major piece of that reform effort. Without going into any further speculation about how the WHO and its member states are handling this current novel coronavirus crisis, I can only observe here that Dr. Ryan’s reappearance at the WHO certainly heightened my appreciation for the WHO reforms – and the realization that Covid-19 was indeed something new and serious.
UPWARD MOMENTUM OF THE COVID-19 CURVE
For me, then, March started with an important shift in my appreciation of Dr. Ryan’s fortune-telling from some 13 years ago. We had been following, with growing shock and alarm, the escalating spread by late February of Covid-19 into neighboring Italy. This was the first that we sensed the striking contrast between the approaching closeness of this virus and the safer distance of any of the others of recent vintage (Ebola or MERS or SARS). Even more alarming, we kept on hearing that the Italian authorities were trying desperately but failing to locate “patient zero” in the midst of a spiraling number of cases. It was no longer a matter of identifying someone who had returned from travelling in China or South Korea or Iran; the worrisome conclusion was that the contagion was now in the community itself.
The surprise factor of this happening in Italy and not some far-off place unrelated to us made us more attentive to our own circumstances. On the first of March, France was reporting a total of 100 Covid-19 cases. One week later, on March 8, there were 1,126 cases! By then, we also had the alarming news of a concentrated number of Covid-19 deaths in the US state of Washington and another outbreak of cases on a cruise ship off the state of California. As it spread throughout the rest of Europe and emerged elsewhere in the US – and India and Brazil and South Africa and Australia – we had to conclude that this was, indeed, the global epidemic – or pandemic, as the WHO finally came to call it, that Dr. Ryan, our CMBD guest speaker of long ago, had predicted.
THE MADNESS TAKES HOLD OF US
With President Emmanuel Macron making two nation-wide appearances on 12 March and then again on 16 March, France was brought into partial and then more complete lock-down as of 17 March. A few days later, on 20 March, France was reported to have over 12,000 cases and some 450 deaths. A week later it was 30,000 cases and over 1700 deaths, and then in only two more days it was 40,000 cases and 2600 deaths! Elsewhere, too, they started with 1 or 10 or 100 and then accelerated exponentially, some countries more dramatically than others.
Although the data on cases and deaths may not be comparable from country to country, state to state, and even from community to community, the essential message about the severity and contagion of Covid-19 is finally sinking in. And now, the dire projections of people like Dr. Ryan from years ago are being reinforced by the data showing sharply upward curves in the ever expanding and growing number of “epicenters” like the Lombardy region in Italy or Mulhouse in northeastern France or New York City in the US.
INTO APRIL – and beyond?
We have come to the end of this crazy, mad month of March. As an American who grew up with the madness of basketball tournaments, I will always associate Covid-19 with March Madness. We have seen panic buying in grocery stores and pharmacies, a shocking fall in the stock markets around the world, a record increase in US unemployment claims and public subsidies of private sector jobs in Europe, public health officials crying out for more and better tests, more protective masks and other personal protective equipment, more ventilators.
For those of us who are not directly involved in the scientific search for a cure or in the delivery of essential services or care for the sick and dying, we are adapting to life in lock-down. We are learning new tools for remote work, education and health – and yes, games and entertainment to replace those basketball tournaments! And of course, we are learning to wash our hands more thoroughly and more regularly, trying not to touch our faces, discovering how to produce a sanitizer, wearing home-made face masks, and keeping a safe distance from anyone whenever we venture out.
The next phase in absorbing the message has to include a search for solutions. Obviously, this is already under way, with a key role for the WHO in mobilizing resources and coordinating the information flow of progress in research, testing and development on vaccines and treatments for Covid-19. The WHO can also play a helpful role in communicating the most effective, up.-to-date and immediate containment measures. With the recognition that any cure will have to wait at least until 2021, the focus is on “flattening” the curve of the outbreak. And even this has taken much too long to be widely appreciated and implemented.
Further reflections in the months ahead will build on this first commentary about Covid-19. Attention will focus on our growing understanding of the prospects for survival and for pivotal transformations in our daily lives – but especially on strengthening our ability to collaborate with each other. In the meantime, we are coping with the immediacy of “staying in place” and watching those numbers go up, at least for the foreseeable future. We are once again reminded of the warning from Dr. Ryan that this may only be the first of many “Covid-19s”. We know that this new March Madness has given us a turning point to remember.
Postscript: Readers are encouraged to follow the daily press briefings of the WHO where Dr. Michael Ryan regularly appears with the WHO Director-General Dr. Tedros. We found the daily briefings through Whats-Ap but one can start the search at www.who.int. For more pointed messaging, check the Covid-19 Narratives of Dr. David Nabarro, who was recently appointed one of the WHO’s six Coronavirus Special Envoys at https://www.4sd.info/covid-19-narratives/.