Soon the public health implications of COVID-19 will be clearer. In Hong Kong, life has changed so much these past six months. The riots, the protests, the arson, the anarchy. And now nature shows what she can do. Seventeen years ago this month; March 2003. It was a bizarre time to be in Hong Kong. That was the previous visitation of another iteration of the coronavirus. It snuck into Hong Kong courtesy of a medical man who stayed in a local hotel and coughed in the elevator. (For some reason my mind goes out to those desperate people who threaten others with blood stained hypodermic syringe needles…Just to underline this reality: a cough can be just as deadly as a gun. Indeed, in an enclosed space a cough can be more deadly than a gun. The major role for masks in the general population is to remind people to cough responsibly.)

Sorry! Side-tracked. In 2003, SARS struck in the Prince of Wales Hospital in Sha Tin in the same week that cruise missiles were raining down on Baghdad at the outset of a war that was always about “weapons of mass destruction”. Weapons of mass destruction. They can be nuclear. They can be biological. They can be chemical. NBC.  But they can also be words or, more specifically, lies. In 2003, we were ground zero and had no idea what was going on. But we had a spectacular leader in public health, Dr Margaret Chan. Every evening she would face Hong Kong and tell the truth. She went on to serve two terms as the Director-General of the World Health Organization.

Seventeen years has passed. A new generation. This time it is their schools which are closing. The Universities too. And now we hear it will be until after Easter. Wow. Co-incidence? We do get very confused here in Hong Kong. Just weeks ago, Hong Kong appeared to be out of control, on the brink of anarchy and heading towards an irreparable social disaster. What was happening then was driven by unnatural forces. We almost succumbed, but did not. Now we face the most horribly natural of natural forces, a new virus where the infectivity seems to be turbo charged. The incubation period is long, which means contact tracing is very complicated. All the while the virus is spreading between symptomless people. This ability to spread is bought at some cost in terms of the threat of the virus to the host. Indeed, the more virulent the virus the shorter an outbreak will be because the hosts will die. How opportunistic are these new viral attacks? What is driving the evolution of the coronavirus? It is changing. Infectivity up. Mortality down.

To survive COVID-19 will take a lot of tolerance, patience, understanding but also a commitment to life. We will know, within six weeks, how smart humanity really is. That is pretty scary in some respects. We love these television programs with super-intelligent masterminds working out the destiny of the world but come on ... if we were that smart would life expectancy be falling in many parts of the world? Would we allow such devastating social inequalities to be a global phenomenon and would we allow the denigration of science by those who are so insanely selfish that they do not care. The Ides of March will soon be upon us. A time for settling debts. What about humanity’s debt to nature? Is COVID-19 a threat or a warning? We will soon find out.



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Andrew Burd (Prof)

The Chinese University of Hong Kong.

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