COVID-19 insights with travel medicine pioneer, Dr Deb Mills

This week, VIVA! Communications’ Principal, Kirsten Bruce spoke with renowned Australian travel medicine pioneer, “Dr Deb” Mills, Brisbane, about widespread governmental failure to heed scientists’ warnings of a potential infectious disease outbreak capable of bringing the world to its knees.

For Dr Deb’s take on the preventability of the COVID-19 pandemic, the ongoing threat of the emergence of other infectious diseases, anticipated changes to travel procedures, and what our “new normal” may look like, read on.

Although few would have predicted 2020 would be the year a global virus would emerge, members of the scientific community, had long been chorusing the inevitability of a devastating viral pandemic.

Ali Kahn, formerly of the Centers for Diseases Control (CDC) said, “a lack of imagination” goes some way toward explaining the devastating levels reached by COVID-19, as people just couldn’t imagine a pandemic actually occurring in this day and age.

According to Dr Deb, most governments were too busy focusing on other “seemingly more important matters” to heed the many expert warnings.

“Bill Gates gave a Ted talk in 2015 regarding the importance of having systems in place to curb future infectious outbreaks. While a journal article published in Hong Kong in 2007 explained the ‘reservoir of SARS-Co-V-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb’. The warnings were there, but people were just too busy to hear them,” said Dr Deb.

The 1918 Spanish Flu pandemic provided valuable lessons in disease control, whereby some cities in the USA used social distancing, while others did not, resulting in dramatic differences in the spread of the virus. Over the ensuing century, it seems the world forgot that the price of being ill-prepared for the next infectious outbreak would be paid in human lives. In addition, many of the trappings of modern life have effectively stoked the fire and made it much easier for a dangerous virus to spread.

“Global disasters caused by once-containable local disease outbreaks are inevitable because populations are growing at an unprecedented rate, and consequently, humans are encroaching on the environment of wild animals, intensively farming domesticated animals and destroying ecosystems,” Dr Deb said.

“The growth of global travel is also a major factor. It is so easy to hop on a plane and fly all over the planet, carrying infectious diseases along for the ride.”

Scientists have long known an outbreak of pandemic proportion was inevitable. Governments have considered research investment to prepare for, and even curtail such an occurrence, however  funding these programs proves unpopular when economies are not in the grip of a crippling global health crisis, and there are many other, urgent priorities to address.

“Because political leaders often lack training in science and infectious diseases, they just don’t fully appreciate how destructive these tiny microbes can be. The sentiment of disbelief that these tiny, unseen things can cause such huge problems persists in many parts of our society.

“Countries such as Korea and Canada, who experienced the SARS epidemic, were much better prepared for the next outbreak, and have been more efficient in managing COVID-19. Those countries however, which had not encountered similar problems in the past, failed to act fast enough and did not have good systems in place, with their populations now facing the tragic consequences,” said Dr Deb.

“The difficulty with COVID-19, relative to SARS, is that this coronavirus can spread before there are symptoms. While SARS was a good test run in the management of a viral outbreak, it wasn’t entirely applicable to the current crisis.”

Containment of COVID-19 has varied worldwide to date. The important question remains however, as to whether the virus outbreak could have been prevented before infecting humans.

“The CDC had people stationed in China, off the back of warnings involving the dangers of viruses in bats, in a bid to prevent any spread of the infection, or transmission to humans. But the staff were all sent home by the current government of the USA. Other systems put in place were dismantled, or never implemented,” Dr Deb said.

“There is good evidence showing a high degree of genetic similarity between COVID-19 and the virus found in bats, which raises the point that perhaps humans shouldn’t be eating wild mammals. However, the wet markets in China were likely an amplifying environment for the spread of the virus, rather than being the initial source of the crossover into humans. When and where that happened is still unknown.”

The strict global lockdowns enforced during the current pandemic have served to curb the spread of coronavirus as well as some other common, travel-related infections.

“We’ve seen a particularly dramatic decline in non-COVID-related respiratory diseases this year. Australian data has shown that in April 2020, a mere 200 odd flu cases were reported. The norm at that time of year is closer to 18,000 cases. This drop is a direct result of social distancing measures and the cessation of international travel, preventing the spread of flu.

“Other travel diseases will not be affected, for example, it’s unlikely we will see a decline in mosquito-borne diseases in travellers when travel resumes,” said Dr Deb.

Dr Deb foresees there will be noticeable shifts in our daily activities beyond COVID-19, including perhaps more time spent outdoors, where we will be safer from respiratory infections. A “new normal” may see those with respiratory symptoms staying at home, while people may never resort to shaking hands again, given the enormous potential for disease transmission through touch.

Similarly, Dr Deb cited the travel industry will work to minimise the incidence of infectious disease transmission. Travel and tourism will be affected until a COVID-19 vaccine is available, and ongoing safety measures will be required to minimise the opportunity for viral spread and future viral outbreaks.

“The tourism industry will now be very attuned to respiratory diseases and preventing their spread. Cruise ship employees for example, will likely have to wear masks while working, and will not work if they are sick. More vigilant procedures will also be implemented in hotels, planes and airports to ensure their cleanliness, and to reduce the incidence of respiratory disease.

“Similarly, travellers will need to adhere to social distancing while travelling, and should expect to undergo disease screening when entering a country. There may even be mandatory two-week-long quarantine periods built into a trip, which will likely lengthen the average trip, and may see the dawn of ‘luxury quarantine’ for those needing to travel,” Dr Deb said.

The COVID-19 pandemic will most likely drive many creative solutions encouraging people to travel as soon, and as safely as possible, once again.

According to Dr Deb, in addition to social distancing, travellers will need to ensure they are vigilant in washing their hands – the single most important measure to limit disease transmission.

As for the fast-tracked development of a vaccine against COVID-19, the international scientific community is now focusing doggedly on this.

“Vaccines typically take about 10 years to develop. To date, there has been no successful vaccine against other coronaviruses, but none of these viruses have ever shut down the entire planet. There are currently over 100 vaccine trials underway globally, and funding is flowing to these projects, given the unprecedented push to develop a coronavirus vaccine,” said Dr Deb.

‘Dr Deb’ Mills is Medical Director of Dr Deb The Travel Doctor, and national spokesperson for the Travel Medicine Alliance. She has studied infectious diseases in Australia, and internationally, and is well published on the topic in medical and consumer media.