The world is in the clutches of a pandemic which has made people lock themselves up in their homes and brought the global economy to its knees. It will bring about a social and cultural revolution; hand washing will become a way of life and social distancing may get trendy. This is probably the first time in history when healthy people have been quarantined at home or in healthcare setups. Deglobalisation has been accelerated as countries are resorting to sealing their borders and import substitution in strategic areas like medicines and health equipment.
Yes, a microscopic entity which is not even a fully live organism, the coronavirus, has accomplished this. It has sealed the largest hole over the North Pole and is responsible for 11,000 fewer deaths is Europe which would otherwise have occurred due to air pollution. Migratory birds are reclaiming wetland habitats, from which they were driven out of, due to polluting effluents being dumped into them. Is this the first time?
No. Every few decades epidemics or pandemics occur. The 1918 Spanish flu pandemic, 2003 SARS epidemic, the 2009 swine flu epidemic, the 2014 MERS epidemic are some of the prominent ones. Several other lesser known ones include the Asian flu and the Ebola outbreak. HIV is an ongoing silent epidemic even today. In the course of an epidemic, a population of people acquires herd immunity to it and is relatively protected; until the next generation of people, with no immunity, grow to significant numbers or there is emergence of a new strain of virus.
Why is modern medicine unable to save the lives lost and the debility caused? Anti-viral drugs are not nearly as effective as antibiotics (drugs used to treat bacterial infections). Drugs to treat HIV should be taken lifelong, and they only reduce the viral load; they cannot eradicate the virus. The best hope to put a stop to the spread of the Covid-19 pandemic to develop herd immunity to it, or develop a vaccine which does the same thing (without costing so many lives). The keyword here is immunity, or the inherent defence mechanism of the body, which is a product of healthy lifestyles.
Across the world, 71% of deaths occur due to non-communicable diseases. Heart diseases are the top killers, followed by cancers, respiratory diseases and diabetes. Modern medicine does not provide cure for most non-communicable diseases; diabetics have to be on medication throughout their lives to keep their blood sugar levels under control. So do people with high cholesterol levels and hypertension (important risk factors for heart diseases).
Development of modern medicine has done us a lot of good. It has reduced maternal and infant mortality. It has saved millions of lives which could have been lost to infections. It is relieving the excruciating pain of terminally ill patients. It is fixing broken bones and dislocated joints. It has provided the world with contraceptive agents (important for several reasons, haha). Most importantly, it has prolonged the life expectancy of the people. An average man in 19th century British-India could expect to live for around 26 years; today, he can plan for a long life of 69 years.
As the lifespan of an individual increases, so does his risk of developing diseases like diabetes, cancer, heart disease and so on. The modern lifestyle also promotes the development of these diseases; for eg., consumption of excess red meat is a cause for contracting colon cancer. But modern medicine does not provide a solution to these health issues. Besides, modern medicine is able to cure most microbial infections, highlighting the mortality and morbidity due to non-communicable diseases.
Side effects of drugs is also becoming a leading cause of morbidity in patients taking lifelong/ long-term medication. For example, hydroxycholoroquine, a drug which has shown some promise for the treatment of covid-19 can cause rhythm disturbances in the heart, heart failure and so on. Anti-microbial resistance, due to misuse of antibiotics, is killing more people in developed countries than actual microbial infections; the situation is replicated in some pockets in developing countries, and is set to expand as health coverage increases. Anti-pain medications, which are frequently taken by arthritis patients, causes kidney failure over the long run.
So, what needs to be done? Modern medicine certainly cannot be cast away. It is saving lives and reducing human suffering to a very large extent. What is needed is a reorientation of the approach of modern medicine from curative treatment to preventive care. When there is no cure, without doubt, prevention is better than cure. The goal should be to improve the overall wellbeing of the population, for eg, improving immunity so that new outbreaks will meet with more resistance. Perhaps, modern medical practitioners should also not completely dismiss the significance of traditional systems of medicine like Ayurveda.
How is India’s health system faring? Stay tuned for the next blog post.