COVID-19 and a bit of Malaria

Wherever you are, I hope you are staying healthy and insulated from the Coronavirus. I am safe and sound in Nigeria and in fact am much safer than in the US. I learned last Friday that a Mastercard employee from Brazil dropped by Chicago to share some tapas with my some old co-workers. He then jetted off to New York and subsequently shut down 2 other offices after he became a confirmed Coronavirus case.

Luckily for me, Africa as a continent has had some of the lowest number of reported cases in the world right now. It’s been posited that the virus does not spread as easily in warm climates. My less optimistic hypothesis would be that the continent has been insulated by less frequent air travel which appears to be the de facto method for country-to-country spread. Unfortunately, that would mean that the 1st reported case (an Italian traveler) could likely increase in the near future as the virus slowly but surely makes its way around the globe.

On diseases:
I’ve had a personal paranoia of the next global disease for a few years. If you don’t remember there was the deadly (and still active) Candida Auris superfungus that made a few waves in 2019 and has a mortality ~10X higher than COVID-19 at 35.2%. At the same time, overuse of antibiotics has led to the rise of drug-resistant “superbugs.” While many people worry about depleting the world’s food or water, antiobiotics should be added to the list of precious limited resources. The CDC’s 2019 report identified 5 other “urgent threats” along with Candida Auris. Combined these bacteria were responsible for ~15K deaths annually: Acinetobacter, C. Difficile (life-threatening diarrhea and colitis), Enterobacteriacae (AKA “nightmare bacteria”), and N. gonorrhoeae. There were also 11 other bacteria and fungi listed under the “serious threat” category. If you’re a fan of retro, we’ve also had a fun return of the preventable mumps, measles, and tuberculosis due to anti-vaccers lowering the herd immunity rate below the recommended 95% threshold.*

For COVID-19, I’ve fluctuated between extreme panic and overconfidence before finally settling into an uneasy wariness. I’ve found that the below graph articulates very clearly the most critical danger of the disease: when it overwhelms a country’s healthcare system.

While Nigeria was praised by WHO for doing a world-class job at containing an Ebola outbreak in 2017, the city is quite densely populated with estimates of over 20 million people. If the virus spread quickly here, new cases could easily overload the current healthcare capacity. The only comfort is that the government has taken the news of the outbreak quite seriously, and had begun educating the public on healthy practices (washing hands, self-quarantine, etc.) weeks ago. For work we are even planning a “full work remote” simulation next Friday in preparation for when the virus could, and probably will, begin to spread in Lagos. It’s been interesting to watch from Africa how the US has failed to take the proactive steps in order to quell the spread of the virus.

While it’s good that people in Nigeria take Coronavirus seriously – there’s also a sobering reality that there are other diseases here that are already killing many people. While the Coronavirus has taken over 5,000 people globally, I’ve had at least 4 coworkers get malaria over the last month, and 1 that contracted malaria and typhoid at the same time. In fact, every year there are more than 400,000 deaths from malaria of which the majority are children in Africa. However, the disease is so ubiquitous here that in my first month I asked a co-worker if he was feeling better after he mentioned feeling a bit “hungover” during his lowlight for the week. His response was: “Yea, much better now. I think I had a bit of malaria.” :O

I’ve heard from a few people the phrase that “the Coronavirus is democratic.” People go on to say that no matter whether you’re rich or poor the virus doesn’t care. While this might not be true within America, I can see how this appears to hold on the global level – many higher-income countries have not been spared the disease. While nobody here wishes calamity on the rest of the world, I can begin to appreciate the almost poetic justice in how Africa, a continent where over 300,000 children can die of diarrhea in a year, has been spared the worst of the virus thus far.

The way Coronavirus has shaken up the world is scary. It’s also shown us how human beings and societies so easily underestimate and then overestimate risk. When the world has settled from COVID-19, I’m sure there will be another crisis: maybe candida auris, or perhaps the impacts of climate change will finally come home to roost. In the meantime, we do the most we can with what we have and hope for the best.

So don’t panic, wash your hands, leave some toilet paper for the rest of us, and we just might come out on the other half of 2020 safely.

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Appendix

*I originally didn’t care about the anti-vaccer movement until I realized it could also negatively impact other people who do make the correct decision to vaccinate their children.