PANDEMIC READINESS: LESSONS LEARNED FROM THE PAST

Abstract

A pandemic occurs due to complex interactions between total number of population on earth, food supplies, environmental condition, human activities and behaviour, human susceptibility, science and technology and health care system. The past pandemics have shown us that the spread of the disease has been facilitated by the movement of people, whether by land, sea or air, by trade or war. When the cause of the disease is not known, the pandemic results in high mortality and economic depression. During the ancient pandemics, such as Justinian plaque and Byzantine plaque (Black Death) where no prior knowledge or experience in dealing with the calamity was known, the reaction of the people was through avoidance, isolation, quarantine and destroying the source (infected person). Over time, the development of science and technological invention, socioeconomic progress, and the health care system development has increased our capacity to recognise the agents of the pandemics, developing the medicine to treat the disease and vaccine to prevent further spread of the infections. During several pandemics of influenza in the last century, the public health intervention at the earliest stage of the epidemic such as social and physical distancing, wearing mask, frequent hand washing, and movement control of the people has helped in slowing down the spread. Medical treatments and immunizations help prevent severe complications and death. The pandemic ended when herd immunity was established in the population because of natural infection or vaccination. However, rapid population growth and human activities have led to environmental intrusion into wildlife habitat, leading to the zoonotic transfer of new infections to the people. Preparedness for any pandemic threat should focus on reducing poverty and poor living conditions, changing risk behaviours that trigger infection, and strengthening public health infrastructure. The monitoring system should be able to detect a lifethreatening infection and provide early warning to other areas for rapid response. Risk communication with vulnerable groups, source containment strategies and multinational collaboration are required to prevent the spread. Public health measures should be implemented promptly until specific treatments and vaccines are available for the pandemic. Effective planning to balance health priorities with economic and fiscal policies is critical to the country's survival. This requires strong leadership and political stability at the local and global levels.