Dick Brass: Why we are lucky in the fight against Covid

Medical professionals have reason to feel positive in the fight against Covid. Photo / Getty Images

Opinion

OPINION:

My brother in Houston tested positive for Covid yesterday. I am writing today about how incredibly lucky we are.

This may seem at first glance an odd statement, given that 316,000 of my fellow Americans are dead from this nasty disease and my brother now has a very small but real chance of joining them. But please hear me out.

My brother AJ is 50, and in good health otherwise. So far, he feels fine but, of course, that could change quickly. We think he was probably exposed last week at a small, masked outdoor gathering with a few neighbours. Two others in the group now have it too.

Like America in general since Covid first appeared, they took precautions - but not nearly enough. They wore masks, but not when they actually ate and drank. They distanced, but obviously not far enough. They were outside, but that's not a magic bullet either.

In Texas, where the right-wing Republican governor has been pushing President Donald Trump's Covid denial and anti-masking madness, AJ is actually regarded as a Covid fanatic who avoids most risky situations.

That's in part because various family bubble members are elderly or immunocompromised. Now everyone is in serious quarantine to make sure it doesn't spread further. So this is going to be a very, very anxious Christmas for the Brass family.

And yet, it could have been so much worse.

The case fatality rate (CFR) for Covid varies by country and situation, but it's thought to be about 1.7 per cent for all cases averaged together in the United States right now.

It's probably less than 1 per cent for AJ. It rises dramatically to 10 per cent and higher for the high-risk elderly. But Covid's close cousin Sars killed about 10 per cent of everyone infected. Mers, another coronavirus, kills about a third.

The CFR for smallpox is similar. Untreated plague kills about two thirds. Ebola kills up to 90 per cent of its victims in some outbreaks. Rabies kills almost 100 per cent of all untreated infections. As did early, untreated Aids.

The fact that Covid is a disease on the low end of potential lethality was not a given. There is nothing special about Covid that required it to be as it is. It could have been as deadly as smallpox or even rabies.

While it's true that successful diseases tend to gradually become less lethal so they can spread more widely without killing off their hosts, there is nothing in biological science that sets the human lethality of a new virus. It is luck. And we were very lucky.

The coronavirus vaccine. Photo / 123RF

Nor was it a given that a successful vaccine could be developed for Covid. There is still no effective vaccine for zika, malaria or Aids. And it's not for want of trying.

President-elect Joe Biden's esteemed Chief Medical Advisor Dr Anthony Fauci has been working hard on an Aids vaccine since the early 1980s. But the unique nature of the HIV virus that causes Aids makes it a very tough nut to crack.

The stunning 95 per cent efficacy of the Pfizer vaccine both New Zealand and the US has purchased was absolutely not guaranteed or even expected. The Moderna vaccine has similar results, and within a year there will be many others. That's luck too.

My wife Regina knows about this from personal experience. She has seen it happen once before.

A retired MD now, she was a young nurse when Aids first appeared in NYC in the early 1980s. One of her patients was Aids' famous Patient Zero. At one time, she kept a single page of paper on which was written the names of every Aids patient in New York City. In a year, there would be many thousands.

As of today, the World Health Organisation estimates that more than 32 million have died of Aids globally. Covid, which has so far killed about 1.6 million, seems unlikely to get anywhere near Aids' grim butcher's bill. The reason? To a great extent, luck.

There is more good fortune, due to amazing progress in medical science and technology since then. It took two years to identify the HIV virus after the first Aids patients appeared in Regina's hospital. It took just weeks to isolate and sequence the SARS-CoV-2 virus that causes Covid.

It took many years before the first effective drug treatments for Aids appeared. It took only months before we were able to deploy dexamethasone and monoclonal antibodies to fight Covid.

In 1982, there was no high-speed global web to facilitate research collaboration. Today, every virologist in the world can work together. Every nation can see what works in Covid-successful nations like New Zealand.

Donald Trump. Photo / AP

In the US, of course, we were hobbled a bit. Our President lied, bungled and ultimately gave up any leadership in fighting Covid. He called it a "hoax", pretended it would go away, and even suggested nonsensical therapies like injecting disinfectants.

Although he did also push for vaccine development, it would be fair to say that few developed countries have done much worse than us. Given Trump, we were very lucky it wasn't even worse.

This is going to be a scary end to a rotten year for our family. It's been much worse already for the millions who have died, suffered or lost loved ones.

On the other side of Trump, it will be possible again under Biden for the world to unite on health. We must put in place enough science, surveillance, and responsibility to prevent another Covid. Trillions of dollars would be cheap insurance.

We can't count on luck going forward.

Dick Brass was vice-president of Microsoft and Oracle for almost two decades. His firm Dictronics developed the first modern dictionary-based spell check and he was an editor at the Daily News, NY