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“Disease X” brings grim tidings for 2021

Many of us were glad to see the end of 2020. The year has seen global upheaval as a result of the COVID-19 pandemic. However, hope is on the horizon. Vaccines are rolling out or are about to be rolled out across the globe, sparking hopes for a brighter year in the form of 2021. These hopes may be short lived, however. According to one doctor, a “Disease X” is yet to come.

disease x, ebola
The isolation ward of the Gulu Municipal Hospital in Gulu, Uganda, during an outbreak of Ebola haemorrhagic fever in October 2000. Image credit: Daniel Bausch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, CDC [Public domain]
“Disease X” is a rather ominous sounding concept, but not a new one. The term refers to an as of yet-unclassified pathogen that the World Health Organization (WHO) alluded to previously that could cause an international pandemic of vast proportions.

At the time of writing, the COVID-19 pandemic has seen the global burden of confirmed cases surge to more than 85 million cases over the past year. Deaths due to COVID-19 number in excess of 1.8 million. The number of lives lost may simply be the start of the issues caused by the pandemic. 

Lockdown measures have created an economic impact that has all but decimated many communities. In India in particular, day labourers numbering in the millions found themselves unable to work at a moment’s notice. This sparked a mass exodus from the cities back to their home villages — an event that likely contributed to the permeance of COVID-19 in India’s rural regions.

By all rights, COVID-19 fulfils the WHO’s concept of being “disease X”. When first reporting on the potential of COVID-19 being the described “disease X”, Health Issues India noted in February of 2020 that “COVID-19 has now far exceeded its previous comparable conditions such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).” 

Yet COVID-19 may be only a forebearer of public health emergencies to come. Professor Jean-Jacques Muyembe Tamfum — famed for being one of the team that discovered the Ebola virus in 1976 — has suggested as much; that the worse may be in store in the near future. 

“We are now in a world where new pathogens will come out,” Muyembe told CNN. “And that’s what constitutes a threat for humanity.” When questioned as to the prospect of “future pandemics…worse than Covid-19, more apocalyptic?”, his grim response was “yes, yes, I think so.”

Ebola was found to cause haemorrhages and killed about 88 percent of patients and eighty percent of the staff who were working at the Yambuku Mission Hospital when it was first discovered. It does, however, differ from COVID-19 in the means of transmission.

While COVID-19 is spread by airborne droplets — thereby making its transmission worryingly rapid due to the fact that simply standing in close proximity to an infected individual runs the risk of transmission — Ebola is spread through contact with the bodily fluids of an infected individual. This transmission method is far less rapid, and typically only presents issues for those who are either in proximity with an infected individual for extended periods, or are actively caring for the individual, such as family or medical staff.

Professor Muyembe has brought grim news to the media’s attention — that of a new potential “disease X”. A woman in the Congo was brought to doctor’s attention when displaying similar symptoms to Ebola such as haemorrhagic fever. After the woman tested negative for a range of tests including Ebola, the doctor’s were left unsure of the nature of the disease, designating the woman patient zero for “disease X.”

Scientists have speculated at this point that the disease could spread at a similar rate to COVID-19, though has the potential for a mortality rate between fifty and ninety percent. Data to validate such claims has — as of yet — not been released to the public. Should such claims be true, and the disease does begin to spread in a similar manner as COVID-19, the results would be no less than “apocalyptic.” 

To put the figure into perspective, with 85 million cases and 1.8 million deaths, COVID-19 has a mortality rate of roughly two percent. When applying the fifty to ninety percent figures, this “disease X” would, at the current caseload of COVID-19, have claimed 42.5 million to 76.5 million lives. 

Such figures are hugely concerning – though, as of yet with only a single case being reported, are purely speculation. What remains true is that warnings of a potential “disease X” have been reported from the Congo region for many years. Zoonotic conditions are rife in the area. Climate change and environmental destruction are only driving the crisis.

Sub-saharan Africa is a hotbed of zoological diversity. Many species have had only sporadic or next to no contact with humans. There are a host of undiscovered diseases amongst these species that have the potential to transmit to humans, or to mutate to allow infection should prolonged contact occur. 

Environmental destruction, often to pave the way for settlements or farming land has brought many of these species into contact with humans. Prolonged exposure to livestock animals has provided a channel through which many of these diseases may eventually spread into a human population. India has seen similar situations with diseases such as Kyasanur forest disease — spread through ticks predominantly to those working in rural areas.

COVID-19 has demonstrated the pace at which zoonotic conditions can spread from a small outbreak to a global pandemic. While the speculated disease X is, as of yet, an isolated incident, this may not remain the case for long, warranting severe caution given the potential for such a severe mortality rate.

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