key: cord-0724040-tfcv5zf0
authors: Kahambing, Jan Gresil
title: COVID-19, natural vulnerability and zugzwang
date: 2020-10-12
journal: J Public Health (Oxf)
DOI: 10.1093/pubmed/fdaa186
sha: 9d028a3200922832f63a0e43b51e46a44d8defef
doc_id: 724040
cord_uid: tfcv5zf0

nan

The coronavirus disease 2019 (COVID-19) is a disaster that merits vulnerability. One way to look at this is to focus on exposure and vulnerability response, particularly on social vulnerabilities that take into account the social, sociohistorical and economic conditions that increase the risk in the pandemic. 1 Another, this correspondence stresses, is natural vulnerability, which stems from natural factors coalescing into increasing biological risks. 2 In mid-August, a strain of COVID-19 commonly found in Europe and the USA was recently identified in Southeast Asia, particularly in the Philippines, Singapore and Malaysia. With a slight alteration from the novel coronavirus in Wuhan, China, the mutated virus albeit indefinitely is more infective and goes straight to target cells. Malaysia calls it a 'superbug,' following samples from India and the Philippines, which has the potential to get worse. 3 The strain was scientifically published to be the D614G mutation in the SARS-CoV-2 spike protein, which 'transmits more e ciently' than the original D614 'wild type' strain. 4 The Philippine Genome Center has confirmed the existence of the dominant strain but insisted on more needed samples to conclude its fast transmissibility. 5 Although the virus, strictly speaking, is not a catastrophe like a natural disaster 6 brought about by anthropocentric conditions, 7 the pandemic is originally natural in terms of its biohazard risks. The division of scholars on the speculation of the strain's mortality or infectivity rate should warrant the concern that risks in the epidemiological status of the pandemic still occupies the main stage, mitigating some thoughts on the virus as an 'invention'. 8 Studies showing the higher virulence of the new strain 9 run the risk of being covered with political agendas that may glaringly intervene to the point of deviating the real deal of the crisis. This seems to be one of the fundamental mistakes that the editors appropriately pointed out, namely, that 'in the final analysis, all countries will be found to have made mistakes and the politicization of COVID-19 by both the left and the right across the world, which will not help in controlling this pandemic.' 10 That being said, the concept of 'herd immunity' as a perceived biological protection cannot be taken as the only solution, despite having to wait for a vaccine. This initially points to population immunity as a COVID-19 'zugzwang' 11 where many side e ects in other areas of intervention may ensue. Second waves and flattening updates do not guarantee the attainment of community immunization. Pakistan, for example, has reportedly flattened its curve but it appears that herd immunity is still nowhere in sight, not to mention that the cause is not yet known. 12 It is to be cautioned, in conclusion, that interventions here and there-in the name of waiting for the solution-might over-focus one to the detriment of the others. In the words of the editors, 'those who have to make or inform the decisions are often in a no-win situation, as every country will be found to have made mistakes by the time the pandemic is over.' This risky paralyzing scenario seems to be the real zugzwang, seeing that natural and social vulnerabilities combined prove to be more fatal altogether.

The author declares no conflict of interest in this paper.

COVID-19 as a natural disaster: focusing on exposure and vulnerability for response

Vulnerable populations in the context of public health emergency preparedness planning and response

Public health and local emergency ethics: vulnerability in Eastern Samar

Living the Anthropocene from the 'end of nature' to ethical prospects

The invention of an epidemic

Could the D614G substitution in the SARS-CoV-2 spike (S) protein be associated with higher COVID-19 mortality?

Prediction is very di cult, especially if it's about the future

COVID-19 zugzwang: potential public health moves towards population (herd) immunity

How did Pakistan Flatten the Coronavirus Curve