Dr John Amuasi

Health Outcomes Researcher at the Global Health and Infectious Disease Research Group says there will be more pandemics to come after coronavirus.

Dr John Amuasi attributes it to the level of interaction of humans to ecosystems and lifestyle, which influence their susceptibility to diseases.

He said humans’ destruction of biodiversity creates conditions for new viruses and diseases like COVID-19.

Indiscriminate felling of trees, killing of animals for food and disruption of ecosystems, which set viruses loose from their natural to new hosts, are major factors.

He cited diseases like rabies and plague, which crossed from animals to human many years.

Dr Amuasi said emerging animal-borne infectious diseases are increasing and very significant threat to global health, economy and security.

Below is the transcription of the interview…

Can you briefly describe yourself?

Dr Amuase: My name is John Amuasi, Faculty lecturer at the school of Public health at KNUST, Department of Global Health and I lead the Global Health and Infectious Disease Research Group at the Kumasi Center for Collaboration Research in Tropical medicine here on the KNUST campus.

Are you surprised about the coronavirus outbreak?

Dr Amuasi: I would say I am surprised in one breath and also not surprised in another breath.

I’m surprised at the kind of effect it has, but not surprised that we can have pathogens that can emerge in a way it did and killed people the way it’s killing.

Journalist: Some scientists say the majority of pathogens are yet to be discovered and that this is just the beginning. Do you agree with them?

Dr Amuasi: It is difficult to tell how many pathogens we have discovered out of there. The truth of the matter is that we do not know. But what we know for sure, is that they are many other pathogens out there which we do not know of.

What should even prove this to us is what we can even see with our naked eye in terms of animal species or multicellular organisms which are visible to the naked eye.

We are still discovering newer ones and one place where we are discovering most of these is deep in the sea. Which is ocean depth man has not been able to access?

So if even what we able to see with the naked eye were discovering more of them then it should tell you, what we cannot see must be a lot more.

But the truth is that we do not know how much are out there.

Should that be a worry?

Dr Amuase: It shouldn’t be a worry per se. The reason is that they’re always microorganisms and pathogens that exist out there. Thus a majority of them we know are not pathogens that will kill or negatively impact on health. In actual fact even within our own bodies, they are what we call bacteria flora. So they are bacteria that exist within our body which allows us to function optimally. And the absence of this is not even good for our health.

They are bacteria, viruses and other pathogens which helps us build immunity. So that we are able to be stronger and be able to fight diseases better. But perhaps what is more alarming or should be of more concern, is the ability to exist pathogens to change in scientific parlance we say “to mutate”. Not only that but also, the potential of untimed microbial resistance, which is pathogens either too were responsive to drugs now becoming resistant. That is something we should be more of concern about those that exist out there which we know nothing about.

Sometimes we develop immunity naturally. So the body mounts this immune response and we are able to tackle the disease without any significant mobility or even mortality.

Or some people are able to become immune and others are not. And those who become immune survive and those who cannot die off and humanity continues.

This occurs to varying degrees with varying levels of impact both depending on who we are, our constitution as human beings as well as the nature of that extraneous agent which will be that pathogen.

I can give you a very classic example of this: you realize how the colonizers came from the west when they came to the shores ofWestt Africa. The missionaries and the traders and others were dying in groups for malaria.

Journalist: There are other concerns by scientists that because humans invade tropical forests and other wild landscapes, which harbour so many unknown viruses that is why we seeing an upsurge in a disease like COVID-19?

Dr Amuasi: Well It is true that human beings over centuries have been taken over pristine dwelling places of other species particularly rainforest. And the reason why we place a lot of emphasis on rainforest is that these very unique habitats which are very dense both in terms of the flora and the fauna macroscopically and microscopically as well.

And these have coexisted for centuries without any intrusion of any distance species. In fact, these are ecosystems, which have evolved over the centuries to allow for a certain balance, so that the animals big and small, the microorganisms, of course, there are not big and small they are all-small but are various sizes able to coexist.

Now entire human being becomes a disruptor not only by the entrance of the species human being but also the way, we destabilise these balance. Right, and in destabilising these balance it allows new powers to emerge. And there is what’s called a species power struggle, these species power struggle pants out to the naked eye alright and also it pants out microscopically. alright.

So you would have new viruses, bacterial and other pathogens now attacking human beings or coming into contact with human beings and trying to find their level and trying to find their balance. It’s up to us human beings we can to be able to have immunity or to be able to develop immunity.

Do pathogens respect species boundaries?

Dr Amuasi: Pathogens will always respect boundaries but the question is, what are these boundaries and what accounts for these boundaries? I will explain.

A pathogen can only function or take over an organism, which is vulnerable. Which is not able to mount a strong enough response to it’s invasion.

Now, these are very complicated or complex microorganisms, which function in complicated ways. So the ways in which a certain pathogen may function in a dog may be different from the way it may function in a human being.

Some of these pathogens can function in both dogs and in human beings like rabies for example. It can infect dogs and then affect human beings. But there are some other pathogens like malaria parasites, which will not affect dogs but can affect human beings because of the nature of the pathogen.

There are others, which can affect a wide variety of species.

What you can say is that there a lot of pathogens that would often respect species boundaries in the broader sense like when you talk of mammals, amphibians, reptiles and others you’d have microorganisms confined to these broad species.

But what becomes often very disruptive is when there is a broad or wide species jump, like say a virus jumping from amphibians to human beings or from fish to human beings or from reptiles to human beings.

Once that is able to happen, the impact that it can have is often catastrophic because it is a very wide gap between the two of them and the species of the microorganism species are only beginning their interaction.

Is it also true that, humans are creating the conditions for the spread of diseases by reducing the natural barriers between virus-host animals in which the virus is naturally circulating and themselves?

Dr Amuasi: Human beings will be at the centre of it all because human beings typically have controlled or influenced the ecosystem in ways that are amazing especially over the past century. The degree of human development, knowledge and interaction has increased exponentially over the past century.

So both by increasing the level of interaction that we have with ecosystems that either too did not have any human involvement or intrusion and also our very lifestyles and the degree of interaction that we have, are all influencing our susceptibility to disease.

Now we are going into a pristine rain forest, cutting down trees, taking away animals, caging them, eating them, and interacting with them.

We are even going as far as reclaiming the sea to build mega cities like what is happening or what happened in Dubai and Saudi Arabia and the Emirate and is happening much closer to home. Even in Nigeria in Lagos, they are actually reclaiming the sea and expanding the megacities.

But not only these activities but how proximal we are to each other. We are living in concrete jungles; people packed together in very small spaces.

Now because we can build up, we just stuck ourselves up instead of spreading wide. Not that one is better than the other per se but now you have densely populated areas. They have megacities. Look at places like Lagos, Accra. Look at how densely populated we are.

Beyond that, look at how easily we are able to move across continents within just a couple of hours.

Today in Ghana we have over seven daily international flight from Europe alone coming in every day. Each carrying at least 200 people. All right.

So that means within a couple of hours you can move from a remote village in Europe to a remote village in Ghana with just a couple of hours and you could be carrying anything and everything.

All right, you may meet people coming from different part of the world and also then we disperse back so there is this influx and efflux continuing everyday which makes it even more difficult to contain the spread of these kinds of pathogens which we may have originally picked from ecosystems that have not had a human intervention.

There are also concerns that viruses and other pathogens move easily from animals to humans in many informal markets especially where they are sold as meat.

Dr Amuasi: Well, pathogens traditionally have moved from animals to human over the centuries.

You can look at the disease like rabies, which centuries ago moved from mammals like dogs into human beings.

This has been happening all the time. You can look at the disease that has caused the greatest pandemics on earth, which is a plague. It is actually spread by rats and this back in the day accounted for one-third of the world population died on account of this it.

Now that is the disease which today we can control quite efficiently. Although, it will interest you to know that most recently we have outbreaks and actually ongoing outbreak of plague in Africa particularly in Madagascar, where people are still dying from the plague. But it is not that these diseases are not there anymore, they are there, they are moving between animal and human all the time, except that our intervention today allow us to better address them.

So that movement of pathogens between animal and humans will continue. It is the impact it will have on human health, and ultimately on the economy and the way in which we behave will determine the course of this world. But we shouldn’t be worried because we can never stop the interactions between human beings and animals and therefore the microorganisms that interact between human being and animals will always be in back and forth.

Scientists warn coronavirus outbreak may just be the beginning of mass pandemics. Do you agree with them?

Dr Amuasi: What I can say is that, whenever this pandemic goes away, it will not be the last; there will be others to come. What we need to do is to be prepared to know what to do.

Maybe I should backtrack a bit and say to be able to identify them as quickly as possible and also to know what to do. We had an epidemic of plague, we had smallpox, we had cholera and the Influenza. So we know that these would keep coming to us, but how can we determine them quickly?

It’s by having a strong routine surveillance system. When we talk about the surveillance system, it sounds technical. But it is just by opening your eyes. When you are able to see better, you can act better, by seeing better means being able to quickly identify disease caused by pathogens which we have not known before.

It’s all the function of having the right health systems and surveillance tools in place. And this is what exactly happens in Wuhan-China where doctor observed an abnormal pattern and then you decided to report, we are seeing people coming in with the severest respiratory distress but the way they’re representing is very similar to SARS, and it could be a problem. Of course, it was shut down and unfortunately, it has contributed to this explosion of the disease.

So being able to set up surveillance system which includes being able to conduct tests for the people who are sick, and not just treating blindly based on the symptoms that they are showing which will help us to large extend to avoid an explosion of the disease like this. But there will be epidemics. This is not the last.

So what should we do?

Dr Amuasi: What we must do, we must focus on mitigating the negative effect of this interaction we have with animals, matter organisms all of which we co-exist within the environment.

One of the things is to be aware of the ways in which these are transmitted. When we become aware of which they are transmitted, we are able to modify our lifestyle so that we reduce the transmission.

A lot of these are transmitted on an account of over-crowding, touching and close contact. When we know these, we can reduce or limit their transmission. A lot of these can also be addressed by the provision of immunisation or vaccination.

Once we are able to develop the appropriate vaccines, the important thing is to make these available as to why they are possible.

The more people are immune to it, the less the chance of it spreading and the fewer people are immune to it, the greater the chance of transmission and we’ve seen this.

The disease like measles which is In the upsurge in Europe, because people have not seen the disease for a decade and feel so there is no need for vaccination or immunization anymore, and we see a resurgence of these kinds of diseases.

And one more thing that we can do to address this also is to constantly be aware that, we live in an ecosystem, and the way in which we disrupt our ecosystem has an Implication for our future as a human beings, and the health and wealth of our planet. Therefore, every attempt or effort to radically disrupt the ecosystem will be met with consequences.

You look at the human being, the animal or the non-human species, and the shared environment in which we live, and make choices and decision in a way that does not unduly disrupt this balance because when this balance is disrupted, we will suffer and that is what we are seeing today.

Dr Amuase: My final word would be that the human species and the human race has come a long way. This isn’t the worst pathogen that we have faced. Although the impact that this is having is quickly moving towards perhaps the worst that humanity has seen.

What am saying is that the pathogen itself is not as destructive as in itself as pathogen biologically as the impact it’s having on our society. This pathogen is going a step further beyond just making people sick and making some die in fact technically less than the number of people who would have died if they had ebola.

Is the degree to which is going to disrupt our way of life, and isolate us as communities and as individuals. This where the problem is. But it is important that we do not fear unnecessarily and that we do not panic. Because when this happens, it further disrupts our lives, disrupts our communities and can send us down a spiral, which would become difficult for us to come out of.

Largely, it is the way we behave and the way we react to this that would determine our future.

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