PAGE 67
2020
A TALE OF TWO PANDEMICS It will have escaped no one’s attention that we are in the middle of a global pandemic of an infectious disease. The pandemic may have caught some of you more, or less, unawares than others. I certainly would be the first to say that I didn’t see it coming, although perhaps I have less of an excuse, as it was just over five years ago that I was working in our last global infectious disease outbreak – the West African Ebola pandemic in 2014-2015 – for the King’s Sierra Leone Partnership.
Parties and a commemorative beer were some of the ways people celebrated the end of Ebola
Although a full lockdown was brief in Sierra Leone, the lower transmissibility and lack of airborne spread of Ebola – when compared to the COVID-19 – meant this was a less useful public health intervention; I vividly remember the empty streets of Freetown. Outside of the lockdown, for long periods businesses were boarded up, schools were shut, and the normally energetic hustle and bustle of streets subdued. Closing down shop, staying at home, and not seeing loved ones is hard whoever and wherever you are in the world but it is always hardest for those who have least, as it was in Sierra Leone. A pandemic may arrive with a bang but disappears with a long and drawn-out whimper. It was almost exactly a year after the peak number of cases that the Ebola outbreak in Sierra Leone was officially declared over. The epidemiological characteristics of COVID-19 mean the ‘tail’ of the epidemic is likely to be longer, although we are fortunate to have an armory of vaccines to hasten the process. In Sierra Leone, the party was memorable and spread across every street; overwhelming joy and relief intertwined with memories of loss. I left Sierra Leone six months after that day but returned six months later – now a year after the official end of Ebola. It was only then I had the pleasure of experiencing the streets, markets and life in what I can only assume was full (and hearty!) swing. The effects of pandemic, such as the one we are in, will be long-lasting but time is a healer. During the time I was in Freetown, we started the process of reopening hospital services and packed a year of medical education and exams into six months. I joined a resurgent running club and trained with young athletes competing in local and West African competitions. When our time comes, we all will be called upon to start the process of rebuilding our lives, communities and workplaces. In Sierra Leone, the rainy season is dramatic and, sadly, sometimes fatal with landslides and streets washed away. People say that the end of rains begins once there has been ‘seven days rain’. We may be in our ‘seven days rain’ but I sincerely hope, and believe, that when it finishes, we will be at the beginning of the end, and the end is where we start from.
It was this experience in Sierra Leone that prompted me to undertake a part-time Masters in Epidemiology at the London School of Tropical Medicine and Hygiene, which in a large part was generously sponsored by a loan from the Old Alleynian Endowment Fund. Since that time, and after five years slow and steady study alongside my day-job as a respiratory doctor, I finished my course in September this year. This timing provides me with an opportunity to reflect on my Masters course in the context of my experiences in West Africa and more recently here in the UK. I hope, as fellow Old Alleynians, you will indulge me by allowing me to briefly share some of these reflections with you today. To start on a sombre note, both pandemics have epitomized the sorrow of loss in solitude. The infectious nature of both viruses has meant that persons unwell and admitted to hospitals endure their disease away from their families and loved ones, treated by staff whose human identify is disguised behind layers of PPE. Some of you may have experienced this personally, others may have seen images. The sadness of each unique circumstance is not describable in words nor is it capturable on screen.
During both pandemics colleagues have been affected. One may think that these persons are affected at random but infectious diseases rarely work like this. Instead, they preferentially affect those who put themselves in harm's way, either unavoidably through their work or through a lack of care for preventative measures.
The OA Endowment Fund provides interest-free loans to OAs hoping to gain a career-related course of study, a post-graduate degree or other qualification. Please contact the Chairman, Syd Martin (83-90) or the Secretary, Nick Rundle (69-76), for further information: alleynclub@dulwich.org.uk
Furthermore, my observation is that those who become infected are not just any healthcare professionals but the bravest, the first to put themselves forward to care and treat people. Despite the tragedy, I am happy to say that there is joy in seeing many recover and most often come straight back to caring, on the frontline.
A few of the Freetown Fashpack runners after competing at the Makeni Street Child Marathon in November 2015
Dr Patrick Howlett (95-02)
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