OPINION | Echoes of 2020: As the Nipah Virus Looms, Can We Survive Another Era of Denial
Reflecting on the 2020 pandemic response, personal stories of survival, and the 2026 Nipah virus outbreak in India. Can history predict how leadership handles new health emergencies?
In December 2019, COVID-19 originated in Wuhan, China. By March 11th, the World Health Organization declared a global pandemic. The world shut down for weeks, leaving millions without jobs. Donald Trump first mentioned COVID-19 on January 22nd, 2020, during a CNBC interview.
When asked if he was worried about the virus, his response was:
“No. Not at all. And we have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.”
As the world saw what happened over the remainder of the first Trump term, with the pandemic, many are fearing the rise of another health emergency. During the initial pandemic response, Trump mocked professionals and continuously lied to the American people while our most vulnerable were dying. Businesses remained open, and classrooms were crowded until the eventual shutdown. It was supposed to be two weeks, but many are still in shutdown.
My personal story with COVID-19 is a very lucky one. At the direction of Trump’s administration, I was prescribed hydroxychloroquine, which, in theory, according to Trump, should treat the virus when his administration recommended this as proper treatment to healthcare professionals. I had cardiac symptoms, and my doctor checked on me every day. No one knew what this virus was, and I was lucky, unlike millions who lost their lives due to government mismanagement of emergency response. During this time, I was also homeless in a shelter, and as the government shut down, so did social services. The shelter did its best to help me by having a nurse check on me and moving the other inhabitants into hotel rooms. As my time was nearing an end and I recovered initially, I found myself in a hotel room for only three weeks, trying to find a place to live. Still, no services were available, and at the time, with my job, I could not afford to pay the growing security deposits and rent. I look back on this time and am thankful for all the people who helped me, bought me food, let me stay a night on their couch, and even let me shower before work.
As the summer approached, the world had shifted drastically from what it once was. Roads were closed and blockaded, allowing businesses to distance their merchandise and dining accommodations. Indoor events did not yet exist, and most events took place outside. Unlike the first day of “lockdown,” the roads were bustling with people, some still wearing. A mask, while the Trump base declared wearing a mask was imposing on their freedoms. As you know, in 2020, police murdered George Floyd, and unrest in the name of justice followed. Trump famously said, “When the looting starts, the shooting starts”.
Now the year is 2026 and we haven’t even finished January. The World Health Organization has declared the Nipah Virus another zoonotic virus of top priority due to its high fatality rate. Currently, the WHO has said the outbreak is contained in West Bengal, India, but with the highly populous areas, many fear a worldwide outbreak is looming. The population of this region is nearly 100 million and positioning itself as one of the most densely populated areas in the world. Approximately 10% or fewer of infected individuals transmit the Nipah virus to others, but transmission is highly heterogeneous, with some “super-spreaders” infecting dozens of others.
How will Trump handle the next pandemic in a world where we have nearly eight hundred measles cases in the United States and we have lost the title of saying as a country the diseases is eradicated which has stood for us nearly two decades now. If you are asking this question, you might consider looking to the past to predict the future. Based on what we know, Trump will downplay the threat, leaving you at risk. Trump has the best medical care in the world and nothing is spared.
As the Nipah Virus spreads rapidly when an outbreak is occurring we can only hope health officials will contain the virus and prevent deaths.
Health Information About Measles:
Key facts
Measles is a highly contagious, serious airborne disease caused by a virus that can lead to severe complications and death.
Measles vaccination averted nearly 59 million deaths between 2000 and 2024.
Even though a safe and cost-effective vaccine is available, in 2024, there were an estimated 95 000 measles deaths globally, mostly among unvaccinated or under vaccinated children under the age of 5 years.
The proportion of children receiving a first dose of measles vaccine was 84% in 2024, slightly below the 2019 level of 86%.
Overview
Measles is a highly contagious disease caused by a virus. It spreads easily when an infected person breathes, coughs or sneezes. It can cause severe disease, complications, and even death.
Measles can affect anyone but is most common in children.
Measles infects the respiratory tract and then spreads throughout the body. Symptoms include a high fever, cough, runny nose and a rash all over the body.
Being vaccinated is the best way to prevent getting sick with measles or spreading it to other people. The vaccine is safe and helps your body fight off the virus.
Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every two to three years and caused an estimated 2.6 million deaths each year.
An estimated 95 000 people died from measles in 2024 – mostly children under the age of five years, despite the availability of a safe and cost-effective vaccine.
Accelerated immunization activities by countries, WHO, the Measles & Rubella Partnership, and other international partners successfully prevented an estimated 59 million deaths between 2000 and 2024. Vaccination decreased an estimated measles deaths from 780 000 in 2000 to 95 000 in 2024 (1).
Signs and symptoms
Symptoms of measles usually begin 10–14 days after exposure to the virus. A prominent rash is the most visible symptom.
Early symptoms usually last 4–7 days. They include:
running nose
cough
red and watery eyes
small white spots inside the cheeks.
The rash begins about 7–18 days after exposure, usually on the face and upper neck. It spreads over about 3 days, eventually to the hands and feet. It usually lasts 5–6 days before fading.
Most deaths from measles are from complications related to the disease.
Complications can include:
blindness
encephalitis (an infection causing brain swelling and potentially brain damage)
severe diarrhoea and related dehydration
ear infections
severe breathing problems including pneumonia.
If a woman catches measles during pregnancy, this can be dangerous for the mother and can result in her baby being born prematurely with a low birth weight.
Complications are most common in children under 5 years and adults over age 30. They are more likely in children who are malnourished, especially those without enough vitamin A or with a weak immune system from HIV or other diseases. Measles itself also weakens the immune system and can make the body “forget” how to protect itself against infections, leaving children extremely vulnerable.
Who is at risk?
Any non-immune person (not vaccinated or vaccinated but did not develop immunity) can become infected. Unvaccinated young children and pregnant persons are at highest risk of severe measles complications.
Measles is still common, particularly in parts of Africa, the Middle East and Asia. The overwhelming majority of measles deaths occur in countries with low per capita incomes or weak health infrastructures that struggle to reach all children with immunization.
Damaged health infrastructure and health services in countries experiencing or recovering from a natural disaster or conflict interrupt routine immunization and overcrowding in residential camps increases the risk of infection. Children with malnutrition or other causes of a weak immune system are at highest risk of death from measles.
Transmission
Measles is one of the world’s most contagious diseases, spread by contact with infected nasal or throat secretions (coughing or sneezing) or breathing the air that was breathed by someone with measles. The virus remains active and contagious in the air or on infected surfaces for up to two hours. For this reason, it is very infectious. One person infected by measles can generate up to 18 secondary infections.
It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts.
Measles outbreaks can result in severe complications and deaths, especially among young, malnourished children. In countries close to measles elimination, cases imported from other countries remain an important source of infection.
Treatment
There is no specific treatment for measles. Caregiving should focus on relieving symptoms, making the person comfortable and preventing complications.
Drinking enough water and treatments for dehydration can replace fluids lost to diarrhoea or vomiting. Eating a healthy diet is also important.
Doctors may use antibiotics to treat pneumonia and ear and eye infections.
All children or adults with measles should receive two doses of vitamin A supplements, given 24 hours apart. This restores low vitamin A levels that occur even in well-nourished children. It can help prevent eye damage and blindness. Vitamin A supplements may also reduce the number of measles deaths.
Prevention
Community-wide vaccination is the most effective way to prevent measles. All children should be vaccinated against measles. The vaccine is safe, effective and inexpensive.
Children should receive two doses of the vaccine to ensure they are immune. The first dose is usually given at 9 months of age in countries where measles is common and 12–15 months in other countries. A second dose should be given later in childhood, usually at 15–18 months.
The measles vaccine is given alone or often combined with vaccines for mumps, rubella and/or varicella.
Routine measles vaccination, combined with mass immunization campaigns in countries with high case rates are crucial for reducing global measles deaths. The measles vaccine has been in use for about 60 years and costs less than US$ 1 per child. The measles vaccine is also used in emergencies to stop outbreaks from spreading. The risk of measles outbreaks is particularly high amongst refugees, who should be vaccinated as soon as possible.
Combining vaccines slightly increases the cost but allows for shared delivery and administration costs and importantly, adds the benefit of protection against rubella, the most common vaccine preventable infection that can infect babies in the womb.
In 2024, 76% of children received both doses of the measles vaccine, and about 84% of the world’s children received one dose of measles vaccine by their first birthday. Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as not all children develop immunity from the first dose.
Approximately 30 million infants remained under-protected against measles in 2024, according to WHO and UNICEF estimates.
WHO response
In 2020, WHO and global stakeholders endorsed the Immunization Agenda 2021–2030. The Agenda aims to achieve the regional targets as a core indicator of impact, positioning measles as a tracer of a health system’s ability to deliver essential childhood vaccines.
WHO published the Measles and rubella strategic framework in 2020, establishing seven necessary strategic priorities to achieve and sustain the regional measles and rubella elimination goals.
Without sustained attention, hard-fought gains can easily be lost. Where children are unvaccinated, outbreaks occur. Based on current trends of measles vaccination coverage and incidence, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) concluded that measles elimination is under threat, as the disease resurged in numerous countries that achieved, or were close to achieving, elimination.
WHO continues to strengthen the Global Measles and Rubella Laboratory Network (GMRLN) to ensure timely diagnosis of measles and track the virus’ spread to assist countries in coordinating targeted vaccination activities and reduce deaths from this vaccine-preventable disease.
The IA2030 Measles & Rubella Partnership
The Immunization Agenda 2030 Measles & Rubella Partnership (M&RP) is a partnership led by the American Red Cross, United Nations Foundation, Centers for Disease Control and Prevention (CDC), Gavi, the Vaccines Alliance, the Gates Foundation, UNICEF and WHO, to achieve the IA2030 measles and rubella specific targets. Launched in 2001, as the Measles and Rubella Initiative, the revitalized Partnership is committed to ensuring no child dies from measles or is born with congenital rubella syndrome. The Partnership helps countries plan, fund and measure efforts to permanently stop measles and rubella
Information About Nipah Virus:
Nipah virus infection is a zoonotic illness that is transmitted to people from animals, and can also be transmitted through contaminated food or directly from person-to-person. In infected people, it causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers.
Although Nipah virus has caused only a few known outbreaks in Asia, it infects a wide range of animals and causes severe disease and death in people.
During the first recognized outbreak in Malaysia, which also affected Singapore, most human infections resulted from direct contact with sick pigs or their contaminated tissues. Transmission is thought to have occurred via unprotected exposure to secretions from the pigs, or unprotected contact with the tissue of a sick animal.
In subsequent outbreaks in Bangladesh and India, consumption of fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats was the most likely source of infection.
Human-to-human transmission of Nipah virus has also been reported among family and care givers of infected patients.
Symptoms:
Human infections range from asymptomatic infection to acute respiratory infection, seizures and fatal encephalitis. Infected people initially develop symptoms that include fever, headaches, myalgia, vomiting and sore throat. This can be followed by dizziness, drowsiness, altered consciousness, and neurological signs that indicate acute encephalitis. Some people can also experience atypical pneumonia and severe respiratory problems, including acute respiratory distress. Encephalitis and seizures occur in severe cases, progressing to coma within 24 to 48 hours.
The incubation period is from 4 to 14 days but an incubation period as long as 45 days has been reported.
Most people make a full recovery, although some are left with residual neurological conditions after acute encephalitis. Some cases of relapse have been reported.
The case fatality rate of Nipah virus infection is estimated at 40–75% but can vary by outbreak depending on surveillance and clinical management in affected areas.
Treatment:
There are currently no drugs or vaccines that specifically target Nipah virus infection. WHO has identified Nipah as a priority disease for the WHO Research and Development Blueprint.
Intensive supportive care is recommended to treat severe respiratory and neurologic complications.
HEALTH INFORMATION FROM THE WORLD HEALTH ORGANIZATION