It seems like years have passed since the world first heard of an 鈥渁typical pneumonia鈥 circulating in the Hubei province of China in December 2019. When we鈥檝e seen similar reports in the past, the illnesses have had a variety of causes, but all were eventually containable. In the late 1990s, it was 鈥渂ird flu,鈥 an influenza virus that spread from birds to humans, strain H5N1. , Hong Kong culled millions of chickens in an effort to contain the virus, but it popped up again in 2003 and since then, sickening 861 and killing 455 of them鈥攁 53% case fatality rate.
"Everybody knows that pestilences have a way of recurring in the world; yet somehow we find it hard to believe in ones that crash down on our heads from a blue sky." - Albert Camus,
In 2002, it was the novel virus that eventually came to be known as coronavirus, for Severe Acute Respiratory Syndrome. It was circulating in China鈥檚 Guangdong province for months before it came to worldwide attention in February 2003, and eventually sickened over 8,000 people in 26 countries before being brought under control by strict quarantine and isolation procedures.
Since 2003, we have seen multiple types of novel avian influenza 鈥渟pill over鈥 from birds into humans in China, circulating alongside H5N1. We鈥檝e seen the emergence of , and , a numerical and alphabet soup of viruses. Virologists and epidemiologists know them well, but the general public was understandably oblivious to their identification.
So when reports of the latest odd pneumonia cases surfaced in December, one of two candidates seemed likely: a novel influenza virus or a coronavirus. The initial reports suggested it wasn鈥檛 easily spread between people: a new avian influenza seemed more likely. But just a few days later, person-to-person spread was confirmed, and cases seemed to be increasing rapidly. By January 8, a new coronavirus was announced, and we knew its entire genetic sequence by January 10.
What we didn鈥檛 know is that we likely already had the in the U.S. by that time, or that the memory of another pandemic would soon be evoked: the influenza pandemic of 1918.
The story of the 1918 influenza pandemic is that it was quickly forgotten in the collective memory of the general public. The most famous book about the outbreak is called 鈥,鈥 written by historian Alfred Crosby. Though it is estimated that a third of the U.S. population was infected and 675,000 died from fall 1918 through spring 1919, the collective amnesia around the epidemic seems almost deliberate: a decision no one personally made, but everyone followed to cleanse their memory of a disease that claimed friends and family members and shut down cities for weeks or months at a time.
Around the world, the effects of the epidemic to understand, track and improve the health of the population. A forerunner to the World Health Organization was formed in 1919. Many countries, including the United States, created or updated their health ministries. A number of countries , realizing it was both unfair and scientifically incorrect to blame individuals for their illnesses, and that it was in the interest of the entire country to keep their citizens healthy.
We have the specter of 1918 over us now, as we use the lessons learned that year to drive our interventions today. Though influenza and SARS-CoV-2 , we can use the same key methods to prevent the spread of both: hand hygiene and social distancing. You鈥檝e probably heard others implore you to 鈥溾 and slow the spread of the virus. These are based on many sources of data, but one that has been shared over and over is the graph of deaths from 1918 influenza in Philadelphia, where they continued to have parades and social gatherings even as the virus spread through the city, versus St. Louis, where they shut down public events much like we are today and had a significantly lower rate of death.
We don鈥檛 know right now how long we鈥檒l have to have these measures in place. Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases (NIAID), has suggested at least eight weeks of extensive social distancing will be necessary. A suggested that eight weeks might not even be long enough, that the virus may surge when social distancing is relaxed.
And there are uncertainties beyond the spread of the virus. We don鈥檛 have great answers about what will happen with unemployment and rent payments over the long term or how the mental health of all of us will be affected after months of physical separation from the rest of society. We don鈥檛 know if we鈥檒l quickly find drugs to help treat the infection or if we鈥檒l be able to develop a vaccine soon enough to make a difference. There are more unknowns than knowns, which is an understandable cause of anxiety for all of us鈥攕cientists included 鈥 though we鈥檙e doing what we can.
But the upside is that we all can play a role in determining our collective future. We can adapt to our new, temporary normal by keeping in contact over social media and video apps, checking in on our elderly neighbors who may be too scared to go out to grab groceries, by donating to food banks and other charities if you鈥檙e able, and by reaching out to others when you鈥檙e struggling and letting us know how we can provide aid.
We have been a divided country, but a pandemic transcends politics. We are all in this together, learning and sacrificing day by day. We don鈥檛 know how this will change our country over the long term when we come out the other side. This pandemic has already exposed the limitations of our safety net, as questions linger about payment for testing and treatment, providing meals when students are out of school, and how to keep the bills paid when a large chunk of our workforce is no longer working. Will we be able to collaborate to forge solutions now and make them more permanent when the immediate viral threat is behind us?
I hope we do. There鈥檚 never been a more important time to live the motto, 鈥淔lashes take care of Flashes,鈥 and to extend that ideal beyond the campus and into our extended communities. Camus knew this as well as he composed The Plague. 鈥淚 have no idea what's awaiting me, or what will happen when this all ends. For the moment I know this: there are sick people and they need curing.鈥