The ever-increasing speed of mainstream communication and the uncontrolled social media environment where all and sundry can post opinions [informed or ill-informed] with impunity… both have magnified, not soothed, the public anxiety over ‘the next scourge’. And so it has become with COVID-19, the latest ‘existential’ threat.
Fanned by three words absent from the lexicon of my youth… impact (not effect); unprecedented (spare me) and existential (a word I once thought peculiar to Albert Camus)… modern multi-media platforms have fanned us into panic mode: the unprecedented existential impact of ‘the virus’ on our daily lives.
While we clearly should be taking this pandemic with the utmost seriousness… it is not just ‘a little ‘flu’: it will not ‘just go away’: it is heart and soul-breaking: it is lethal… we also need to pop up our heads for a moment, take a COVID-19-free breath, and reorient COVID-19 within the perspective of the age-long historical struggle of human vs. disease.
COVID-19 is not the first, is as yet, likely not the worst, and certainly won’t be the last threat that humans have faced… and survived. All have left scars and bruises, but all have been identified, managed, and eventually conquered. Spare a thought those on my ‘short list’:
Leprosy: the ‘Bubonic Plague’ or ‘Black Death: Smallpox: the many diseases that spread through immune-naïve first-peoples after the invasion and/or colonisation: Malaria: Cholera and Typhoid: Tuberculosis: the “Spanish” flu: Polio: Measles: HIV/AIDS: H1N1 ‘swine’ flu: SARs: MERs: and now, COVID-19. Plus, there are the ‘background noises’ of chicken pox, mumps, the common cold…
Each scourge, to the people of their time, signalled the end of the world. Each tested and strained the ‘public health care’ of their time to breaking point. Each sickened, maimed, and killed with impunity.
COVID-19 is a threat – yes. But it is also subject to a vastly more sophisticated scientific response than was available to fight previous contagions.
Putting COVID-19 into an historical context…
Leprosy was a slow killer… over years it disfigured then eventually killed. Although now treatable with a slew of antibiotics, this bacterial infection is still with us: the World Health Organisation leprosy fact sheet estimates that ‘in the 20 years from 1994 to 2014, 16 million people worldwide were cured of leprosy’… and, to be cured, you must have caught it in the first place. So, it is still ‘oot there’.
The bubonic plague – the single greatest historical scourge of humanity – is also still ‘oot there’. Only last week [5/7/20], an outbreak of this flea-spread bacterial infection was reported in Mongolia. As with leprosy, antibiotics still win the day… though as with many bacterial infections, increasing drug resistance is a real issue.
Smallpox, the only virus on my list to be ‘eradicated’ [the last known case was in 1977]. Soberingly, though, Henderson’s definitive history of smallpox estimates that some 300 million died from the disease in the 20th century.
Historically, most contagions were confined to Euro-Afro-Asia, whilst the Americas, and Oceania were disease-free. That all changed with Renaissance exploration and the spate of “I claim for King and Country” colonisation. Arguably, the single worst legacy of the Renaissance was not oppression and slavery [unforgivable though they were], but the spread of mortal disease to utterly immune-naïve populations. First peoples: the native Americans [North and South], the Australian aboriginals, the Maori, the Polynesian and Melanesian islanders, and the Inuit were decimated by Euro/Asian diseases. At least the tropic-naïve Europeans did suffer some payback: tropical malaria, yellow fever, dengue, and schistosomiasis!
Cholera and typhoid ripped through industrialising 17th – 20th century Europe. Water-borne, they taught us – eventually – of the importance of water quality, though outbreaks still ‘plague’ populations, worldwide.
Tuberculosis [once, ‘consumption’] is also far from dead! It remains embedded in most communities and we ignore it at our peril. Further, our TB drug cupboard is being rapidly depleted by increasing antibiotic resistance.
Influenza – the most feared outbreak being the ‘Spanish flu’ of 1918-19 that killed between 20 and 50 million worldwide – remains with us. The ever-mutating ‘flu’ virus still kills more than 500,000 each year. The ‘Spanish flu’ started in a US army barracks in Philadelphia [take note, Trump, as you castigate China for COVID-19]… and poor Spain won the ‘title’ only because the Spanish Royal family were the first global ‘notables’ to succumb to it.
Polio remains strong in my own memory. As a medical student, I vividly remember training in the Iron Lung wards at Fairfield Infectious Diseases Hospital in the ’60s! Ask anyone 80 or older about their fear that their child might bed healthy but wake permanently paralysed. Vaccination against polio and smallpox has delivered two of the greatest 20th century public health wins, but while smallpox might be gone, not so polio. Remember: vigilance and vaccination.
So, while making no mistake, our anxieties are well-founded and I am not attempting to minimise the gravity of COVID-19, we do need to remember that humans have trodden this path before… and won.
To all you out there, stay careful, adhere to public health instructions, shun social media mistruths, and place faith in science above politics. Seek help early if you are in unmanageable distress.
And… try to retain your sense of perspective.
To all – but especially to all those who live in this coastal community that we all love so much – be as thoughtful of others as you would have them be to you. Be patient, be considerate, and be kind.
John Agar
