a cartoon of a pandemic creeping up from behind
Illustration by Giovanni Spera
Health

What We Can Learn from Pandemics of the Past

Wondering how coronavirus might change the world? Look to history.
10 April 2020, 7:45am

This article was originally published on VICE Italy.

The Antonine Plague, the Black Death, the Spanish flu and the Hong Kong flu of 1968 – the human race had confronted at least 13 pandemics before the coronavirus was declared one by the World Health Organisation on the 11th of March, 2020, most of which brought with them deep social and political change.

Uncertainty is a main driver of the anxiety many are feeling about our current environment – suddenly, our world looks very different. It's only natural to wonder what things will look like when we're all allowed to shake hands, hug each other and travel again. Will anything change in our way of life, or will we immediately go back to our old ways? Though it's hard to predict, it's worth looking at history to see how these kinds of events have shaped humanity in the past.

I discussed the idea with Barbara Gallavotti, biologist, scientific journalist and author of Le Grandi Epidemie (The Big Epidemics), a book about the impact of large-scale infectious diseases on mankind. Gallavotti believes history can offer some clues: "We have to understand that the current situation is nowhere close to what we've lived through before," she said. "This time, our response has been infinitely quicker. We don't have to go too far back – just think of HIV/AIDS in the 1980s."

This pandemic, which killed 32 million people between 1981 and 2018, provoked further discrimination against the minority groups it affected most: men who have sex with men, and intravenous drug users. It was seven years before the US Federal Drug Authority approved the first drug to treat the disease.

In comparison, scientists had already sequenced the coronavirus genome by the 10th of January, just two months after the first case was officially acknowledged in China, and the race is on to develop the first vaccine. The fact that we're better equipped and better motivated to solve the current coronavirus pandemic doesn't make it any less urgent, but in the past month we've heard plenty of arguments that negate that urgency. "We talk about how coronavirus 'affects elderly people' in the same way many used to talk about HIV affecting gay people and drug addicts," said Gallavotti. "Back then, it diminished the sense of urgency and caused many more deaths."

In the US, the Reagan administration actually suggested cutting AIDS spending in 1985 and was largely seen to be ignoring its rapid spread, until the shock revelation that Hollywood actor Rock Hudson was dying of the condition. After his death, Ronald Reagan made his first public mention of the pandemic in a 1987 speech, saying, "It's important that America not reject those who have the disease, but care for them with dignity and kindness."

In terms of communication, Gallavotti said we can learn a lot from deadly mistakes made during the Spanish flu, which killed at least 50 million people between 1918 and 1920. "In some US states, authorities tried to minimise the situation, and infections increased," she said. In San Francisco, however, politicians and medical leaders joined forces, mandating masks and taking out a joint full page ad in newspapers, urging people to "wear a mask and save your life". Anyone found without one could be fined or even locked up. By communicating the gravity of the situation early on, Gallavotti explained, the city was able to avoid a worse fate.

Throughout history, crises have also led to unpredictable societal changes. During the Crisis of the Late Middle Ages, in 14th and 15th century Europe, epidemics such as typhoid and the Black Death (1347 to 1351) created such a gap in the workforce that many workers were able to demand higher salaries – although some experts say that any extra money was lost to huge inflation at the time. Some even credit the plague for causing a social and cultural revolution that led to the Renaissance era, and studies have found that, after the plague both diets and life expectancy improved. Gallavotti pointed out that the Black Death, which wiped out up to 60 percent of the European population at the time, was on an entirely different scale to coronavirus. "But these emergencies do make us reflect," she said.

It's also natural to wonder whether the conversations coronavirus has sparked about globalisation, pollution and certain healthcare systems will amount to any real change. "I think it's unlikely globalisation will be called into question, or the ease with which people move around," said Gallavotti. "Infections were spread around the world before we moved around so much. The Black Death emerged in Asia and spread to Europe, just like coronavirus."

According to Gallavotti, the more urgent issue is human intervention into nature – especially agriculture. Animal-to-human transmissions were behind the emergence of SARS, Ebola, bird flu and coronavirus, and the current pandemic has put live animal markets under the microscope. "We need to understand that the pervasiveness of man in nature doesn't only damage the environment, it also puts us at risk," she said.

As for the importance of an economic safety net, Gallavotti said: "A welfare state that guarantees healthcare for everyone is fundamental. Together with technological development, that has really been making a difference today in comparison to the past." After the Spanish flu, governments began introducing universal healthcare, starting with Russia and followed by the UK, France and Germany. Some countries still don't have proper universal healthcare, but that might change – one survey in March found that 40 percent of Americans were more likely to support universal healthcare after the emergence of coronavirus.

Gallavotti said that pandemics have often revealed humans as short-sighted. "We were repeatedly warned about the potential for a pandemic during the SARS and swine flu outbreaks in the early-2000s," she said. "Those warnings weren't crystal-ball-gazing, either: they were based on real data. Now, we're being confronted by what really matters. I hope it will help us re-set our priorities."

No history lesson can tell us how the coronavirus crisis will end. But we can gain an appreciation for the things we were taking for granted until recently. They are the things that suddenly seem to matter so much: universal healthcare, scientific progress and respect for nature. They might be the keys to getting us to the other side of coronavirus, and beyond.

This article originally appeared on VICE IT.