Pandemics and History

The Week magazine recently published several articles about pandemics and Covid-19. Some of the information is quite interesting. Information from The Week and some other sources is summarized below.

History

One article discussed pandemics and history. The Black Death plague started in 1347. It was caused by a bacterium. It killed about 200 million people, which then was about 55-60% of the global human population. Health authorities in Europe responded by instituting public health measures that are still in use today, including quarantines, routine health inspections and hospitals.

Another effect of the Black Death was to end European feudalism and serfdom. The deaths caused a labor shortage that shifted the balance of power from feudal lords and nobility to workers. The labor shortage allowed serfs to break free from the lords that in essence owned them. They were free to look for work under better conditions. That economic system shift paved the way for modern capitalism.

In 1802, a Yellow Fever epidemic in the French colony of what is now Haiti caused the deaths of about 50,000 French troops who were controlling the island. Yellow Fever is a virus infection that is transmitted by mosquitoes. The death toll caused the troops to withdraw, causing massive economic losses to Napoleon. The losses forced Napoleon to sell 828,000 square miles of land to Thomas Jefferson for $15 million in what is now called the Louisiana Purchase.[1]

The Spanish flu, which probably originated on a Kansas poultry farm, brought widespread death to troops fighting in trenches in World War I. Spanish flu was an exceptionally virulent form of H1N1 influenza virus. About 50 million people worldwide died in the pandemic, which included about 675,000 Americans.

Among the Americans who were killed were members of the US delegation to the 1919 Paris Peace Conference. Many of those delegates were opposed to forcing Germany to pay reparations as part of the treaty of Versailles. With the American anti-reparation voice weakened, delegates approved harsh reparations against Germany. That both humiliated the Germans and economically crippled the country. Both factors are considered by some historians to be key factors in the rise of Hitler. Some consider the economic impact of Spanish flu to be a major factor in the rise of nationalism and authoritarianism.

In terms of public health, the Spanish flu epidemic provoked public health innovations, including spawning the field of virology and accelerating research in the field of epidemiology.

Covid-19

In terms of predictions about long-term effects of Covid-19, experts are beginning to speculate. Some evidence suggests that the pandemic is decreasing political polarization in the US, a trend that has been in progress for about 50 years. The thinking there is that Covid-19 constitutes a common enemy and such threats tend to unite societies. Of course, that socially unifying factor is opposed by the president's heavy and usually effective reliance on social polarization and division to maintain power. How the matter of social cohesion and improved functionality will play out is completely unclear to me.

Other experts suggest that nationalism, authoritarianism and xenophobia could increase in the US. Others project that telemedicine and other online activities will increase in acceptance and use. Not surprisingly, some experts who speak from political ideological points of view are projecting social and governmental changes that fall in line with their ideology, e.g., a libertarian sees more deregulation in our future.

Another short story in The Week asserted that the state of New York probably delayed its shutdown due to a years-long feud between governor Cuomo and NYC mayor Bill de Blasio. Epidemiologists estimated that if New York had shut down 1-2 weeks earlier, about half of the death toll could have been avoided. That was asserted in an article published by ProPublica. If that is true, then petty political bickering fueled by personal ambitions caused thousands of needless deaths.

In terms of personal political ambitions and big egos, another article The Week published mentioned congressional testimony by Dr. Rick Bright, the top US vaccine development official. Bright testified that the president ignored his urgent warnings in January about Covid-19. Because there was no master plan in place, he believed that lives were needlessly lost. The president had fired Bright, calling him a disgruntled employee. Bright had called for serious scientific vetting of hydroxhchloroquine as a treatment for Covid-19. He claimed that the administration had put “politics and cronyism ahead of science.” Not surprisingly, that angered the president.

Face masks

The Lancet published research about the effectiveness of wearing face masks. A meta analysis of multiple studies indicate that wearing a face mask does decrease the rate of viral infections from infected people compared to people who do not wear a face mask in the presence of other people. The data also indicated that staying 6 feet away from an infected person is appears to be more effective than staying 3 feet away. ABC News summarized the analysis like this: "Staying 3 feet away from another individual can lower the risk of transmission to less than 3% from an estimated 12%, the researchers found. A distance of 6 feet could lower that risk to 1.5%. And wearing a mask can reduce the risk to about 3% from roughly 17%."

Another source commented on The Lancet meta-analysis: "Keeping at least one metre from other people as well as wearing face coverings and eye protection, in and outside of health-care settings, could be the best way to reduce the chance of viral infection or transmission of COVID-19, according to a systematic review and meta-analysis synthesising all the available evidence from the scientific literature, published in The Lancet. ..... The study, conducted to inform WHO guidance documents, is the first time researchers have systematically examined the optimum use of these protective measures in both community and healthcare settings for COVID-19. The authors say it has immediate and important implications for curtailing the current COVID-19 pandemic and future waves by informing disease models, and standardising the definition of who has been 'potentially exposed' (ie, within 2 metres) for contact tracing."

Statistics: Why Groups of 10 or less

Finally, an NPR broadcast segment in the last day or two explained why groups of 10 people or less are often recommended as the size limit of social gatherings. Statistics dictates the number. If the community Covid-19 infection rate is say, about 2%, then on average, one would expect that in a group of 100, about 2 people would be infected. Also, as social gatherings increase in number of participants, there is a trend for people to be closer together in closed venues in buildings and in limited outdoors areas such as a small backyard. By limiting group gatherings to 10 or less, (1) the chance of anyone being infected drops drastically (about 100-fold if I recall the data right -- I can't find a link to that info), and (2) people are generally better able to stay physically separated. Due to the larger area that is usually present, gatherings outdoors are limited to 25 or less to reduce the possibility that an infected person is present.