We are now in the midst of pandemic of a coronavirus disease called COVID-19 caused by a virus called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), and there is some anxiety regarding certain unknown aspects of this virus. For example, the death rates appear significantly higher than those of the regular flu (note however that COVID-19 is not a flu or even related to the flu), but there is uncertainty as to whether this is due to an underreporting of milder non-lethal cases. However, the majority of deaths seem to occur among older weak people with previous health problems, and infected people that do not yet have symptoms upon viral infection do not seem to be a major driver behind the spread of the virus. Will COVID-19 turn out to be a disease no more serious than the flu, or will it be much worse?
In a previous post I quoted the late horror writer, H. P. Lovecraft, who wrote that “The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.” But even as we remain somewhat fearful about what we don’t know regarding COVID-19, we must remember not only what we do know about diseases today and the fact that we have the tools fight them, but also how little we knew about them in the past and how helpless we were.
Let’s start with the Black Death.
The Bubonic Plague or Black Death ravaged many areas of the world in antiquity. The disease is caused by a bacillus, Yersinia pestis, which infects rats (although other animal hosts are also common) and is then transmitted to humans by fleas that bite infected rats. The most famous outbreak of the plague was that which occurred in Europe from 1347 to 1351 and which wiped out an estimated two thirds of the continent’s population (about 50 million people). Poor public hygiene and crowded living conditions in Europe created an excellent environment for the spread of disease. The role of germs or insects in the causation of disease was unknown, and physicians were helpless against the onslaught of the disease which was blamed on several things ranging from foul air and unfavorable planetary alignments to divine punishment for sins.
Today it is difficult to comprehend the sheer level of terror triggered by the plague in Europe and the breakdown of society and institutions that it caused. Corpses accumulated in the streets. Family members abandoned their dead and dying. Government officials, doctors, and priests deserted their posts. In some cities up to 80% of the population was wiped out. Some rulers instituted draconian measures like boarding up houses with all the occupants inside if one person in the house was infected, thus condemning all those inside to die. Ignorance, superstition, and fear combined to trigger barbaric behavior in mobs of people that targeted and killed individuals or certain groups of people like gypsies or Jews who were rumored to be behind the causation of the plague.
Several plague pandemics ravaged Europe over hundreds of years causing the death of millions. It was only in 1894 that the Swiss-French physician, Alexandre Yersin, discovered the plague bacillus and the role of rodents in its spread, and in 1898 the French physician Paul-Louis Simond discovered the role of fleas in the transmission process. This allowed the implementation of effective public hygiene measures that finally controlled the disease.
Now let’s move on to the so called Spanish Flu.
From 1918 to 1919 an influenza pandemic called the Spanish Flu killed 50 million people in the world and 500,000 in the United States. Due to World War I, any news about the flu that could be used as propaganda by the enemy was censored in many countries including the US, but the general public could tell that something out of the ordinary was going on. Unlike previous flu infections, this strain of influenza mostly affected and killed people in the prime of their life (20 - 40 years old), and it quickly overwhelmed the health care system in many localities which had to resort to interring the dead in mass graves. There was no way to treat influenza or the deadly secondary infections it generated, so fighting the disease consisted on mostly preventive measures such as good hygiene, quarantine, closing venues where large numbers of people congregated, and supportive care for those infected. The fear of the times of the plague returned. Scores of people locked themselves in their houses, refused to help their neighbors, and refused to go to work emptying the streets of some cities and towns.
The causative agent of the flu was originally believed to be a very small bacterium, but the development of the field of virology eventually led to the understanding that the flu is caused by viruses. With the invention of the electron microscope in the 1930s, viruses like the ones that cause the flu could be visualized. In 1999 the Spanish Flu virus was recovered from people who died during the pandemic. The virus was reconstructed in 2005 and studied to figure out what made it so virulent.
So how do the last two pandemics compare to the COVID-19 pandemic today?
Unlike what happened with the Black Death or the Spanish Flu, we know exactly what COVID-19 is. We know what the virus looks like, and what it does and how it does it. We have a good idea of where it originated and how. We have sequenced its genome in record time, and used that information to make test kits that permit the identification of those people that are infected, so they can be quarantined and questioned about their contacts and the places they have been. We have antibiotics to treat secondary infections triggered by the virus. We are testing antivirals that may be of use against the virus, and we have also begun to develop vaccines. There is a vast worldwide network of organizations such as the Global Virus Network and the World Health Organization that are tracking the spread of COVID-19 and coordinating the sharing of information among experts in different disciplines at every level and informing the public. There are government agencies such as the Centers for Disease Control and Prevention (CDC) in the U.S. that are monitoring the individual cases in a given country, coordinating the public health response, and advising the government and the general population.
Humanity’s knowledge of disease and its response to it has come a long way since the times of the Black Death and the Spanish Flu. We will continue fearing the unknown, but thanks to science this “unknown” has been made much smaller. Today we fear less.
The painting of Marseille during the Great Plague by Michel Serre is in the public domain. The photograph of an emergency hospital during influenza epidemic in Camp Funston, Kansas, circa 1918 is from the National Museum of Health and Medicine, and is used here under an Attribution 2.0 Generic (CC BY 2.0) license. The transmission electron micrograph of a SARS-CoV-2 virus particle (that produces the disease COVID-19), isolated from a patient, was captured and color-enhanced at the National Institute of Allergy and Infectious Diseases (NIAID) Integrated Research Facility (IRF) in Fort Detrick, Maryland, and is used here under an Attribution 2.0 Generic (CC BY 2.0) license.
When asked about what science has done for humanity many people would probably mention medical advances. Indeed science has allowed us to create vaccines, antibiotics, drugs, surgical methods, and many other things to treat human disease and improve human health. There are millions of people today upon the face of the earth (including yours truly) who would not be here if it weren’t for these medical advances. But this is not the most important thing that science has done for us.
Other people would allude to the technological advances that science has made possible that have improved our lives. Inventions like refrigerators, air conditioners, cars, planes, phones, computers, and many other things have greatly improved our lives and increased our freedom and abilities. But this is not the most important thing science has done for us.
Even others will mention the way science has opened our eyes to the mystery and beauty of realms previously unseen by us such as when we contemplate images of faraway worlds relayed to us by the probes we have sent into space, or the images of the life of cells and other organisms in the microscopic world. But this is not the most important thing science has done for us.
So what is it?
Let me give you a hint. Recently millions of Americans watched an eclipse of the sun. By all accounts it was a festive event where people expressed amazement at the natural phenomenon. But here is the key thing. No one ran to hide in their basement during the eclipse. No one felt that the eclipse was a “bad omen”. No people were sacrificed to “prevent the moon from swallowing the sun”. The eclipse did not influence domestic or foreign policy. It was just a celestial body (the moon) transiting in front of another (the sun) and casting its shadow on the earth. Amazing? Fantastic? Incredible? Yes. Scary? Foreboding? No.
Figured it out?
This is the gift of science. It has given us information about what things are and what they aren’t; about what can happen and what can’t, and about how things work, and why. This allows us to live better lives free of the shackles of superstition. It allows us to act rationally in response to the changing world about us and optimize our lives. And why is this? Because ignorance in the face of occurrences that may have an impact on our lives generates fear and fear is the begetter of some of the most barbaric behaviors that humanity has ever witnessed.
Ever read about when the black plague decimated most of medieval Europe? The best minds of the period could not get beyond explanations such as an “unfavorable conjunction of planets” or an “infected air”. Among other explanations was a divine punishment for sinfulness. The sheer panic and terror led family members to abandon each other, doctors and priests to desert their posts, and mobs of people to target those who were different such as gypsies or Jews, who were exterminated in many places. After hundreds of years and many outbreaks, it was finally worked out that the plague was caused by a bacterium (Yersinia pestis) which is transmitted by fleas, which in turn are carried by animals like rats. Scary? Yes, but just merely a natural occurrence that is well within our power to control. Today there are still cases of plague, but they can be kept to a minimum through sanitation and easily treated with antibiotics.
When human beings are concerned (or made to be concerned) about threats real or imaginary, they will believe anything and do anything, and this weakness is often successfully exploited by those among the “powers that be” who want to implement their social or corporate agendas, further their standing or careers, or simply profit. Furthermore, because science is so successful at finding the truth, these “powers that be” have understood that a very important part of their plan has to be the delegitimization of science.
Thus the anti-vaccination movement claims that pro-vaccination scientists are controlled by the vaccine industry. The anti-climate change movement claims that climate change scientists are controlled by the liberal science funding agencies. The creationist movement claims that evolution science is part of the war on Christianity. The alternative therapies lobby claims that the medical establishment is preventing citizens from using inexpensive and equally effective treatments. The gun lobby has successfully prevented government funds from being used to study gun violence claiming that it would be part of a slippery slope towards the erosion of key constitutional rights.
The above highlights a sad truth about a gift. A gift is a two part process. The first part occurs when it is given, but the second part involves receiving it. In our complex world where fantasy and folly can de facto become a reality if enough people believe them, science can be successful in transmitting us its gift only to the extent that its discoveries are accepted by individuals and societies.
Eclipse: CCO Creative commons license “Free for commercial use. No attribution required”. The black death by Leo Reynolds, Attribution: NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0) license.