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COVID-19: When History Has No Lessons

“With such a timely specialization, why aren’t you on CNN right now?,” asked a well-meaning individual at a gathering over drinks a few weeks ago, as the conversation inevitably turned to the coronavirus, which still seemed like a far away phenomenon. “What does the historian of medicine think of all this?”, asked another. Feeling at a loss for convincing responses, the historian could only sheepishly predict that health care systems risked being dramatically overwhelmed. The historian’s discomfort, however, was not a symptom of professional reluctance to make predictions, nor a refusal to embrace the authoritative voice of an expert. In this case, the historian simply did not know.

The coronavirus pandemic offered many medical historians a Warholian moment of celebrity – a meagre consolation in these trying times, that we do not condemn or judge. We have witnessed (and taken part in) an avalanche of articles, videos, and online discussions on the ‘lessons’ and ‘guidance’ drawn from the history of epidemics, which can be applied to the COVID-19 outbreak. The current emergency calls for the recollection of ‘urgent pasts’, just as many recent epidemics have spawned comparisons to past illnesses. Think only of the way the HIV-AIDS epidemic and other ‘emerging diseases’ (Ebola, Marburg virus, etc.) during the 1980s and 1990s have been labelled ‘plagues,’ a metaphorical allusion reflected in the title of Laurie Garrett’s bestselling book, The Coming Plague.

In the vast repertory of past epidemics, the novel coronavirus found its chosen precedent: the 1918 Spanish flu. Experts, then, have evaluated the relative merits of stressing analogy, parallels or difference between the two crises. On the one hand, there are pragmatic teachings about the efficiency of social distancing, based for example on the comparative assessment of public health strategies in different US cities in 1918-1919 (see below the now famous St Louis-Philadelphia comparison, adapted from a 2007 epidemiology article). On the other, one cannot miss the long list of differences between two epidemics and two viruses separated by a century of changes in medical knowledge and techniques, global interconnectedness, economic structures, and so on.

But recollection is not a virtue in itself. Analyses based on precedents prove problematic, as they might orient actors towards outdated strategies.

Read entire article at Public Seminar