“The pandemic which has
just swept round the earth has been without precedent.”
So noted a May 1919 article in the journal Science, “The Lessons
of the Pandemic.” The author, Maj. George A. Soper, was an American civil and
sanitation engineer who, among other accomplishments, had devised a plan for
ventilating New York’s subway system. He was famous for having linked, in 1904,
a series of typhoid fever outbreaks to a cook named Mary Mallon who was herself
immune to the disease: Typhoid Mary, the first asymptomatic superspreader known
to modern science.
اضافة اعلان
The pandemic, of course, was the Spanish flu of 1918-1919, which
caused 50 million deaths worldwide, including 675,000 in the United States.
Scientists had no idea what had hit them, Soper wrote: “The most astonishing
thing about the pandemic was the complete mystery which surrounded it.” Viruses
were still unknown; the illness was clearly respiratory — pneumonia was a
common result — but the culprit was thought to be bacterial. (The actual
pathogen, an H1N1 influenza A virus, was not identified until the 1990s.)
“Nobody seemed to know what the disease was, where it came from
or how to stop it,” Soper wrote. “Anxious minds are inquiring today whether
another wave of it will come again.”
The pandemic currently underway could hardly be more transparent
by comparison. Within weeks of the first cases of COVID-19, in Wuhan, China,
scientists had identified the pathogen as a novel coronavirus, named it
SARS-CoV-2, sequenced its genome and shared the data with labs around the
world. Its every mutation and variant is tracked. We know how the virus
spreads, who among us is more vulnerable and what simple precautions can be
taken against it. Not one but several highly effective vaccines were developed
in record time.
So perhaps one clear lesson of our pandemic is that, when
allowed, science works. Not flawlessly, and not always at a pace suited to a
global emergency. The Centers for Disease Control and Prevention (CDC) was slow to
recognize the coronavirus as an airborne threat. Even now, medicine has a
better grasp of how to prevent coronavirus infection — masks, social
distancing, vaccination — than how to treat it. But even this is edifying. The
public has been able to watch science at its messy, iterative, imperfect best,
with researchers scrambling to draw conclusions in real time from growing heaps
of data. Never has science been so evidently a process, more muscle than bone.
And yet still the virus spread. Travel restrictions, school
closures, stay-at-home orders. Illness and isolation, anxiety and depression.
Loss after loss after loss: of dear friends and family members, of employment,
of the simple company of others. The CDC concluded that 2020 was the deadliest year in American history. For some,
this past year seemed to last a century; for far too many people, this past
year was their last.
So let another lesson of our pandemic be this: Science alone is
not enough. It needs a champion, a pulpit, a spotlight, an audience. For
months, the sound and obvious advice — wear a mask, avoid gatherings — was
downplayed by government officials. Never mind the social fabric; discarding
one’s mask was cast as an act of defiance and personal independence.
Read today, Soper’s essay stands out at first for its quaint
medical advice. He urged his readers, sensibly, to “avoid needless crowding,”
but also to “avoid tight clothes, tight shoes” and to chew one’s food
thoroughly. He added, “It is not desirable to make the general wearing of masks
compulsory.”
Most striking, though, are the main lessons he drew from his
pandemic, which are all too applicable to ours. One, respiratory diseases are
highly contagious, and even the common ones demand attention. Two, the burden
of preventing their spread falls heavily on the individual. These create,
three, the overarching challenge: “Public indifference,” Soper wrote. “People
do not appreciate the risks they run.”
A hundred-plus years of medical progress later, the same
obstacle remains. It is the duty of leadership, not science, to shake its
citizens from indifference. Of course, indifference does not quite capture the
reality of why we found it so challenging to stop congregating indoors or
without masks. This pandemic has also revealed, perhaps, the power of our
species’ desire to commune. We need each other, even against reason and sound
public-health advice.
A week before “Lessons” appeared in 1919, Soper published
another article, in the New York Medical Journal, making the case for an
international health commission. “It should not be left to the vagaries of
chance to encourage or stay the progress of those forms of disease, which
neglected, become pestilences,” he argued. He imagined a supragovernmental
agency charged with investigating and reporting the trajectory of dangerous
diseases — “a live, efficient, energetic institution possessing real powers and
capable of doing large things.”
He got his wish. Soper modeled his vision on the International
Office of Public Health, established in Paris in 1908 and later absorbed into
the United Nations World Health Organization (WHO), which was founded in April
1948, just two months before his death. But the WHO could not contain COVID-19,
either. Preventing the next pandemic will require far more coordination and
planning within and between governments than was mustered this time, much less
century ago.
“Let us hope that the nations will see the need” and “initiate
the work which so greatly requires to be done,” Soper wrote in 1919. Let us
hope that, before the next pandemic comes, we will have done more than hope.
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