Brainstorm: What Past Pandemics Can Teach Us

Jacob Fulton and Neya Thanikachalam

This isn’t the first time the world has survived a pandemic, and it is possible history will repeat itself. What can the 1918 influenza and HIV/AIDS epidemic tell us about what lies ahead? Listen as Jacob Fulton and Neya Thanikachalam break down the social and historical context of the novel coronavirus.

STEVEN THRASHER: The people who are out there in the world are the ones getting the most exposure, and that’s starting to emerge to show a pretty strong racial and class component.

JACOB FULTON: Welcome to Brainstorm, a podcast exploring all things science, health and tech-related. From The Daily Northwestern, I’m Jacob Fulton…

NEYA THANIKACHALAM: And I’m Neya Thanikachalam.

JACOB FULTON: And today we’re going to break down the social and historical context surrounding COVID-19. This is the first episode of a series on COVID-19, so keep an eye out for more episodes in the coming weeks.

NEYA THANIKACHALAM: COVID-19 is not the first pandemic of the last century, or even of the last 40 years. But at a time when we’re more connected than ever, it’s easier to see how our governments are responding to everything that’s going on. Before we can really understand these times that are unprecedented, strange or any other buzzword you have read in your listserv emails, it’s important to take a look at what came before. And Sarah Rodriguez, a senior lecturer in the global health program in Weinberg, is going to help us do that.

SARAH RODRIGUEZ: A lot of people have made comparisons to the 1918 pandemic because, one, it was a global pandemic. Many, many people were impacted — if not directly by being sick, by having a family member be sick. Businesses were closed, sporting events were canceled, churches were asked not to meet, bars were closed.

JACOB FULTON: Those measures might sound familiar. Over the past few weeks, we’ve been introduced to social distancing and self-isolation. People are staying inside for weeks or months on end, only leaving their houses for essential reasons. Families are canceling vacations, rescheduling weddings and missing funerals, all in the name of safety. Even in their own neighborhoods, people are staying six feet apart from anyone they pass to reduce the spread of the virus. But, that is not necessarily the new normal for everybody. Because there is no national standard, states are following a case-by-case basis for shutting down nonessential businesses and administering shelter-in-place orders. Most states — but not all — are following that protocol. Just listen to recent press conferences from Illinois Gov. J.B. Pritzker, who put his entire state under a stay-at-home order, and Nebraska Gov. Pete Ricketts, who said he doesn’t plan to enforce similar restrictions any time soon.

J.B PRITZKER: If there are actions that I can take that will save lives in the midst of this pandemic, no matter how difficult, then I have an obligation to take these actions.

PETE RICKETTS: As we look at — and we will continue to re-evaluate the data — but as we look at the data, we are seeing that we are different from other states.

JACOB FULTON: Even in states with restrictions, not everyone is following the rules. Some people believe the orders are too strict and will do more harm than good.

PROTESTERS: Ohio back to work. Ohio back to work. Ohio back to work.

JACOB FULTON: That was a group of protesters from outside the Ohio Statehouse on Tuesday. They were protesting the state’s shutdown, calling on the governor to open up businesses again.

So, the response hasn’t been the same in all locations. And when we look back to 1918, the reaction times among different cities made a big difference. That’s according to the executive director of Northwestern’s Institute for Global Health, Robert Murphy.

ROBERT MURPHY: Philadelphia and St. Louis took two different approaches to the flu epidemic back then. Philadelphia basically did nothing until it was too late. St. Louis closed bars and banned gatherings, early on in the epidemic. It’s quite clear that people in St. Louis did much better than the people in Philadelphia. By the time the Philadelphia people caught on, they had already had quite a few deaths.

NEYA THANIKACHALAM: According to the Proceedings of the National Academy of Sciences, St. Louis had less than half the flu-related deaths per capita than Philadelphia — all because of social distancing measures. However, the 1918 influenza outbreak is often forgotten in the scope of global history. This is at least partially because it took place at the same time as World War I, so people were distracted, to say the least.

JACOB FULTON: In more recent memory, another virus drawing comparisons is HIV, or the human immunodeficiency virus. That virus is spread through contact with bodily fluids, but COVID-19 is a respiratory virus, which means it spreads through the air. Medill Prof. Steven Thrasher is a faculty member in the Institute of Sexual and Gender Minority Health and Wellbeing, and has spent years researching and reporting on HIV.

STEVEN THRASHER: HIV is a relatively weak and inefficient virus. It has been floating around the universe for who knows how long. It maybe entered mammals a hundred years ago, it took many decades to move into humans. Even though we think of it, we start seeing it in 1981, HIV was probably circulating on the North American continent for at least three decades before we first saw it. So it’s very, very slow moving.

NEYA THANIKACHALAM: Thrasher also said HIV is slow-acting and relatively hard to catch. Most people affected by the virus only start showing symptoms seven to 15 years after transmission. But we know that’s not true for COVID-19.

STEVEN THRASHER: Everything about coronavirus is fast. It’s lightning quick. From the time it moved from mammals to humans, and then from the first humans to potentially infecting all humans, is just weeks or months. And what happens in the body is also quick. People are exposed, and it seems to cycle through them, or, if they get worse and unfortunately if they die, it can also happen within weeks.

JACOB FULTON: Though the viruses may be different, they share an important similarity. Both were prominent in marginalized communities, which created a sense of stigma around those groups. HIV disproportionately affected the LGBT community, particularly black men who had sex with men. Often, people associate viruses with the communities they are prevalent in, creating harmful stereotypes. For example, AIDS was initially named GRID, which stands for gay related immune deficiency, explicitly connecting the LGBT community to the disease.

SARAH RODRIGUEZ: There has been a historical tendency to blame and lay blame and/or stigmatize groups that are seen as, quote unquote, being more susceptible, or perhaps the ones, quote unquote, spreading the disease. We can think of when polio first became more epidemic in form in the late 19th to early 20th century, on the east coast of this country. Immigrants from eastern and southern Europe were often blamed as being the ones who were most susceptible and most likely to be spreading the disease to the native, white-born population on the east coast.

NEYA THANIKACHALAM: In the case of COVID-19, the virus’s origins in China have created a strong cultural association between the pandemic and Asian communities worldwide. Here in Evanston, there have been multiple instances of anti-Asian American vandalism, and that’s a pattern that has emerged across the nation. With President Trump referring to the virus as the “Chinese Virus,” this association has wide-reaching implications.

STEVEN THRASHER: It’s very much being imagined as Asian and Asian American, and there’s a lot of nationalism around how it is conceived. The United States didn’t take it as seriously because it was something that was imagined as happening somewhere else. And there are all kinds of racial and class dimensions to how this virus is playing out.

JACOB FULTON: Thrasher said that people of color are more likely to be affected by COVID-19, as they make up a significant portion of the essential worker population, and are less likely to have equal access to healthcare. As The Daily reported earlier this week, Evanston is seeing that disparity play out locally. Preliminary numbers show that black residents are more likely to contract COVID-19.

NEYA THANIKACHALAM: Many experts are saying that COVID-19 is exposing flaws in different countries’ infrastructures, from health to economic policy.

SARAH RODRIGUEZ: Historians have often talked about how a pandemic actually incites change. We saw that with cholera in the 19th century. The global spread of cholera in the 19th century kind of prompted health leaders and political leaders to actually do things about getting clean water to people. That pandemic actually moved people toward the importance of clean water supplies, and sanitation and sewage disposal, etcetera. We could think broadly about the COVID-19 pandemic. It also sort of brought to the surface, if you will, some of the limits or stresses on our system.

Maybe this is what brings universal health coverage to the United States, because it’s showing that obviously, we knew this before the pandemic, but not everyone has health coverage in this country. So perhaps this will be sort of an impetus for that kind of change.

JACOB FULTON: Thanks for listening. We’ll see you on the next episode of Brainstorm, where we break down the science behind COVID-19 and explain its spread.

This episode was reported and produced by myself, Jacob Fulton, and Neya Thanikachalam. The audio editor of The Daily Northwestern is Molly Lubbers. The digital managing editors are Kalen Luciano and Heena Srivastava, and the editor in chief is Marissa Martinez.

Email: [email protected], [email protected]
Twitter: @jacobnfulton1, @neyachalam

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