I’m reliably informed that travel broadens the mind. I’m happy to accept this as an axiom but see no reason why self-isolation shouldn’t attempt to do the same. So in that spirit, may I introduce you to George Santayana philosopher, essayist, poet and novelist.
Born in the 1850s in Madrid you might be forgiven for being unfamiliar with his work, although I suspect you’ll know the translated version of one of his essays. He suggested that those who cannot remember the past are condemned to repeat it. This is probably the root of the much-quoted variation ‘those who do not learn from history are doomed to repeat it‘. His thinking gave me pause for thought when considering the Coronavirus outbreak. Are there any lessons to be learned from the 1918 pandemic and the way it was handled? How do we compare in this crisis?
Some suggest there are. John M. Barry of the Center for Bioenvironmental Research of Tulane and Xavier Universities, New Orleans and author of The Great Influenza: The Epic Story of the Deadliest Plague In History is one. The ‘Spanish flu’ epidemic of 1918 began in January 1918 and ended in June 1920. It killed an estimated 35 million–100 million people worldwide, or 1.9–5.5% of the entire population.
The good news is current comparisons suggest the 2020 Coronavirus is neither as transmissible nor as fatal as the 1918 flu. However, it is far closer in both to the 1918 flu than to the normal seasonal influenza we have grown to anticipate each year. It’s also little too early to be making such definitive statements with any certainty. Time will be the final arbiter on that point.
Several scholars, including Barry, cite three significant factors that could be described as significant mistakes, things that allowed the virus to continue its spread or failed to slow the rate of transmission.
The first of these was the small matter of the First World War. More specifically, the focus on the war above all else. Both Sparta and Rome had been known to suspend hostilities during plagues and similar health epidemics only to return where they left off after they were all nicely rested. While it’s hardly realistic to expect The Great War to pause on health grounds, prioritising it well above everything else has been seen as an error in prioritisation. Retained professions and those working in factories were urged to go into the workplace even if they were feeling unwell for the greater good of the war effort. In so doing, they merely spread the virus further and reduced the general workforce capacity to contribute to that effort.
I wonder how much of a stretch it is to compare the machinery of war with the wheels of capitalism? While it is true that the economy is important to us all, placing it above public health (by not imposing home working, moving meetings online and cancelling conferences) we may be repeating the same mistake. Moving a bunch of people to attend mainly optional gatherings isn’t doing anything to reduce the potential spread and provide time and space to handle those in most severe need.
Some of you may be aware that for some time I have been of the opinion that common sense most certainly is not common. We may have to nudge employers and governments to permit remote, agile and home working in the short to medium term. We also have to tackle those whose work ethic is stronger than their social awareness.
I recently did my own bit of social distancing – from Twitter – but Vaughan pointed out this tweet from a former follower on that platform.
I had two nearly simultaneous thoughts. Firstly who is stupid enough and frankly selfish enough in a pandemic to take their cough, sneeze and fever into the workplace. The second was, why didn’t someone with love and a smile tell him/her to bugger off home tout suite and stop spreading their snotty germs doing neither themselves or their colleagues any good. So much for error number one, giving priority to other things, what of the other two?
The second item was first raised by a US military chef and beekeeper who observed.
We treated the honey like it was in the hive when it was really in the pot
What he was saying was our thinking was far too isolated, we lacked the holistic view. In the hive, honey is held within a small cell defined by the honeycomb and we can treat each cell in isolation. This is how the US military and later the US government treated the 1918 epidemic. The military response was defined and implemented by the War Office, the health response elsewhere, but none considered the impact of the other.
In the UK we have two governmental decisions taking different paths depending on whether you are in London or Edinburgh. In Scotland, this weekend’s old firm derby between Rangers and Celtic won’t be going ahead as the Scottish Parliament has banned gathering of more than 1000 in the open air.
In Twickenham (or Cardiff) this weekend it’s quite possible that 80,000 people could gather to watch a rugby match. The Westminster government doesn’t consider that sporting stadia (the cell of sport) present a significant risk. What I would suggest they haven’t thought about is the cell of transport. The stadium may not present a risk, however, the tube trains, coaches and trains bringing and returning the 80,000 are in my view quite a different matter. We do seem to be taking a departmental rather than whole of government approach which is exactly what 1918 tells us not to do.
The third and most significant of the errors identified from the 1918 experience is communication. Greater weight was given to this issue as it was found to have gone straight to public trust which once lost is pretty hard if not impossible to recover. There were three strands which caused the problem. An initial wave of misinformation and poorly controlled messaging in the press meant people took actions which did nothing to improve their safety or reduce the overall risk.
Perhaps the nearest corollary to this today would be the misinformation and coronavirus clickbait on social media platforms. Only today on Twitter, people were being urged to snort vitamin C powder as a preventative measure against the virus. Plus ca change indeed.
The second strand focused on the deliberate downplaying of the seriousness and extent of the pandemic (at least in its early stages). Essentially, the response was ‘kicked down the road’ by a few weeks which we now know can make a huge difference to the effectiveness of that response. Yesterday and today (and whisper it) I heard myself saying a sentence I thought I would never utter.. Jeremy Hunt seems to get it, maybe he’s what the NHS needs. What brought on this unlikely position? Well both today and yesterday Mr Hunt has been expressing surprise that we haven’t done anything yet.
“I think it is surprising we are not doing anything at all when we have just four weeks to get to where Italy is. You would think everything we do between now and then should be aimed at reducing the spread and severity” – Jeremy Hunt MP
A measure used by the US military in WWI to determine if the message was getting out in a convincing way is quite helpful here. They measured how many decisions not made by the government were made in other places. It’s a tough concept in the abstract, but here are a couple of examples. The Westminster government says there is no need to stop sport in major stadia. Yesterday that a decision to the contrary was made in Edinburgh and today in England and Wales by the rugby league authorities, the London marathon and many other sporting bodies.
As a student of history, I would have to say I would give us no more than 3 or 4 out of ten in terms of having learned any lessons from 1918. Perhaps with a less deferential and hopefully better-informed populace, we may get better outcomes. Let’s hope so.
Finally, I’m working on the Barnum and Bailey theory of leave them wanting more and if you can’t do that leave them with a song they can sing. For those wondering how long you should wash your hands here’s a timely reminder from none other than Gloria Gayner whose chorus is helpfully 20 seconds. Well, it made me smile. Five days down, nine to go.