J.R. McNeill is a history professor at Georgetown University.
Fauci is right to sound the alarm, but despite more than 650,000 deaths worldwide and counting, the coronavirus pandemic is not the perfect storm. Paradoxically, it may save us from one.
The novel coronavirus is indeed efficient in spreading from human to human, but much less so than the measles or smallpox viruses. It has, relative to most infections, a high degree of morbidity and mortality, but far lower than measles, smallpox, plague, yellow fever and a handful of other diseases.
Mercifully, we haven’t seen a perfect storm since 1918, when an influenza strain killed about 50 million people (the equivalent of 200 million people today).
Between 1492 and 1650, a series of epidemics, including measles and smallpox, killed tens of millions in the American hemisphere. Combined with various forms of violence, they lowered the Americas’ population by 50 to 95 percent and global population by roughly 5 to 10 percent.
The plague pandemic from 1346 to 1352 cost up to half the population in Europe and North Africa, possibly claiming a quarter of the global population. No one knows how seriously it may have affected East and South Asia or the rest of Africa. It did not touch the Americas. The grisly experience stands alone in the annals of pandemics.
We are not at risk of a global measles or smallpox pandemic. Effective vaccines exist, and through globally coordinated campaigns, smallpox was eliminated as a human disease in the late 1970s. But so-called emerging diseases — new to humans if not necessarily to other creatures — do bring this risk. Huge numbers of unidentified viruses and other potential human pathogens are swirling around in bat and rodent colonies. Most of these viruses cannot replicate within human cells, but some surely can. And some will be both more adept at spreading from human to human and more deadly than this coronavirus.
When one arrives, we will surely respond better than in 2020. This virus caught us unprepared, despite warnings from epidemiologists, disease historians, journalists and intelligence agencies. These prophets, like Cassandra, were ignored almost everywhere. Collectively, we let our guard down, believing the golden age of health ushered in by vaccines, antibiotics and sanitation infrastructure was permanent — a faith sustained by ignorance of epidemiology and history.
Even the SARS outbreak from 2002 to 2004 failed to rouse us from our complacent torpor. It spread inefficiently but was much more dangerous than its later cousin. It helped awaken Singapore, Hong Kong, South Korea and to some extent China and Canada to the risks of emerging diseases. But because it killed fewer than 800 people and affected few countries, the alarm was heard mainly by people attuned to epidemiology.
In 2020, the likes of President Trump, Jair Bolsonaro, Vladimir Putin and Xi Jinping struggled to recognize the covid-19 challenge. They were too ignorant of epidemiology and history to imagine what it might become and too ignorant to believe what public health experts were telling them until it was too late.
Machiavelli wrote in “The Prince” that evils that may arise in affairs of state, as in medicine, are easily cured if foreseen at a distance, which only the talented can do. “But when, from want of foresight, they are suffered to increase to such a height that they are perceptible to everyone, there is no longer any remedy.” Outside of a few cases, including South Korea, Vietnam, New Zealand, Rwanda and Singapore, heads of state could not foresee what was headed their way.
Leaders will likely be no cleverer in the years to come, but they will remember the disastrous responses of 2020. The coronavirus may or may not provoke biological immunity among survivors, but it will provoke a societal immunity — or at least strong resistance — in the form of preparedness for the next pandemic. While we mourn the victims of covid-19, we will build more robust early-warning systems for emerging diseases and better pandemic response systems on local, national and international levels. That will be costly, but the public will see it as money well spent.
Perhaps if we find an effective vaccine and contain the coronavirus, voices will arise in a generation — or perhaps longer given enough education in science and history — questioning the expenditure. As with mosquito control or vaccination regimens, sustained success carries the seeds of failure once people no longer fear what is prevented. Expect protective measures to lapse and for humanity to be unprepared again. Let’s hope on that future occasion there’s another Anthony S. Fauci around and that, once again, it’s not a perfect storm.
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