“If a severe pandemic materializes, all of society could pay a heavy price for decades of failing to create a rational system of health care that works for all of us.”
– Irwin Redlener
We Texans like to consider ourselves a hardy lot. Not much scares us – not communists, Islamic terrorists, hurricanes, triple-digit temperatures, or even gingivitis. When the 2014 Ebola scare hit Dallas, locals rumbled through their daily routines without any real concern that a fatal microbe – one with a roughly 90% death rate – lurked in the air. Actually, it was in the bloodstream…of a handful of individuals. Ebola, like HIV and bad attitudes, is a blood-borne pathogen and therefore, not transmittable via the air. Thus, I thought it odd that the South by Southwest Festival (SXSW), an annual gathering of film, music and media artists in Austin, had been canceled this time because of the current, ongoing coronavirus outbreak. I still can’t believe that Austin – a city that prides itself on being “weird” – has been humbled by a viral intruder. But it has. Sadly, thousands of weirdos from across the globe will not be able to descend upon the capital of one of the most conservative dominions in the United States and find kindred souls through their mutual love of art and music. And humanity’s mutual love of going to work and to school, shopping and taking vacations also has been undermined by a wicked little microbe.
For COVID-19 – the critter formerly known as a coronavirus – the mystery continues unabated. I haven’t seen this much hysteria over a disease since AIDS popped up nearly four decades ago. With the death toll now exceeding 3,000 and the confirmed number of infections pushing 100,000, COVID-19 is proving to be a formidable bacterial opponent. The flu-like virus has reached every continent except Antarctica and (as many of these things tend to do) shows no signs of slowing. What are we bipedals on the third rock from the sun supposed to do?
A century ago the world was recovering from two cataclysms: the Great War (World War I) and the “Spanish flu”. It seems the latter followed the former. Millions of people displaced across Europe by the ravages of conflict – sickened and hungry – inadvertently created a cesspool of illness. To this day, no one really knows where exactly the Spanish flu evolved (some say the Midwestern U.S. was the point of germination), what made it so lethal, or why it spread so quickly and so far. In the ensuing decades, some virologists declared that the closest analogy is the 14th century “Black Plague”, a scourge that managed to ravage much of the known world – from Western Asia to Northern Africa to Iceland. The “known world”, of course, being what European scholars thought existed, circa 1300 C.E.
The “Black Plague” was a Eurasian pandemic; a merciless spread of the bubonic plague across regions that hadn’t yet realized the beauty of handwashing and Kleenex. From roughly 1347 C.E. to 1352 C.E., the ailment took approximately 20 million lives. It impacted commerce and trade and terrified ignorant souls into comprehending the fragility of their existence. It shaped the entire region; one of the birth places of modern humanity; a womb of agriculture and farming.
The 1918-19 Spanish flu remains the most severe pandemic in recent virological history. Doctors in both Europe and the U.S. first identified the virus in military camps in the spring of 1918. Within two years the virus, now identified as a strain of avian H1N1, had directly affected roughly 500 million people and killed an estimated 50 million. And much like the 14th century “Black Death”, the “Spanish flu” retreated into the annals of medicine, once it appeared to have inflicted enough agony upon a vulnerable populace. In a time before antibiotics, contemporaries of the “Black Death” and “Spanish flu” resorted to isolation, quarantine, prayer and general hysteria. So what’s new?
In the century since the “Spanish flu” quagmire, the planet has experienced two similar microbial outbursts: the 1956-58 “Shanghai flu” and the 1968-70 “Hong Kong flu”. The Shanghai menace was an H2N2 avian virus first reported in China in early 1956. It had originated from a mutation in wild ducks and combined with a pre-existing human strain. A vaccine was introduced in 1957, and the pandemic slowed down. A second wave developed in 1958, however, and went on to become part of the regular wave of seasonal flu. Overall, the “Shanghai flu” killed about 5 million people across the globe. By 1968, the H2N2 Asian flu had disappeared from the human population and is believed to have gone extinct in the wild.
Then, in 1968, the “Hong Kong flu” arose. Developing from an H3N2 avian virus, it first appeared in Hong Kong in July of 1968. Within two months, the virus had spread across Asia and into Europe. By autumn, it reached the Western Hemisphere. As with the Spanish flu, the Hong Kong flu appears to have come to the United States along with military troops arriving home from battle. In this case, it was the Vietnam War, which had begun to impact all of Southeastern Asia by 1968. In total, the Hong Kong flu killed approximately 1 million people.
AIDS bears some similarities to all of the aforementioned influenzas disasters, in that it appeared unexpectedly and incited mass hysteria. But HIV germinates within blood and blood-related elements. Despite warnings from religious zealots and other uneducated morons, it cannot be transmitted via sneezing and coughing.
The most recent influenza-style epidemic was the 2002-03 SARS (Severe Acute Respiratory Syndrome) virus. Officially dubbed SARS-CoV, it is thought to be an animal-borne microbe – perhaps bats, which spread to other mammals, such as wild felines. It somehow spread to humans and was first identified in southern China in November of 2002. It infected about 1,800 people and killed less than 300. No known SARS cases have been documented since 2004.
The contemporary COVID-19 has sparked the usual rash of histrionics. The sight of people clad in hazmat attire scrubbing walls and airline seats is matched only by the plethora of wary citizens navigating the streets of the world’s metropolises while wearing face masks. Aside from the SXSW event, Chinese New Year events saw dramatic shifts in travel and attendance, and the latest installment of the James Bond franchise, “No Time to Die”, has had its worldwide premier delayed from April 10 to November 25. Italy, which has experienced the greatest number of COVID-19 infections outside of Asia, has seen an overwhelming drop in tourism to some of its most famed landmarks. Saudi Arabian authorities have suspended the year-round “umrah” pilgrimage to Islam’s holiest place, in a bid to stop the spread of the virus. The usual masses of people circling the granite Kaaba at Mecca’s Grand Mosque has been reduced to a handful of brave souls.
Here in the U.S. we’ve seen a run on hand sanitizer, face masks, generators, non-perishable food items, and even hazmat suits. People are refusing to shake hands and will touch elevator buttons and door handles only if there’s a latex glove or a paper towel between them. I can only suspect that the same has occurred in other countries. These precautions are not unwarranted. In a world with a population rapidly approaching 7 billion, it’s not illogical to envision millions of people literally dropping dead on the streets.
While the epidemic seems to have slowed in Wuhan, China (the place of its birth), it continues across the planet. We’re far from the death toll of even the Hong Kong flu. And most of the fatalities have occurred in individuals over the age of 65 and / or in people with underlying health conditions, such as diabetes and heart disease. This should be expected of any viral scourge.
My greatest concern, however, is that the real biological menace – the one that could wipe out literally millions, if not billions of people – has yet to emerge. Such a pandemic would be unprecedented in human history. And it would impact everyone, much like the 1918 Spanish flu, which affected even strong, healthy people. The very young, the very old and the very sick are always the first victims of any airborne disease. Epidemiologists will continue to march across the globe in search of the next viral threat, and the rest of us will continue to wonder if our time will end in the depths of elderly sleep or swaddled in the confines of plastic.