Learning from the past

When epidemics spread with no end in sight it generates either panic or pessimism, leading to resigned fatalism

Since time immemorial humankind has been periodically exposed to the scourge of epidemics that have in their wake resulted in countless deaths, decimated societies, nations and entire civilisations. Despite advancements in scientific knowledge, whenever we are exposed to a hitherto unknown organism, it takes its toll before a cure or a vaccine is available. Yet certain common public health measures known to us for some time can, if introduced early on, influence the trajectory of an epidemic. These measures have successfully been applied in controlling many communicable diseases including the 1918 Spanish flu, and more recently the Ebola and Zika viruses.

One of the most outstanding public health triumphs of our times was the eradication of smallpox, an affliction that had hounded human civilisation for over 3,000 years. Smallpox killed, maimed and scarred millions around the globe. Although smallpox eradication efforts were aided for nearly two centuries by the availability of a vaccine, these efforts were only impactful when reliance on mass immunisation was supplemented by public health measures that included active case surveillance, containment and mass awareness. Dr William Foege, who is credited with developing the global strategy for the eradication of smallpox, in his book, A House on Fire, lists some lessons that are applicable to combat epidemics even today.

According to Dr Foege, a key element in epidemic control efforts is harnessing social will, defined as the collective expression of what people want or desire, not for themselves as individuals, but for the collective benefit of others. Despite decades of efforts, progress to eradicate smallpox was achieved only in the 70s, when people showed the social will to eradicate the scourge from society by providing resources and opportunities to protect others. Leadership helps to build social will, by engaging people, providing them with truthful, accurate information based on science, data and facts thereby earning their confidence and trust. Social will can help generate political will, allowing governments to make crucial decisions. However, these decisions must be guided by scientific advice from public health experts. For instance, in our case experts are cautioning that the steady increase in the number of positive cases among those being tested may require introducing periodic lockdowns. According to Professor Christopher Nichols, a historian at the Oregon State University, an important lesson that the 1918 pandemic taught us was that our decisions must be guided by science and not socio-economic concerns.

Another lesson learned from epidemic control measures applied in the recent past is to build philanthropic coalitions bringing together the public, private, corporate sectors and the pharmaceutical industry to join hands. Globally, pharmaceuticals have played a significant supportive role in helping cash-strapped governments overcome disease outbreaks by donating medicines equipment and supplies. We must tap into this resource to ensure affordable care is available to all. In case we decide on a lockdown strategy, private sector philanthropy could be enlisted to provide targeted social assistance that includes food rations to poor households.

When epidemics spread with no apparent end in sight it generates either panic or pessimism, leading to a sense of resigned fatalism. Realistic optimism must therefore be propagated to counter this tendency and to keep those who are trying to protect others focused and motivated.

Surely, we can overcome the pandemic through national unity, cohesive policies, but most importantly by following a consistent approach guided by established and emerging science.

Published in The Express Tribune, June 28^th, 2020.

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