WHEN IS A PANDEMIC OVER ?
Channel: THE EXPERTISE talks
Date: 2020-07-04

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According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes.

“When people ask, ‘When will this end?,’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins.

In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease. Allan Brandt, a Harvard historian, said something similar was happening with COVID-19: “As we have seen in the debate about opening the economy, many questions about the so-called end are determined not by medical and public health data but by sociopolitical processes.”

Endings “are very, very messy,” said Dora Vargha, a historian at the University of Exeter. “Looking back, we have a weak narrative. For whom does the epidemic end, and who gets to say?”

In the Path of Fear In the preceding months, more than 11,000 people in West Africa had died from Ebola, a terrifying viral disease that was highly infectious and often fatal. The epidemic seemed to be waning, and no cases had occurred in Ireland, but the public fear was palpable.

That pandemic ended, but the plague recurred. One of the worst outbreaks began in China in 1855 and spread worldwide, killing more than 12 million in India alone. Health authorities in Mumbai, India, burned whole neighborhoods trying to rid them of the plague. “Nobody knew if it made a difference,” Yale historian Frank Snowden said.

Or perhaps it was a change in the rats. By the 19th century, the plague was being carried not by black rats but by brown rats, which are stronger, more vicious and more likely to live apart from humans.

Another hypothesis is that the bacterium evolved to be less deadly. Or maybe actions by humans, such as the burning of villages, helped quell the epidemic.

The plague never really went away. In the United States, infections are endemic among prairie dogs in the Southwest and can be transmitted to people. Snowden said that one of his friends became infected after a stay at a hotel in New Mexico. The previous occupant of his room had a dog, which had fleas that carried the microbe.

Such cases are rare and can now be successfully treated with antibiotics, but any report of a case of the plague stirs up fear.

One possibility, historians say, is that the coronavirus pandemic could end socially before it ends medically. People may grow so tired of the restrictions that they declare the pandemic over, even as the virus continues to smolder in the population and before a vaccine or effective treatment is found.

“I think there is this sort of social psychological issue of exhaustion and frustration,” Yale historian Naomi Rogers said. “We may be in a moment when people are just saying, ‘That’s enough. I deserve to be able to return to my regular life.’”

It is happening already; in some states, governors have lifted restrictions, allowing hair salons, nail salons and gyms to reopen, in defiance of warnings by public health officials that such steps are premature. As the economic catastrophe wreaked by the lockdowns grows, more and more people may be ready to say “enough.”

“There is this sort of conflict now,” Rogers said. Public health officials have a medical end in sight, but some members of the public see a social end.

“Who gets to claim the end?” Rogers said. “If you push back against the notion of its ending, what are you pushing back against? What are you claiming when you say, ‘No, it is not ending.’”

The challenge, Brandt said, is that there will be no sudden victory. Trying to define the end of the pandemic “will be a long and difficult process.”


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