COVID-19 and the anti-lessons of history
Authors: Robert Peckham
Journal: The Lancet (2020)

As the outbreak of coronavirus disease 2019 (COVID-19) in China's Hubei province continues and new cases of the disease increase globally,1WHOCoronavirus disease 2019 (COVID-19) situation report—38.https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200227-sitrep-38-covid-19.pdf?sfvrsn=47fdaf7_4Date: Feb 27, 2020Date accessed: February 27, 2020Google Scholar there is pressure on historians to show the value of history for policy. How can the past assist in the real-time management of the crisis? What insights can be gleaned from the ongoing epidemic for future disease preparedness and prevention? Lurking in the background of these interrogatives is a more or less explicit accusation: why haven't past lessons been learned? The gist of some commentaries seems to be: "there is almost nothing surprising about this pandemic".2Specter M The new coronavirus and preparing for the next viral pandemic.The New Yorker. Feb 15, 2020; https://www.newyorker.com/news/daily-comment/the-new-coronavirus-and-preparing-for-the-next-viral-pandemicDate accessed: February 17, 2020Google Scholar The history-as-lessons approach pivots on the assumption that epidemics are structurally comparable events, wherever and whenever they take place. The COVID-19 outbreak "creates a sense of déjà vu" with the 2003 outbreak of severe acute respiratory syndrome (SARS).3Kock RA Karesh WB Veas F et al.2019-nCoV in context: lessons learned?.Lancet Planet Health. 2020; (published online Feb 6.)https://doi.org/10.1016/S2542-5196(20)30035-8Summary Full Text Full Text PDF PubMed Scopus (56) Google Scholar Citing early estimates of the disease's infectiousness, based on an analysis of the first 425 confirmed cases in Wuhan,4Li Q Guan X Wu P et al.Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia.N Engl J Med. 2020; (published online Jan 29.)DOI:10.1056/NEJMoa2001316Crossref Scopus (10666) Google Scholar comparisons have been drawn with the 1918–19 influenza pandemic.5Soucheray S Data suggest nCoV more infectious than 1918 flu, but what does that mean? CIDRAP.http://www.cidrap.umn.edu/news-perspective/2020/01/data-suggest-ncov-more-infectious-1918-flu-what-does-meanDate: Jan 30, 2020Date accessed: February 26, 2020Google Scholar Although in some respects the outbreak of COVID-19 presents a compelling argument for why history matters, there are problems with analogical views of the past because they constrain our ability to grasp the complex place-and-time-specific variables that drive contemporary disease emergence. A lessons approach to epidemics produces what Kenneth Burke, borrowing from the economist and sociologist Thorstein Veblen, called "trained incapacity"—"that state of affairs whereby one's very abilities can function as blindnesses".6Burke K Permanence and change: an anatomy of purpose. University of California Press, Berkeley, CA1984Google Scholar Habitual modes of thinking can diminish our capacity to make lateral connections. When the present is viewed through the lens of former disease outbreaks, we typically focus on similitudes and overlook important differences. In other words, analogies create blind spots. As Burke commented, "a way of seeing is also a way of not seeing—a focus on object A involves a neglect of object B".6Burke K Permanence and change: an anatomy of purpose. University of California Press, Berkeley, CA1984Google Scholar A lessons approach to the past, which usually comes from outside the discipline of history, reinforces an idea of the past as a series of interlinked crises that offer instructive insights into cause and effect.7Roitman J Anti-crisis. Duke University Press, Durham, NC2013Crossref Google Scholar Historians need to push back against easy analogies and examine the specific contexts of outbreaks, asking, for example, in what ways SARS and COVID-19 are in fact comparable. The designation of the new virus as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses8Gorbalenya AE Baker SC Baric RS et al.Acute respiratory syndrome-related coronavirus: the species and its viruses—a statement of the Coronavirus Study Group.bioRxiv. 2020; (published online Feb 11.) (preprint).https://doi.org/10.1101/2020.02.07.937862Google Scholar recognises it as genetically related to but different from severe acute respiratory syndrome coronaviruses (SARS-CoVs). What is striking, but too little commented on, are the differences between the historical moments of the emergence of SARS and COVID-19. The SARS outbreak occurred in late 2002 and 2003, not long after China had resumed sovereignty over Hong Kong in 1997. Under the terms of the Sino-British Joint Declaration signed between the Chinese and UK Governments in December, 1984, the former British colony was guaranteed the status of special administrative region. In March, 2003, Hu Jintao formally succeeded Jiang Zemin as President of China. Although the Chinese Government was initially condemned for withholding information and concealing the extent of the SARS epidemic,9Huang Y The SARS epidemic and its aftermath in China: a political perspective.in: Learning from SARS: preparing for the next disease outbreak: workshop summary. National Academies Press, Washington, DC2004: 116-136Google Scholar the early 2000s saw China's increasing international engagement. China acceded to the World Trade Organization in 2001, the year that Beijing was elected to host the 2008 Summer Olympics. Over the past 7 years, China's President Xi Jinping has sought to extend Chinese influence abroad while tightening his grip on power at home.10Economy EC The third revolution: Xi Jinping and the new Chinese state. Oxford University Press, New York2018Google Scholar Some would argue that this enhanced authority has enabled him to put in place draconian, Mao-style infectious disease containment measures including the lockdown of cities.11Zhong R Mozur P To tame coronavirus, Mao-style social control blankets China.The New York Times. Feb 15, 2020; https://www.nytimes.com/2020/02/15/business/china-coronavirus-lockdown.htmlDate accessed: February 17, 2020Google Scholar Bruce Aylward, a senior adviser to WHO's Director-General who co-led the WHO-China Joint Mission on COVID-19 in late February, 2020, praised China's efforts as "probably the most ambitious, and I would say, agile and aggressive disease containment effort in history".12WHOPress conference of WHO-China Joint Mission on COVID-19.https://www.who.int/docs/default-source/coronaviruse/transcripts/joint-mission-press-conference-script-english-final.pdf?sfvrsn=51c90b9e_2Date: Feb 24, 2020Date accessed: February 26, 2020Google Scholar Meanwhile, the protests in Hong Kong from June, 2019, have been a reaction to a perceived erosion of the territory's quasi-autonomy as a special administrative region. While ostensibly an anti-government protest against the introduction of an extradition bill, the Hong Kong protests could be viewed as an attempt to push back against Xi's expansion of central power.13Khan N Fan W "Prepared to die": Hong Kong protesters embrace hard-core tactics, challenge Beijing.The Wall Street Journal. Aug 6, 2019; https://www.wsj.com/articles/prepared-to-die-hong-kong-protesters-embrace-hard-core-tactics-challenge-beijing-11565038264Date accessed: February 17, 2020Google Scholar Concurrently, a US–China trade war instigated by President Donald Trump's imposition of tariffs on China in 2018 is hitting the Chinese economy.14Puzder A Talent J The trade war hits China where it hurts.The Wall Street Journal. Aug 11, 2019; https://www.wsj.com/articles/the-trade-war-hits-china-where-it-hurts-11565552398Date accessed: February 17, 2020Google Scholar The COVID-19 outbreak is compounding this economic situation, holding out the potential for a global recession with major disruption to global supply chains.15The EconomistThe new coronavirus could have a lasting impact on global supply chains.The Economist. Feb 15, 2020; https://www.economist.com/international/2020/02/15/the-new-coronavirus-could-have-a-lasting-impact-on-global-supply-chainsDate accessed: February 26, 2020Google Scholar Taken together, these entangled circumstances have created a unique setting in which the COVID-19 outbreak is evolving. In an interview with the Hong Kong newspaper Ming Pao, the physician Joseph Sung, who had a leading role in the fight to contain SARS in 2003, underscored the striking differences between Hong Kong society then and now. "At that time, society was more united", Sung said of the SARS era, "whereas now people feel they have to rely on themselves for protection. They have less trust in the government".16But KM Joseph Sung: lax quarantine measures by the Hong Kong government and insufficient checks on travel histories.Ming Pao. Feb 13, 2020; ([in Chinese]).https://news.mingpao.com/pns/%E8%A6%81%E8%81%9E/article/20200213/s00001/1581532185740Date accessed: February 17, 2020Google Scholar Analogies of COVID-19 are rarely extended to encompass these intermeshing social and political environments. The lessons approach skates over this history, even as history's expediency as a tool for instruction is flaunted. Historians need to contest false analogies that obscure, rather than elucidate, the social processes partly driving new infections. They need to challenge efforts to corral and straitjacket the past into summary lessons. By contrast, espousing an anti-lessons approach to history might prevent trained incapacity. Such an approach could help to ensure a strategic open-mindedness to emergent threats at a time when borders of many kinds are going up across the globe. This online publication has been corrected. The corrected version first appeared at thelancet.com on March 16, 2020 This online publication has been corrected. The corrected version first appeared at thelancet.com on March 16, 2020 I declare no competing interests. Department of ErrorPeckham R. COVID-19 and the anti-lessons of history. Lancet 2020; 395: 850–52—In this Comment, the dates in references 13 and 14 have been corrected. These corrections have been made to the online version as of March 16, 2020. Full-Text PDF Department of ErrorZhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; published online March 9. https://doi.org/10.1016/S0140-6736(20)30566-3—In this Article, the units for d-dimer, haemoglobin, and high-sensitivity cardiac troponin I have been corrected to μg/mL (d-dimer), g/L (haemoglobin), and pg/mL (high-sensitivity cardiac troponin I). In figure 1, the start of systematic corticosteroid for non-survivors has been changed to day 13 after illness onset. Full-Text PDF