The Pandemic Century

Title: The Pandemic Century – A History of Global Contagion from the Spanish Flu to Covid-19

Author: Mark Honigsbaum

Publisher: WH Allen, 2020 (First)

ISBN: 9780753558287

Pages: 357

 

Natural and manmade disasters strike human societies every now and then. As the world is just getting back on rails after the disastrous spread of Covid-19, other infectious diseases like monkey pox threaten from some corners. Similarly, when the threat of a major war was ebbing after the last one in 2003 Iraq, Russia invaded Ukraine. War and pestilence have been legendary evils that afflict mankind. This book narrates the major outbreaks of diseases in the century from the end of World War I in 1918. The end of the long drawn-out War coincided with the outbreak of Spanish Flu which killed 50 million people across the globe. The disease’s spread was greatly enhanced by the demobilized soldiers returning home from the warfronts. The book is about the events, processes and the reasons why epidemics strike despite our best efforts to predict and prepare for them. Mark Honigsbaum is a medical historian and journalist specializing in the history of infectious disease. He is a lecturer in the department of journalism at the City University of London.

 

Influenza struck in 1918 when there was no idea of what a virus was and how it caused diseases. Bacteria were known, but antibiotics lay two decades in the future. Convalescence at a comfortable location, eating good food and avoiding mental tension were the prescribed antidotes to serious illnesses. As such, such an infection was de facto death sentence for the poor who could not afford the cost of recuperation. Concentration of recruits from rural and urban districts in overcrowded barracks led to the pandemic’s unusual characteristics. Contrary to normal, people of the age group 20-40 died most. It was years later that it was understood that it was caused by a virus. Though influenza was a viral infection, bacteria of the Bacillus family were also identified in many people. Mysteriously, these bacteria were not found in other patients. This contradiction baffled many researchers pursuing a cure. It was only later that it was realized that this bacteria was only a fellow traveler. In some cases it caused death, but the primary agent was the H1N1 virus.

 

Doom-mongers usually cite the occurrence of new and exotic diseases as a corollary to growth in science and technology. Conspiracy theorists allege that all major epidemics are caused by leakage from bio-warfare labs or deliberately spread by high-end pharma companies for commercial gain. Honigsbaum presents a simple but logical explanation for the outbreaks. Humans exert powerful evolutionary pressure on micro-parasites due to their changing social and cultural behaviours or through their impact on the environment of animal and insect ecologies. Sometimes these pressures select for a particularly virulent strain of the parasite or present it with an opportunity to colonize a new host and extend its ecologic range. Technologies and changes to the built environment designed to improve hygiene and ameliorate the conditions of life are giving rise to new threats to health and wellbeing. Legionella pneumophilia has been around for millennia, but it was not until we began building cities and equipping buildings with indoor plumbing and hot water systems that we presented the bacterium with a new ecological niche in which to prosper. This bacterium causes the Legionnaires’ disease which is spread through cooling towers of central air-conditioning systems in large buildings. The part on infections from pet birds and animals warns readers of the risks associated with close intimacy to pets. Parrots and parakeets experience mild infection of psittacosis when young but would never show any symptoms in the wild. In captivity – crowded, filthy and without exercise or sunlight – a flare up of the infection is to be expected. Psittacosis, or parrot fever, can be fatal to humans.

 

Honigsbaum notes with a touch of warning that new diseases come out all the time and it is particularly ironic when medical science practitioners unknowingly assume that they have obtained all knowledge that is there to know regarding diseases and its aetiological agents. AIDS was the epidemic that drove home the lesson that despite vaccines, antibiotics and other medical technologies, infectious disease had not been banished but posed a continuing and present threat to technologically advanced societies. If AIDS had struck in the 1950s, scientists would not have identified it, as the contemporary understanding of retroviruses was very limited. As such, the epidemic broke out at precisely the moment when scientists working in oncology and retrovirology specialists were inclined to believe that a retrovirus was the cause and possessed the tools and technology to test the hypothesis. This argument is ideal food for conspiracy theorists who claim that the HIV virus leaked out from a research lab. However, we have to keep in mind that coincidence is the one thing these people cannot cope with. This brings us to a discussion on the methodology of science and why existing theories have to be revised occasionally. The author elaborates that there is no such thing as absolute certainty in science. Paradigms are constantly being refined by new observations and if anomalies are found, it may be discarded and a new paradigm may come to supplant it. The best scientists welcome anomalies and uncertainty, as this is the way scientific knowledge advances.

 

The book discusses several outbreaks of deadly diseases that shook the medical community at a fundamental level and which produced anxious moments for the administrators. All of them affected the developed world or in cases such as Ebola, had the potential to cause infections in the developed world. Diseases that are endemic to the underdeveloped world are not seen here. What is repeatedly stressed however is the ease with which a contagious disease that entered a human body can reach any part of the world in a matter of just three days, helped by air travel and interconnectivity of the various parts of the globe. In the case of the 2002 SARS outbreak in Hong Kong, the disease infected several people in a particular floor of the hotel in which they were staying. Before it affected people in other floors, the disease reached Canada as one person flew there. The book was published in early 2020, so only a brief mention of the arrival of Covid-19 is given. The author expresses his concern at the prospective death toll in India where he assumes that the infrastructure is nonexistent to handle a disease of this magnitude. Left liberal activists of India had raised this concern with false arguments which the author is unable to spot. It contains an opinion piece by noted novelist Arundhati Roy that ‘although Kerala boasts 38,000 government hospitals, the same is not true of other Indian states where the public health system has been starved of funds and few tests are being conducted’ (p.278). If you do a search, you’ll find that Kerala has only 1200 hospitals and would be struck by the disconnect these so called ‘intellectuals’ have with reality and reason. In the end, India ended up doing far better than most developed nations in death toll, hospitalization and vaccination.

 

The book is recommended.

 

Rating: 3 Star