How Pandemics End: Learning the Lessons of History

How Pandemics End: Learning the Lessons of History
A nurse prepares to enter the sub-intensive care unit of the San Filippo Neri hospital in Rome, Italy, Oct. 29, 2020 (AP photo by Alessandra Tarantino).

The COVID-19 pandemic has made everyone much better versed in basic epidemiological modeling than they were eight months ago. We have all familiarized ourselves with exhaustive data collection and the analysis of epidemic curves based on prior crises, the reproduction rates of the SARS-CoV-2 virus and the daily influx of new cases. Yet, even for professional epidemiologists, the question of when this pandemic will end has no simple answer. Certainty is a luxury rarely afforded to scientists, and this is particularly true in the world of public health.

However, we do know that pandemics do not attack indiscriminately. While we are all susceptible to pathogens, our social structures and the inequities within them shape our pandemic responses, often putting the most marginalized at greater risk. Throughout history, social inequalities, shaped in no small part by centuries of racial injustice, colonial violence and economic divides, have affected how diseases spread and who was most vulnerable to infectious pathogens. When a proper response to a health crisis has been stymied primarily by a lack of political will, then, too, have epidemics exposed the injustice in our societies.

Similar dynamics are at play again today with COVID-19. The pandemic, which has now infected more than 46.5 million people around the world and killed more than 1.2 million, has emerged on all continents and in all but a handful of countries, with epicenters shifting from Wuhan in China, to Milan, to New York and beyond. Today, the three countries that have recorded the most positive cases⎯the United States, India and Brazil⎯account for nearly 50 percent of all coronavirus infections so far. The new surge in cases across Europe that has sent countries back into lockdown should alert us to the dangers of complacency and the need for sustained, coordinated public health responses. Yet in some areas, where the caseload has ebbed and lockdowns eased, some have wondered whether life may soon return to normal, or if further waves are on their way.

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