So much has happened this year already and it is only the 1st of April. Nine long months more to go to start anew. As an epidemiologist only partly contributing to epidemiology (and mostly working in Outcomes Assessment), I am pulled into the ongoing news cycle of the COVID-19 pandemic even though I have work that keeps me away from it. But how can anyone, leave alone an epidemiologist, turn away from this living laboratory whose results we can only partly imagine and partly deduce from ever-changing, dynamic models? These models are dynamic because they are dependent on variable inputs like population demographics, policy, public health messaging, degree and nature of social distancing, compliance, severity of cases, healthcare facilities, to name just a few.
Everyone who is under lock down now to prevent or minimize the spread of COVID-19 understands the importance of physical distancing while staying emotionally and socially connected. The internet has helped us much in this. But how did people do this historically during other times of crises such as wars, pogroms/genocides, previous pandemics, incarceration, or kidnappings? How did they stay sane given additional fear and stress factors such as being discovered hiding, breaking the law or being hunted? What experiences did they endure? What degrees of mental strength did they possess or cultivate? What routines of habit did they cultivate? In a series of blog posts I hope to put a collection together as a testament to human trials and tragedies, including triumphs over life's unexpected and sometimes grueling circumstances.
I start with what history teaches us about life under pandemics -- about implementing quarantine and conveying need for social distancing. This National Geographic article has charts demonstrating lowered curves and second waves in cities where social distancing wasn't enforced long enough.
In 2007, two studies published in the Proceedings of the National Academy of Sciences sought to understand how responses influenced the disease’s spread in different cities. By comparing fatality rates, timing, and public health interventions, they found death rates were around 50 percent lower in cities that implemented preventative measures early on, versus those that did so late or not at all. The most effective efforts had simultaneously closed schools, churches, and theaters, and banned public gatherings. This allowed time for vaccine development and lessened the strain on health care systems.
The studies reached another important conclusion: That relaxing intervention measures too early could cause an otherwise stabilized city to relapse. St. Louis, for example, was so emboldened by its low death rate that the city lifted restrictions on public gatherings less than two months after the outbreak began. A rash of new cases soon followed. Of the cities that kept interventions in place, none experienced a second wave of high death rates.
This NYT article is an introduction to social distancing during the plague.
Charles II issued a formal order in 1666 that ordered a halt to all public gatherings, including funerals. Already, theaters had been shut down in London, and licensing curtailed for new pubs. Oxford and Cambridge closed.But here is what catches my eye in this article:
Isaac Newton was one of the students sent home, and his family was among the wealthy who fled the cities so they could shelter in place at their country homes. He spent the plague year at his family estate, teasing out the foundational ideas for calculus.If only all of us can hunker down, discipline our minds and focus on one accomplishment. But the distractions in this modern world are too many, at least for me.
In my next post, I will write about some people who weren't as fortunate as Newton was and describe how they passed their time, so our own lock downs seem like a vacation in comparison.
