Sunday, April 12, 2020

Thoughts From Lockdown: On Pandemics, Slighted Gods, and Public Policy

Deaths from the 1918 flu pandemic in colonial Nigeria

I recently finished Laura Spinney’s Pale Rider, a book about the 1918 flu pandemic and its impact on the world. I have been thinking about the current pandemic and I wanted to share some of my thoughts. Let’s dive in.

**1**

There will be more pandemics. There are many viruses lurking in reservoirs such as bats, waiting for an opportunity to cross to humans. As more people eat exotic animals and come into closer contact with wildlife, there will be more interactions that open the door to zoonosis.

A zoonosis is a human illness caused by a pathogen that has crossed from nonhuman animals. Ebola is a zoonosis, having crossed over from bats. Lassa fever, the Zika virus, and all influenzas are zoonoses. AIDS has zoonotic origins, crossing from chimps to humans before mutating into a human-only disease.

We should distinguish between zoonotic and non-zoonotic diseases. It is difficult and potentially impossible to eliminate zoonotic diseases because the pathogens also exist in nonhuman animals. We can declare an Ebola outbreak over after 42 days without new cases, but that does not mean we conquered ebola. The virus continues to exist in its reservoir, fruit bats, and will get other chances to cross the species barrier. On the other hand, the variola virus that causes smallpox does not exist in a reservoir outside humans. Once the final case was resolved in the late 70s, we declared it gone forever in 1980.

There are conspiracy theories that the coronavirus was engineered. These have already been addressed elsewhere but I wanted to make a point. Nature does not need our help to create devastating pathogens. Malaria, which some scholars argue is the all-time leading cause of human death, is caused by a plasmodium that is found in nature. Understanding zoonosis and accepting it as a sufficient explanation is an important weapon in our arsenal against future pandemics.

There will be more pandemics because the conditions that aid the rise of zoonosis are accelerating. Rising populations are putting more people in close contact with wildlife and more people are eating and handling exotic animals for various reasons. This is a global challenge. In the connected world we now live in, a small spark in a distant village can light the whole place on fire.

**2**

When you first saw Thor command lightning in the movies, did you think of Sàngó? Yoruba readers may be familiar with Sàngó, the Yoruba god of thunder and lightning (electricity was added to his portfolio after its discovery). The Yoruba people that deified Sàngó lived far away from the Germanic tribes that worshipped Thor, but similarities in the gods they created typify something. Humans tend to ascribe things we don’t yet understand to gods.

During the 1918 flu pandemic, many people proclaimed it was a punishment from God. Okay – what crime were people being punished for? There were many theories, one of which was that the flu was retribution for humanity’s decision to turn away en masse from the one true path. Problem is, they could not agree which god was punishing them and which path was the true one. If this argument sounds familiar, it is because similar arguments have surfaced again 102 years down the line.

Among other differences between science and the type of dogma that blames slighted gods for pandemics, the former is willing to ask questions, search for answers, and improve the quality of knowledge over time. Science and dogma often clash, as they did in Spain’s Zamora in 1918.

Zamora was hit by the flu pandemic in September 1918. Authorities called for people to stay home and newspapers carried instructions for minimizing infection by avoiding crowded places. However, an influential local bishop was convinced the plague was a punishment from God because Zamoranos had neglected him. He therefore ordered a novena – prayers on nine consecutive days – in honor of St Rocco, the patron saint of plague and pestilence. Large crowds gathered for prayers and communion, and congregants lined up to kiss relics. The city and cathedral were packed. You can guess what happened afterwards. An incredible number of Zamoranos lost their lives. When the pandemic passed, Zamora had suffered more deaths than any other Spanish city.

Between 50 and 100 million people died in the 1918 flu pandemic, but proof that it was caused by a virus was not obtained until 1933. The first x-ray picture of any virus was taken in 1941, 21 years after the last direct victim of the 1918 flu pandemic died. We now know a lot more about viruses than we did in the 1900s but we still don’t know enough. We know what the coronavirus looks like and how to slow its spread but we don’t know how to protect ourselves against it yet.

The nature of science and its reliance on progressive discovery means that it will never have all the answers. It is important to understand this. The fact that we cannot currently protect ourselves against the coronavirus does not mean all the advancements in virology over the past century are wasted. It does not mean science has failed. All else remaining equal, those advancements will eventually culminate in a world where many people are protected from this virus and others like it. The same way small pox was eradicated, polio has been confined to only a few areas, and contracting HIV is no longer a death sentence. You can pray and follow the latest public health guidance at the same time.

To our credit, humanity seems to be doing better now than we did in 1918. Many believers of different faiths immediately grasped the severity of the situation and supported calls to suspend religious gatherings. Some clergymen have proved themselves more responsible than governments: the Catholic Diocese of Port Harcourt asked churches to remain closed despite their State Governor lifting the ban on large gatherings over the Easter weekend.
**3**

Another learning from Pale Rider is that the demands of national security, a thriving economy, and public health rarely align. Government officials defending the first two in a pandemic undermine the third simply by doing their job. How do you keep some economic activity going while keeping as many people as possible safe? There are no easy answers and all governments are learning as they go. The situation is more complicated in poorer countries such as India and Nigeria, with a high proportion of daily earners and the absence of social safety nets. How do you limit unrest by keeping food on people’s tables while also keeping them safe?

It is interesting to note that it is not enough for governments to do things that work, they must also do things that people think are working. No one is assessing their government’s policies in a vacuum anymore, especially as there is easy access to news from other countries. For example, people called for markets to be disinfected in Ibadan after videos surfaced of streets being disinfected in China. But if you’re a State Governor allocating limited resources, is there a point to disinfecting markets in Ibadan? Likely not. Consider an enclosed space such as an elevator where a respiratory virus can spread easily. If healthy people spend enough time in an elevator with a sick person – they are likely to become infected, no matter how frequently the elevator is thoroughly disinfected.

Disinfecting streets in China
It seems on the surface that freedom of movement and other rights that are enshrined in western countries are inconsistent with some of the measures a government must take to halt the spread of a pandemic. My favorite example is how people in the UK turned out en-masse to sunbathe after the government asked the country to go into a lockdown. People are quick to defend their freedoms, but seem unwilling to accept the responsibilities that come with it. Thoughts similar to this led historian Alfred Crosby, who told the story of the flu in America, to argue that democracy is unhelpful in a pandemic. 

The world is more optimized today than it has ever been. Many companies watch their inventory closely, ensuring they only have what they need. That works well most of the time but breaks down horribly once a pandemic forces border closures. Optimized can quickly become equal to fragile. There is also the fact that a large number of gig economy workers have to work every day to make a living and cannot afford to take sick days. Our current world does not have enough slack built in because we have long believed that slack is inefficient. I am glad that my job offers an opportunity to shape how some companies respond to this situation, and I look forward to seeing if and how things change in the wider world after this pandemic.

**4**

I say “after this pandemic”, because there will be an “after”. The 1918 flu pandemic must have felt like hell to experience, but it eventually went away and life returned to normal. People went to parks again and drank at pubs; the world even went back to war within two decades.

There are many other thoughts I have excluded from this post to reduce its length. I continue to discuss those with friends over long WhatsApp conversations. I wrote a separate post, available here, about keeping your head up through these trying times.

Thank you for reading to the end. If you are interested in more about the 1918 flu pandemic, I recommend Pale Rider as a great book on the subject. I hope you continue to stay well…may the force be with you.

Koye.
April 2020.

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