Humbled by nature: 600,000 dead in U.S from COVID-19

“Fully vaccinated.”

Today’s the day. Wednesday, June 16, 2021. Two weeks have passed since my second dose of Moderna COVID-19 mRNA vaccine was administered.

Our parents generation had V-E Day or Victory in Europe Day, the public holiday celebrated on May 8, 1945 to mark the end of the Second World War in Europe, while V-J Day or Victory over Japan Day was celebrated Sept. 2, 1945 in the United States, Aug. 14-15, elsewhere by our Allies. But as he witnessed the first detonation of a nuclear weapon on July 16, 1945, a piece of Hindu scripture from the Bhagavad Gita ran through the mind of Robert Oppenheimer: “Now I am become Death, the destroyer of worlds.”

Our generation now has its own individual V-Day: Vaccinated against COVID-19 Day.

Some 675,000 Americans died over three years between January 1918 and December 1920 during the three waves of the Spanish Flu pandemic when the country’s population was 103.2 million. Today, the population of the United States is more than 331 million. The world population in 1918 was about 1.8 billion, compared to about 7.8 billion people today.

COVID-19 is the second-deadliest plague in modern history, having killed as of June 15 more than 600,000 people in the United States in slightly more than 16 months. The COVID-19 death toll stands at about 3.8 million case fatalities worldwide. It’s unusual clinical course of unpredictability in patients, ranging from an asymptomatic infection the person isn’t even aware of to death in a hospital intensive care unit (ICU), often with no good explanation available even after age and comorbidities are accounted for, makes it all the more terrifying. Some diseases are so deadly death is almost certain. COVID-19 is not like that. Rather it is like playing a macabre viral version of Russian Roulette. Maybe. Maybe not.

At the same time, effective messenger Ribonucleic Acid (mRNA) and viral vector vaccines offering full protection against COVID-19, some of which were relegated to the scientific research backburner since their initial discoveries and on-again, off-again preliminary work in the mid-1980s, were brought to fruition in warp speed in 10 months rather than the normal 10 years it takes to bring a new vaccine to market. Despite the COVID-19 vaccines impressive efficacy and good safety record to date, I’m under no illusion that we the vaccinated are not all part of a population level experiment. We surely are. Not something I would have said in advance I’d be anxious to sign up for, but as the Scottish philosopher James Boswell’s Life of Samuel Johnson, quotes in 1777 the latter to say: “Depend upon it, sir, when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully.”

And, of course, as the last 18 months have unfolded, all of this has been accompanied by an “infodemic” of social media and real life (if there is still that separation for some) sometimes accidental misinformation but more often deliberate disinformation from modern-day armchair Barbarian Visigoths, who revel in the propagation of their anti-mask and/or anti-vax propaganda. Until they die of COVID-19. It’s not like we didn’t have a heads-up of what to expect on this front in the battle against COVID-19. In 1998, Andrew Wakefield and 12 of his colleagues published a case series in the Lancet, which suggested that the measles, mumps, and rubella (MMR) vaccine may predispose to behavioural regression and pervasive developmental disorder in children. Despite the small sample size (n=12), the uncontrolled design, and the speculative nature of the conclusions, the paper received wide publicity, and MMR vaccination rates began to drop because parents were concerned about the risk of autism after vaccination.

All pretty remarkable, since the name COVID-19 didn’t exist prior to Feb. 11, 2020 when the World Health Organization (WHO) named what had been provisionally known as Novel Coronavirus 2019-nCoV and first reported from Wuhan, China on Dec. 31, 2019. In terms akin to chaos theory, think of it perhaps as the as the Wuhan butterfly effect, regardless of whether the origins of COVID-19 should someday prove to be natural or the result of a gain-function experiment gone awry resulting in an accidental lab leak at the Wuhan Institute of Virology. The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2 for what would become known as COVID-19. The World Health Organization, perhaps finding the recommended name a tad too resonant politically to SARS from the not-so-distant past, opted instead for the official name COVID-19.

Human beings live in the realm of nature, they are constantly surrounded by it and interact with it. Man is part of nature, a humbling reminder for all of us to what we so quickly forget 15 minutes after the last pandemic ends. Until the next one begins.

The first time I wrote on what would soon be characterized as the current pandemic was on Jan. 23, 2020. A week later on Jan. 30, WHO Director General Tedros Adhanom Ghebreyesus, an Ethiopian biologist, following the recommendations of the WHO Emergency Committee, declared that the Novel Coronavirus 2019-nCoV outbreak constituted a Public Health Emergency of International Concern (PHEIC). On March 11, the WHO elevated the viral outbreak to the status of full-blown pandemic.

The headline to my Jan. 23, 2020 post wondered, “The fire this time? Pandemic prose, and waiting and watching for the ‘big one’ (The fire this time? Pandemic prose, and waiting and watching for the ‘big one’ | soundingsjohnbarker (wordpress.com) In a matter of weeks, there was no question the question mark could be dropped and the sentence turned into a categorical statement; it was indeed the fire this time, and the “big one” had arrived as an unwanted New Year’s Eve 2019 guest.

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2020 vision: Look back and lean forward as we revisit COVID-19 and early scenes of a biological Armageddon

It was a time before social distancing, face masks and coronavirus vaccines. 

March 11, 2020 was a Wednesday. It was also the day the world changed.

On that day, a year ago today, the World Health Organization (WHO) officially declared COVID-19 a pandemic, after the novel coronavirus was detected in more than 100 countries.

That same day, the Dow Jones plummeted into bear market territory, the National Basketball Association (NBA)  abruptly halted its season, then-U.S. President Donald Trump announced a European travel ban in a national address and Tom Hanks and his wife Rita Wilson announced they had contracted the virus while filming in Australia. That was one day: March 11, 2020.

March 2020 was simply the March that never ended. Last March, the calendar may have said 31 days, but in truth it was the month without end. Never mind notions of March coming in like a lamb and going out like a lion, or vice-versa, or beware the Ides of March, that sort of thing. A year ago this month was far more terrifying, yet simultaneously, surreal than anything so pedestrian as lambs, lions and ides.

The National Center for Medical Intelligence (NCMI) at Fort Detrick, Maryland warned as far back as November 2019 that a contagion was sweeping through China’s Wuhan region, changing the patterns of life and business and posing a threat to the population. The report was the result of analysis of wire and computer intercepts, coupled with satellite images. The medical intelligence (MEDINT) cell within Canadian Forces Intelligence Command (CFINTCOM) gave a similar warning in January 2020.

As early as Jan. 23, 2020, I had written here: 

Novel Coronavirus 2019-nCoV [as it was then provisionally known], which “shows signs of being far worse than SARS-CoV, has resulted in lockdowns today in two Chinese cities, Wuhan and Huanggang. The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2 for COVID-19. The World Health Organization, perhaps finding the recommended name a tad too resonant politically to SARS from the not-so-distant past, opted instead for the official name COVID-19.

“Yi Guan, a Chinese virologist, who played an important role in tracing the development of SARS-CoV, said, ‘I’ve experienced so much and I’ve never felt scared before. But this time I’m scared,’ Nathan Vanderklippe, Asia correspondent for the Globe and Mail, and Alexandra Li, in Beijing, reported today.”

A few paragraphs later, I wrote “2019-nCoV was first detected last month in Wuhan City, Hubei Province, China, and the virus did not match any other known virus. The U.S. Centers for Disease Control and Prevention describes it as ‘an emerging, rapidly evolving situation.'”

Yet that same day – Jan. 23, 2020 – the Geneva-based WHO said that “now is not the time” to call a global health emergency related to a new coronavirus that has left 17 dead and more than 500 others infected in China, according to reports from the Associated Press, CTV News Channel, and other media. A “Public Health Emergency of International Concern” (PHEIC) must be an “extraordinary event” that poses a global risk and requires co-ordinated international action, according to the WHO. Global emergencies had been declared before, including for the Zika virus outbreak in the Americas, the swine flu and polio.

That decision would be revisited just a week later on Jan. 30, 2020, when, following the recommendations of its emergency committee, WHO Director General Tedros Adhanom Ghebreyesus declared that the novel coronavirus outbreak constituted a Public Health Emergency of International Concern (PHEIC).

Less than six weeks later, the WHO said a Public Health Emergency of International Concern was now a global pandemic.

The day before COVID-19 was declared a global pandemic, the New York State National Guard were  deployed to the New York City suburb of New Rochelle in Westchester County to enforce a COVID-19 containment area comprising a circle with a radius of about one mile.

In Italy, scenes from the new contagion were apocalyptic by mid-March of last year. “Unfortunately we can’t contain the situation in Lombardy,” said Daniela Confalonieri, a nurse at a hospital in Milan “There’s a high level of contagion and we’re not even counting the dead any more,” she said.

Underscoring the scale of the drama, soldiers transported bodies overnight March 18 and 19, 2020 from the northern town of Bergamo, northeast of Milan, whose cemetery has been overwhelmed.

An army spokesman said 15 trucks and 50 soldiers had been deployed to move coffins to neighbouring provinces. Earlier local authorities had appealed for help with cremations as their own crematorium could not cope with the huge workload.

One of the most chilling things on this side of the Atlantic, and there have been many, that I’ve heard to date during the COVID-19 pandemic, was this audio clip posted on Twitter last March 21. I heard this brief 30-second clip on Twitter March 24, 2020, the day after the “surge” hit New York City. Tim Mak is National Public Radio (NPR’s) Washington investigative correspondent – and an emergency medical technician (EMT), which is how he got the message. Aside from the subject matter, there is something eerie about that electronically-generated voice on the automated message that went out, with this message:

“This an emergency message. This is a priority request for D.C. MRC volunteers (District of Columbia (DC) Medical Reserve Corps (DC MRC)…” (https://twitter.com/i/status/1241471610395267084)

The District of Columbia (DC) Medical Reserve Corps (DC MRC) supports the DC Department of Health (DC Health) in its role as lead for public health and medical emergency preparedness, response and recovery by recruiting, training, and deploying medical and non-medical volunteers to assist with planned events and emergencies.

Last March 30, I wrote on Facebook: “Consider this. Ordered earlier this month to “lean forward,” a military term familiar to those who serve in the United States Navy, meaning the willingness to be aggressive, to take risks, the U.S.Navy hospital ship USNS Comfort (T-AH-20), homeported at Naval Station Norfolk, Virginia, sailed from port up the Atlantic seaboard Saturday and arrived in New York Harbor this morning.

“The Comfort will provide relief for New York hospitals by taking on non-COVID-19 cases and allowing the hospitals to focus on the most critical patients suffering from the virus.

“Picture this.

“What those sailors, military doctors and nurses, officers, enlisted personnel and civilians aboard the USNS Comfort (T-AH-20) must have been thinking as they answered the call of duty and sailed north into a Biological Armageddon.”

The following day, on March 31, 2020, I posted again on Facebook, “Waking up every morning in March 2020: ‘Red alert. All hands stand to battle stations’” (https://www.youtube.com/watch?v=wV30YwXaKJg).

Since Feb. 6, 2020, COVID-19 has killed more than 530,000 people in the United States, more than influenza has in the last five years, notes the Johns Hopkins Bloomberg School of Public Health.in Baltimore. COVID-19 has a higher severe disease and mortality rate than influenza in all age groups, except perhaps children under the age of 12. “Influenza is a significant burden on the population, but COVID-19 has had a vastly larger effect,” Johns Hopkins says.


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Philadelphia: The greatest social distancing debacle in modern pandemic history occurred 102 years ago today in the City of Brotherly Love on Sept. 28, 1918

Philadelphia.

The greatest social distancing debacle in modern pandemic history occurred 102 years ago today in the City of Brotherly Love on Sept, 28, 1918. That was the day Philadelphia public health director Wilmer Krusen allowed the Fourth Liberty Loan Drive parade, with some 200,000 people jamming Broad Street, “cheering wildly as the line of marchers stretched for two miles,” to proceed, as the second and far more deadly wave than the first of the Spanish Flu pandemic rolled out across the American landscape. Within a week of the rally an estimated 45,000 Philadelphians were afflicted with influenza.

Some 675,000 Americans would die in the pandemic, while the worldwide death toll was probably somewhere around 50 million. The world population in 1918 was about 1.8 billion, compared to about 7.8 billion people today. How bad were things in September and October 1918, during the waning weeks of the First World War, in the United States? Some frontline public health scientists by October and November thought the United States on the verge of an extinction-level event. “If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the earth within a matter of a few more weeks,” wrote Victor Vaughan,  a former president of the American Medical Association (AMA), and head of the U.S. Army’s division of communicable diseases, as he sat in the Office of the Surgeon General of the Army in October 1918.

John M. Barry’s 2004 book The Great Influenza: The Story of the Deadliest Pandemic in History, chronicling the 1918-19 Spanish Flu pandemic, to my mind anyway, remains the definitive historical work to date in the field. Barry also serves as an adjunct member of faculty at the Tulane University School of Public Health and Tropical Medicine in New Orleans.

Wilmer Krusen’s actions – and inaction – as the case may be, in allowing the Fourth Liberty Loan Drive parade, with some 200,000 people jamming Broad Street, to proceed has been looked at again in recent years.

Both the Smithsonian magazine (https://www.smithsonianmag.com/history/philadelphia-threw-wwi-parade-gave-thousands-onlookers-flu-180970372/) and Quartz (https://qz.com/1754657/the-1918-parade-that-spread-death-in-philadelphia/) have published interesting pieces over the last couple of years on what happened in Philly in September and October 1918.

But what really struck me is the very, very rapid breakdown in public order, Barry chronicles, despite official protestations to the contrary.

Nurses, who were right on the front lines, and truly, truly heroic in the earliest stages of the pandemic, in many cases soon just stopped coming to work. Many, of course, were too sick to, gravely ill or dying themselves, but many who were still well stopped coming to work out of fear of becoming infected themselves, and perhaps also infecting their loved ones. The same happened across many different public offices.

Government in many cases, and particularly at the municipal level, pretty much ceased to function – and that happened very, very quickly. State and provincial governments weren’t much better in many cases, and federal governments were, to be very charitable, slow off the mark. The international institutions we have now, for the most didn’t exist in 1918.

Philadelphia is one of Barry’s chilling examples that has stayed with me. Things were so bad there in the fall of 1918, when the Spanish Flu pandemic arrived in the city, that a group of volunteer women, holding no official titles or offices, who lived on Philadelphia’s “Main Line,” home of the city’s old money and prestige, essentially took over the key functions of the city government and co-ordinated Philadelphia’s response to the pandemic.

In essence, the Ladies Auxiliary, albeit a very well off, and a very well connected one, saved the day in Philadelphia in 1918, but it was a very close thing indeed.

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Demagoguery and demonization pass for discourse and civility vanishes from the public stage (2)

Compared to many other subjects I write about, I don’t write about Donald Trump very often. I don’t follow him on Twitter. I don’t watch Fox News (I cancelled my Shaw Cable TV more than three ago, back in July 2017, writing two months later on Sept. 5, 2017, “Two months post-cable television (and therefore post CNN and Donald Trump) and $150 to the good (me, not Shaw).”

Not being a complete media recluse, however, as there is still the internet, I do know The Donald – a.k.a. President Donald Trump – accepted the Republican Party’s re-nomination for president last night at the party’s national convention, promising to “rekindle new faith in our values” and rebuild the economy once more following the COVID-19 pandemic. He also said, being gathered on the massive South Lawn at the White House, known as the “People’s House,” they cannot help but marvel at the “great American story.” This is a common and recurring theme in American history. Earlier this month, I completed my eleventh Hillsdale College online course, titled “The Great American Story: A Land of Hope,” taught by Wilfred M. McClay, the G.T. and Libby Blankenship Chair in the History of Liberty at the University of Oklahoma, and co-director of the Center for Reflective Citizenship at the University of Tennessee at Chattanooga.

A little more than four years ago, as President Donald Trump was then running for president as Citizen Donald Trump, a man best known to many Americans in 2016 as the host for the first 14 seasons of The Apprentice, the American reality television program created by British-born American television producer Mark Burnett (of Survivor fame) that judged the business skills of a group of contestants, I wrote my first significant blog post about Trump on July 17, 2016 in a piece headlined, “Demagoguery and demonization pass for discourse and civility vanishes from the public stage” (https://soundingsjohnbarker.wordpress.com/2016/07/17/demagoguery-and-demonization-pass-for-discourse-and-civility-vanishes-from-the-public-stage/). The Apprentice, which I didn’t canvass at the time, was produced at Trump Tower in New York City between 2004 and 2015. Episodes ended with Trump eliminating one contestant from the competition, with the words “You’re fired!”

Interestingly, while the headline, “Demagoguery and demonization pass for discourse and civility vanishes from the public stage” may appear to be contemporaneous with Trump and Trumpland today, and certainly could be, it wasn’t written that way exactly:

“Consider the headlines for Sunday, July 17, 2016: CBS News is reporting in a July 16 its headline “W.Va. lawmaker: Hillary Clinton should be ‘hung’ on National Mall.” The story goes onto say, “A member of the West Virginia House of Delegates is causing a stir after tweeting that Hillary Clinton should be ‘hung on the Mall in Washington, DC.

“‘CBS affiliate WOWK-TV reports that Michael Folk, a Republican legislator who is also a United Airlines pilot, posted a tweet Friday night saying: ‘Hillary Clinton, you should be tried for treason, murder, and crimes against the US Constitution… then hung on the Mall in Washington, DC.

“Meanwhile, Charles P. Pierce has a July 14 piece in Esquire magazine, headlined, “This Isn’t Funny Anymore. American Democracy Is at Stake.” The subhead reads: “Anyone who supports Donald Trump is a traitor to the American idea.” Pierce writes at the top of the story that not “until Wednesday did we hear clearly the echoes of shiny black boots on German cobblestones.”

“Really?

“Is this the best we can do in terms of civics and public discourse in 21^st century America? Call anyone we disagree with a traitor and perhaps for extra outrage allude to Hitlerism and Nazism? Is demagoguery the only currency we traffic in for what passes as ideas?

“We stand at a dangerous international moment in history when an intersection of events conspire to resurrect Fascism on a scale not seen since the 1930s.”

In retrospect, I think both the headline and story have held up well over four years. I also wrote at the time:

“If Donald Trump wins the presidency in November, the world won’t end. I may not much like a Trump presidency, but the Supreme Court and Congress will not be dissolved [although Trump will probably make several nominations for upcoming vacancies on the bench that will make me wish the court had been dissolved. But that’s OK; Republican life appointments to the highest court in the United States often prove over time to be stubbornly independent, demonstrating you couldn’t have asked more from a Democratic appointee. It’s kinda complicated.]

“Trump’s also unlikely to push the hot-war nuclear button, should he find himself ensconced in the Oval Office next January.  Want to know what was really dangerous? The dance Democratic President John F. Kennedy, the living Legend of King Arthur and Camelot, had with Soviet premier Nikita Khrushchev during the Cuban Missile Crisis of October 1962. That was the almost the end of the world as you knew it. Right then and there. Not Donald Trump hyperbole.

“There are plenty of examples in recent American history before where the crème de la crème cluck their tongues in displeasure at the electoral wisdom of the hoi polloi [think Brexit for the current British equivalent.] So what? Minnesota didn’t wind up seceding to Northwestern Ontario and amalgamating Duluth with Kenora when pro wrestler Jesse Ventura was elected and served as governor of Minnesota from January 1999 to January 2003.

“California survived when Arnold Schwarzenegger, the Austrian-born American professional bodybuilder and movie actor wound up getting himself elected to serve two terms as governor of California from November 2003 until January 2011.

“And speaking of California, an earlier Republican governor, Ronald Reagan, also a movie actor, went on from the statehouse to the White House, elected to two terms as president between January 1981 and January 1988. Each time – when Reagan, Ventura and Schwarzenegger were elected – Henny Penny cried out the sky was going to fall. It didn’t.

“I was living in Somerville, Massachusetts in November 1980 when Ronald Reagan was elected president.

“I had been working as supervisor for Cambridge Survey Research where I oversaw telephone call center employees for Democratic National Committee (DNC) pollster Pat Caddell’s firm in Cambridge, Massachusetts during the 1980 Jimmy Carter-Ronald Reagan presidential election campaign.

“We lost the election. Big time. I well remember going to work a few days after, late in the afternoon, riding above ground aboard a subway car on the Red Line “T.” The November sky was a foreboding steel-gray, with leaves all fallen now from the trees. And there it was, as we headed into Harvard Yard, giant spray –painted graffiti on a cenotaph proclaiming “Ray-Gun” had been elected.

“As it turned out, Reagan did have a fondness for his Strategic Defense Initiative (SDI), nicknamed Star Wars. But the dreamed-for global missile shield didn’t come to fruition. Instead, Reagan, along with Mikhail Gorbachev, general secretary of the Communist Party of the Soviet Union, managed to end the Cold War with perestroika [restructuring] and glasnost [openness] becoming part of the everyday vocabulary of Americans by the late 1980s, rolling from their tongues as if they had been saying the two Russian words forever.

“Demagoguery, while deeply disappointing as it is being manifested by Trump and his supporters, is neither new nor fatal to American politics. It is also not surprising when people feel that politics is a rigged game they can’t possible win at under the normal rules of the political elites.”

I admit over the last four years, I have reflected many times on the line, “”If Donald Trump wins the presidency in November, the world won’t end,” and wondered if I was being too optimistic because there have been days and nights with Trump when well, Trump, is Trump. And that can indeed be a scary thing.

My friend Bernie Lunzer from back in my Newspaper Guild union days from 1997 to 2001 perhaps put it best yesterday, writing, “Central frustration – we won’t change Trumpists by laughing at them or telling them they’re stupid. I share those feelings but they don’t help. They are motivated by other things. Maybe we can’t change them because their base motivation is racism? So then they are simply enemies? We still need to do something other than acting smarter and sanctimonious. I don’t have answers. But do take this election as serious.”

This reminds me indirectly of an article Thomas Frank penned for The Guardian and published on Nov. 6, 2016 – just two days before the last presidential election (https://www.theguardian.com/commentisfree/2016/nov/06/republicans-and-democrats-fail-blue-collar-america) headlined, “The Republicans and Democrats failed blue-collar America. The left behind are now having their say.” Frank, a political analyst, historian, journalist and columnist, is also the founding editor of The Baffler magazine, and author of the 2004 book, What’s the Matter with Kansas? as well as Listen, Liberal: Or, What Ever Happened to the Party of the People? published in 2016.

Do better.

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Hope in a dangerous time: Projected peak in daily deaths and hospital resource use reached or at hand for U.S.

The Institute for Health Metrics and Evaluation (IHME) is an independent population health research center at UW Medicine, part of the University of Washington, that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. While there is no shortage of models to look at, IHME’s infectious disease modelling for estimating the COVID-19 pandemic growth rate and basic reproduction number (R0) for the United States has been among the best.

With that in mind, here are two reasons for hope this Easter Sunday 2020, although the payoff will only come later, so be prepared to wait until at least June, maybe even July, because this is going to be a case of delayed gratification, measured in months, not days:

• It has been one day since projected peak hospital resource, including all beds, intensive care unit (ICU) beds, and invasive ventilators in the United States on April 11;
• It has been two days since the projected peak in daily deaths on April 10 of 1,983 deaths (the actual number was slightly higher, 2,056);

While models differ on peaks, the United States is close to its peak of the novel coronavirus disease, Food and Drug Administration Commissioner Dr. Stephen Hahn said on ABC’s This Week earlier today.

Canada’s pandemic is in earlier stages. Many countries reached their first 500 cases before community transmission started in Canada.

Like any mathematical model, there are caveats and disclaimers to be noted. The Institute for Health Metrics and Evaluation model prominently notes that it is making its “COVID-19 projections assuming full social distancing through May 2020.” Assuming “full social distancing” from now through May 31 strikes me as one very big assumption. Still, the U.S. government’s early modelling suggested that only 50 per cent of Americans would observe the stringent federal social distancing guidelines, currently in effect until April 30, when in actuality U.S. Surgeon General Dr. Jerome Adams said last week that a much larger number – 90 per cent – were observing the guidelines.

My best guess is the United States will reboot the economy too quickly in early May, against public health advice, and there will be a resurgence of COVID-19 cases, but the resurgence, while regrettable and wholly unnecessary, will be a temporary setback, delaying, but not wiping out the gains being made right now through social distancing, and shutting down the economy, with the exception of “essential” work,  whatever that really means from state-to-state, community-to-community.

I wrote a piece Jan. 23 headlined, “The fire this time? Pandemic prose, and waiting and watching for the ‘big one’  (https://soundingsjohnbarker.wordpress.com/2020/01/23/the-fire-this-time-pandemic-prose-and-waiting-and-watching-for-the-big-one/) where I wondered, “How quickly we could we make a trip back to a modern-day equivalent to the Dark Ages of the 5th to 11th centuries?” I think the early evidence we have seen in the 10 weeks since then suggests not so very long, and that the best parallel in modern times will turn out to be the “Spanish Flu” influenza pandemic of 1918, although it killed about 675,000 people in the United States, compared to COVID-19, which will likely kill about 10 times less than that.  The Institute for Health Metrics and Evaluation in Seattle projects 61,545 COVID-19 deaths by Aug. 4. Well less than then the 1918 influenza pandemic, but a greater number of Americans killed than in the Vietnam and Afghan conflicts combined.

The National Center for Medical Intelligence (NCMI) at Fort Detrick, Maryland warned as far back as last November that a contagion was sweeping through China’s Wuhan region, changing the patterns of life and business and posing a threat to the population. The report was the result of analysis of wire and computer intercepts, coupled with satellite images.

The medical intelligence (MEDINT) cell within Canadian Forces Intelligence Command (CFINTCOM) gave a similar warning in January.

In the summer of 2005, the Center for the History of Medicine at the University of Michigan in Ann Arbor was asked by the Defense Threat Reduction Agency (DTRA) to conduct research into and write a report on American communities that had experienced extremely low rates of influenza during the infamous 1918-1920 so-called “Spanish Flu” influenza pandemic.

They selected seven communities that reported relatively few if any cases of influenza, and no more than one influenza-related death while non-pharmaceutical interventions (NPI) were enforced during the second wave of the 1918-1920 influenza pandemic. The communities were:

• San Francisco Naval Training Station, Yerba Buena Island, California;
• Gunnison, Colorado;
• Princeton University, Princeton, New Jersey;
• Western Pennsylvania Institution for the Blind (WPIB), Pittsburgh, Pennsylvania;
• Trudeau Tuberculosis Sanatorium, Saranac Lake, New York;
• Bryn Mawr College, Bryn Mawr, Pennsylvania;
• Fletcher, Vermont

Over time, it will be interesting to see what, if any, COVID-19, outliers there are in the United States. Internationally, there are a few countries in Africa that still have no cases, but the bulk of COVID-19-free countries are in the Pacific. Nations such as Vanuatu, Palau, Solomon Islands, Tonga and Samoa have been protected to date by their remoteness.

According to the most recent Institute for Health Metrics and Evaluation projections, subject to the caveats and disclaimers mentioned earlier, deaths per day should drop to 976 in the United States by May 1; 47 on June 1, and none after June 19, as a dread spring gives way to a summer of hope.

Here in Canada, the Public Health Agency of Canada says that ‘Prior to stronger public health measures, each infected person (case) in Canada infected 2.19 other people on average.”  When each COVID-19 infected person infects fewer than one person on average, the pandemic will die out, the agency says. “Models cannot predict what will happen, but rather can help us understand what might happen to ensure we can plan for worst cases and drive public health action to achieve the best possible outcome.”

Any backsliding, of course, in April and May on physical (social) distancing, self-isolation of cases, quarantine of contacts, and preventing importation of infection from other countries internationally through border controls and nationally through domestic travel restrictions, and all bets are off.

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Misplaced patriotism and public health propaganda are no disinfectants for a pandemic

John M. Barry’s 2004 book The Great Influenza: The Story of the Deadliest Pandemic in History, chronicles the 1918-19 Spanish Flu pandemic. It is a compelling read, and placenames such as Haskell, Kansas, an isolated and sparsely populated county in the southwest corner of the state, remain etched in my mind.

Barry also serves as an adjunct member of faculty at the Tulane University School of Public Health and Tropical Medicine in New Orleans.

But what really struck me was the very, very rapid breakdown in public order, Barry chronicles, despite official protestations to the contrary.

Nurses, who were right on the front lines, and truly, truly heroic in the earliest stages of the pandemic, in many cases soon just stopped coming to work. Many, of course, were too sick to, gravely ill or dying themselves, but many who were still well stopped coming to work out of fear of becoming infected themselves, and perhaps also infecting their loved ones. The same happened across many different public offices. Can any of us really know what we would have done faced with similar circumstances? I think not.

Government in many cases, and particularly at the municipal level, pretty much ceased to function – and that happened very, very quickly. State and provincial governments weren’t much better in many cases, and federal governments were, to be very charitable, slow off the mark. The international institutions we have now, for the most didn’t exist in 1918.

Philadelphia is one of Barry’s chilling examples that has stayed with me. Things were so bad there in the fall of 1918, when the Spanish Flu pandemic arrived in the city, that a group of volunteer women, holding no official titles or offices, who lived on Philadelphia’s “Main Line,” home of the city’s old money and prestige, essentially took over the key functions of the city government and co-ordinated Philadelphia’s response to the pandemic.

In essence, the Ladies Auxiliary, albeit a very well off, and a very well connected one, saved the day in Philadelphia in 1918, but it was a very close thing indeed.

But how did things get so bad in Philadelphia in the fall of 1918?

On Sept. 28, 1918, despite sound advice and warnings to the contrary, Philadelphia public health director Wilmer Krusen insisted on allowing a Fourth Liberty Loan Drive parade, with some 200,000 people jamming Broad Street, “cheering wildly as the line of marchers stretched for two miles.” It was after all the patriotic thing to do in the final Allied push to defeat the Central Powers and win the First World War.

“Within 72 hours of the parade, every bed in Philadelphia’s 31 hospitals was filled,” Kenneth C. Davis wrote in Smithsonian magazine in September 2018. “In the week ending October 5, some 2,600 people in Philadelphia had died from the flu or its complications. A week later, that number rose to more than 4,500. Allison C. Meier in an article for Quartz last November noted that historian James Higgins, writing in Pennsylvania Legacies, observed that by the first week of October 2018, roughly five weeks into the outbreak, “Philadelphia’s mortality rate accelerated in a climb unmatched by any city in the nation –perhaps by any major city in the world.”

We really are not very particularly good at learning the lessons of history. Or when we think we have, we often draw the wrong lessons. Misplaced patriotism. Public health propaganda. These are no disinfectants for a pandemic.

The original name of the new coronavirus was provisionally known as Novel Coronavirus 2019-nCoV, before the World Health Organization (WHO) adopted the name COVID-19.  The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2 for COVID-19. The World Health Organization, perhaps finding the recommended name a tad too resonant politically to SARS from the not-so-distant past, opted instead for the official name COVID-19.

The revised World Health Organization’s case fatality rate earlier this week of 3.4 per cent from 2 per cent for COVID-19 on March 3 is a 70 per cent fatality increase.

“I think the 3.4 per cent is really a false number,” U.S. President Donald Trump told Sean Hannity, one of his favourite conservative Fox News hosts, in a phone interview broadcast live March 4.

In the early 1980s, I watched with surprise and unexpected admiration as C. Everett Koop, an evangelical Christian, who served as surgeon general under U.S. Republican president Ronald Reagan from 1982 to 1989, and was well known for wearing his uniform as a vice admiral of the United States Public Health Service Commissioned Corps, had the singular political courage to speak the truth about the science of AIDS as our knowledge increased. According to the Washington Post, “Koop was the only surgeon general to become a household name.”

Who will be the next C. Everett Koop, with the courage to speak truth to power, afflicting the comfortable, while comforting the afflicted? Someone Ike the late Dr. Li Wenliang, the whistle-blower ophthalmologist who sounded the alarm after contracting the virus while working at Wuhan Central Hospital.

There have been some exemplary public health responses to the COVID-19 public health emergency of international concern, such as those of Dr. Bonnie Henry, British Columbia’s, provincial health officer, whom André Picard, the health columnist at The Globe and Mail, earlier today described as setting “the standard for public health communication. Too often, public officials are dispassionate and robotic. Using clear language and showing genuine emotion makes your message more relatable and impactful.”

And then there have been the less than exemplary public health responses – or perhaps more accurately – lack of response.

When is a pandemic not a pandemic? When the World Health Organization (WHO) has Dr. Tedros Adhanom Ghebreyesus as its director-general apparently.

“I think it’s pretty clear we’re in a pandemic and I don’t know why WHO is resisting that,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Devi Sridhar, a professor of global public health at the University of Edinburgh who co-chaired a review of WHO’s response to the 2014-16 Ebola outbreak in West Africa, said a pandemic declaration is long overdue.

While none of this is easy when we don’t yet have a clear idea of the transmissibility and virulence of COVID-19, it is equally true the absence of true, timely public health information and honest decision-making, we risk further fostering a not insignificant climate of international government and institutional distrust, leading to social media platforms being lit up with stories such as the ones suggesting that the novel coronavirus is a genetically engineered biological weapon with a protein sequence included elements of HIV, the virus that causes AIDS – either a Chinese one that had escaped from a laboratory in Wuhan or an American one inflicted on Wuhan, or that COVID-19 is perhaps some kind of so-called “false flag” operation to distract us from someone or something else.

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