Spanish Flu on the cusp of no longer being the reference point for modern pandemic plague

Some 18 months after the World Health Organization (WHO) declared the coronavirus COVID-19 to be a global pandemic on March 11, 2020, the world stands on the cusp of it replacing the Spanish Flu influenza pandemic of January 1918 to December 1920 as the reference point – the benchmark, as it were – for measuring modern pandemic plague. That will occur very shortly as the United States crosses the threshold of 675,000 COVID-19 deaths in what is now the novel coronavirus’ fourth wave there; a toll that will then exceed that of the Spanish Flu of a century ago in America.

All pretty remarkable, since the name COVID-19 didn’t exist prior to Feb. 11, 2020 when the World Health Organization named what had been provisionally known as Novel Coronavirus 2019-nCoV and first reported from Wuhan, China on Dec. 31, 2019. COVID-19 is caused by the SARS-CoV-2 virus.

It is important to note the “in America” qualification. As Laura Spinney writes in her very timely 2017 book, Pale Rider: The Spanish Flu of 1918 and How It Changed the World, our picture of the Spanish Flu pandemic, beginning in the waning last months of the First World War, just over a 100 years ago, is very much a reflection of the North American and European influenza pandemic perspective and experience, rather than that of say, India, South Africa or Iran, although the Spanish Flu, named not for its country of origin but rather because wartime press censorship was more relaxed in neutral Spain than either the Central Powers or Allied Powers in 1918, allowing for more early news coverage of the illness, which within months swept the world, much like COVID-19.

While some 675,000 Americans died over three years between January 1918 and December 1920 during the three waves of the Spanish Flu pandemic, 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.

Also, while global death toll estimates for the Spanish Flu pandemic are speculative to some extent, it is generally accepted it killed somewhere between 50 and 100 million people worldwide. COVID-19’s global death toll stands at about 4.7 million.


There are, of course, all kinds of similarities – and differences – between COVID-19 and the Spanish Flu pandemic: They are not the same type of virus; the former is a coronavirus, the latter an influenza virus. But compulsory masking as a public health-driven non-pharmaceutical intervention (NPI) has been similarly divisive in societies in both pandemics.

The rolling real time daily death count on the online COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) in Baltimore functions as our equivalent of the Bulletin of the Atomic Scientists’ “Doomsday Clock,” circa 1947, and the clock itself, set at 100 seconds before midnight last Jan. 27, is being profoundly influenced by COVID-19.

“Founded in 1945 by Albert Einstein and University of Chicago scientists who helped develop the first atomic weapons in the Manhattan Project, the Bulletin of the Atomic Scientists created the Doomsday Clock two years later, using the imagery of apocalypse (midnight) and the contemporary idiom of nuclear explosion (countdown to zero) to convey threats to humanity and the planet,” writes John Mecklin, the editor-in-chief. “The Doomsday Clock is set every year by the Bulletin’s Science and Security Board in consultation with its Board of Sponsors, which includes 13 Nobel laureates. The Clock has become a universally recognized indicator of the world’s vulnerability to catastrophe from nuclear weapons, climate change, and disruptive technologies in other domains.”

The Center for Systems Science and Engineering, in the Department of Civil and Systems Engineering in the Whiting School of Engineering at Johns Hopkins University’s Latrobe Hall in Baltimore, launched its a tracking map website with an online dashboard for tracking the worldwide spread of what was then known as the Wuhan coronavirus (2019-nCoV) as it appeared to be spreading around the globe in real-time in January 2020.

Lauren Gardner, a civil engineering professor and CSSE’s co-director, spearheaded the effort to launch the mapping website. The site displays statistics about deaths and confirmed cases of COVID-19 across a worldwide map.

“We built this dashboard because we think it is important for the public to have an understanding of the outbreak situation as it unfolds with transparent data sources,” Gardner said when Hopkins launches it last year. “For the research community, this data will become more valuable as we continue to collect it over time.”

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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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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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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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