12 d’abril 2020

Stories from spanish flu epidemic

THE SPANISH FLU EPIDEMIC AND ITS INFLUENCE ON HISTORY.  Stories from the 1918–1920 global flu pandemic

From Chapter 11:
Perhaps the most lasting legacy of Spanish flu is that it barely left a legacy at all. While it has continued to be studied and analysed in niche virology circles, the collective memory seemed to stub it out and hurry to move on. Were it not thanks to a handful of dedicated historians such as Geoff Rice and Richard Collier, who collected personal accounts of the tragedy through the 1970s and 1980s, many first-person testimonies may have been lost. There are a few explanations of this mass memory loss and one of them related to honour. Perhaps in order to dull the painful reality of the loss of a treasured father, husband, brother or son, much pomp was  conveyed onto the memory of those who died in battle. Dying from flu, however, did not convey the same sense of honour. In fact, in a world where eugenics had played a strong role so far, it made otherwise brave men appear weak and flawed.
 Time is a healer, though, and there are lots of good reasons to be interested in Spanish flu now, a hundred years on from the pandemic; to honour the dead, to analyse the medical response, to measure the impact of the virus on the health of the population through the relatively new discipline of
epigenetics … but perhaps the most pressing reason for us to remember the outbreaks from a virology, epidemiology, sociology and historical point of view, is because of the high possibility it could happen again.
 The outbreak of Spanish flu at the start of the twentieth century is considered to be one of the deadliest infections in the history of humanity, affecting a minimum of 30 per cent of the global population, and killing around 5 per cent.
In a previous post you may find additional details.


11 d’abril 2020

How pandemics shaped our world

Germs, Genes, & Civilization. How Epidemics Shaped Who We Are Today

From Chapter 11:
In his futuristic work The Shape of Things to Come, published in 1933, H. G. Wells relies on a novel plague to eliminate half the population of Earth in 1955–1956 and usher in a new era. Although this epidemic was largely modeled on the Black Death, Wells had his “maculated fever” waft around the world on the wind instead of spread by fleas. His fictitious disease emerged from captive baboons in the London Zoological Gardens. The Shape of Things to Come was written as a prediction of the future in an age when most scientists foresaw only the eventual eradication of infectious disease, not its resurgence.
So what should we predict? First, let’s consider the global situation. The British Empire was the last great civilization. Improved hygiene, originating from the industrialized West, led to worldwide decreased infant mortality. That, in turn, created a population boom that undermined the profitability of the European colonial empires. Despite poor hygiene and rampant disease relative to the industrial nations, the birth rate still outstrips infant mortality in Third World countries. The ongoing population explosion is the single most important biological trend in today’s world.
Denser populations, coupled with poverty, are promoting the spread of disease. Although tuberculosis is in the lead right now, most of those infected do not fall ill. As the remaining sensitive humans are weeded out, the incidence of TB in the Third World will begin to decline naturally, just as it did in Europe a century ago.
In the advanced nations, AIDS will affect homosexuals and intravenous drug users but have marginal impact on the mainstream. Its major effect, especially in the United States, will be to increase the cost of health care in the inner cities. This will help enlarge the growing gap between rich and poor. In Africa and, to a lesser extent, other third world regions, AIDS will thin out the promiscuous and malnourished, and favor the spread of religious puritanism, particularly, Islamic sects.
Still more serious, in my opinion, are malaria and other insect-borne infections that are spreading in the tropics. Rising world temperatures promote the spread of insects that transmit many tropical or subtropical diseases. Human construction and irrigation projects are helping, as is the steady increase in insecticide resistance among the insect carriers. An ugly long-term threat is the possible adaptation of tropical viruses to be carried by insects that survive in colder climates

PS. Further reading

Fascinating classics written long ago that are still good reading:
Defoe, Daniel. Journal of the Plague Year. New York: New American Library, 1960. (Original edition 1723.)
Although a work of fiction, the author lived in times when the bubonic plague was still around.
Nightingale, Florence. Notes on Nursing: What It Is and What It Is Not. New York: Dover Publications, 1969. (Original edition 1859.)
For a nice little old lady, Florence Nightingale was amazingly blunt and opinionated. She made generals tremble in their shoes. She would have made Hillary Clinton wilt!
Most important modern works:
Ewald, Paul W. Evolution of Infectious Disease. Oxford: Oxford University Press, 1994.
Seminal work on the evolution of infectious disease from the modern genetic and evolutionary viewpoint. Rather academic.
Herlihy, David. The Black Death and the Transformation of the West. Cambridge, MA: Harvard University Press, 1997.
Expounds the idea that the Black Death was responsible for the emergence of Western democracy.
McNeill, W. H. Plagues and Peoples. Garden City, NY: Anchor Press, 1976.
The most important single source that summarizes and explains the idea that epidemics affected human history.
Zinsser, Hans. Rats, Lice & History. Boston: Little, Brown and Company, 1934. (Reprinted quite frequently.)
Classic on typhus fever and history from the viewpoint of a microbiologist.
Narrow in focus, yet fascinating:
Cantor, Norman F. In the Wake of the Plague. New York: Free Press, 2001.
How the Black Death remodeled European society.
Cockburn, Aidan, and Eve Cockburn. Mummies, Disease and Ancient Cultures. Cambridge, U.K.: Cambridge University Press, 1980.
Grmek, Mirko D. Diseases in the Ancient Greek World. Baltimore: Johns Hopkins University Press, 1989.
A selection of other interesting books:
Cartwright, Frederick F., and Michael D. Biddiss. Disease and History. New York: Dorset Press, 1972.
Crawford, Dorothy H. Deadly Companions. Oxford: Oxford University Press, 2007.
Diamond, Jared. Guns, Germs and Steel. New York: W. W. Norton, 1998.
Garrett, Laurie. The Coming Plague. New York: Penguin Books, 1995.
Oldstone, Michael B. A. Viruses, Plagues, and History. New York: Oxford University Press, 1998.
Preston, Richard. The Hot Zone. New York: Random House, 1994.
Wills, Christopher. Yellow Fever, Black Goddess: The Coevolution of People and Plagues. Reading, MA: Addison-Wesley, 1996. (First published in the United Kingdom by HarperCollins as Plagues: Their Origins, History and Future.)


PS. The exit of the lockdown

10 d’abril 2020

Contagion

Now is the time to watch this great film:


And you'll get convinced that unless we have a vaccine soon, all things will be very dificult to manage...

09 d’abril 2020

Understanding COVID-19

How Will COVID-19 Affect the Health Care Economy?

COVID-19 and risks to the supply and quality of tests, drugs, and vaccines

Virtual health care in the era of COVID-19

Daily briefing: This is the state of COVID-19 vaccine development now

Disease Control, Civil Liberties, and Mass Testing — Calibrating Restrictions during the Covid-19 Pandemic

Thousands of coronavirus tests are going unused in US labs

Selected links on COVID-19.

From NEJM
Consider, for example, a policy in which people seeking to return to work, school, or social activities are asked to undergo baseline testing for infection and antibodies. Positive tests for infection would trigger self-isolation. Negative tests would certify freedom of movement for a defined period — say, 2 or 3 weeks — after which additional negative tests would renew the certification. If antibodies are determined to provide long-term protection against both reinfection and transmission — which is plausible but not yet established — a positive serologic test would warrant longer-term certification.
Aggregating test results at community and state levels would support a reliable disease-surveillance system. A testing regimen’s stringency could then be dialed up or down, depending on community prevalence of Covid-19. China is following a version of this approach by grading community risk on a four-tier, color-coded scale.
And...if antibodies and infection are negative? What do you do? And... if this affects to 85% of population?. As is the case of Heinberg in Germany?

I would like to highlight the last one, how spply and demand for lab test doesn't match, in US and elsewhere...

08 d’abril 2020

Economics of pandemics (3)

Economics of coronavirus: COVID-19 impact and policy interventions

La salida: Retomar el trabajo (Fugong Fuchan)

Selected readings from Barcelona GSE.
You'll find there our yesterday article and on AES Blog: La salida: Retomar el trabajo (Fugong Fuchan)


07 d’abril 2020

Health system responses to COVID-19

Beyond Containment:Health systems responses to COVID-19 in the OECD

From OECD report:
The main focus of this brief is on the policiesaimed at providing effective care and managing the pressure on health systems. Four key measures health systems are putting in place in response to the epidemic are considered: 1)ensuring access of the vulnerable to diagnostics and treatment; 2)strengthening and optimising health system capacity to respond to the rapid increase in caseloads; 3)how to leverage digital solutions and data to improve surveillance and care; and 4)how to improve R&D for accelerated development of diagnostics, treatments and vaccines

PS: From Francesca Colombo


06 d’abril 2020

Economics of pandemics (2)

Mitigating the COVID Economic Crisis: Act Fast and Do Whatever It Takes

Crucial contribution from key economists. A must read.

Outline:

Introduction
Richard Baldwin and Beatrice Weder di Mauro

1 So far, so good:  And now don't be afraid of moral hazard
2 Flattening the pandemic and recession curves
3 Limiting the economic fallout of the coronavirus with large targeted policies
4 Italy, the ECB, and the need to avoid another euro crisis
5 The EU must support the member at the centre of the COVID-19 crisis
6 Helicopter money: The time is now
7 What the stock market tells us about the consequences of COVID-19
8 Ten keys to beating back COVID-19 and the associated economic pandemic
9 Saving China from the coronavirus and economic meltdown: Experiences and lessons
10 China's changing economic priorities and the impact of COVID-19
11 Singapore's policy response to COVID-19
12 The experience of South Korea with COVID-19
13 COVID-19: Europe needs a catastrophe relief plan
14 The COVID-19 bazooka for jobs in Europe
15 The monetary policy package: An analytical framework
16 Bold policies needed to counter the coronavirus recession
17 Europe ís ground zero
18 Economic implications of the COVID-19 crisis for Germany and economic policy measures
19 Finance in the times of COVID-19: What next?
20 How COVID-19 could be like the Global Financial Crisis (or worse)
21 Protecting people now, helping the economy rebound later
22 Policy in the time of coronavirus
23 Containing the economic nationalist virus through global coordination
24 The case for permanent stimulus