28 April 2020

Society might forget coronavirus sooner than you think

Our memory of previous pandemics, like polio or Sars, suggests the long-term consequences of Covid-19 might not be so long-term.

By Stephen Bush

MANILA, PHILIPPINES - OCTOBER 14: A community health worker shows a vial of an oral polio vaccine, during a mass vaccination campaign to combat the resurgence of the polio virus, at a slum area on October 14, 2019 in Manila, Philippines. The Philippines is aiming to vaccinate over 9 million children after the country's health department announced an outbreak of polio, 19 years after the World Health Organization declared the country free of the infectious disease. Health Secretary Francisco Duque has blamed poor immunization coverage and lack of proper sanitation and hygiene as the cause of the resurgence of the disease. The Philippines has been struggling to regain the publics trust in vaccines since 2017, when it was discovered that a dengue vaccine manufactured by French firm Sanofi could cause health risks to people who had not previously had the disease. Recently, the country declared a dengue epidemic after hundreds have died of the mosquito-borne disease. (Photo by Ezra Acayan/Getty Images)

One thing that’s struck me during this pandemic is how small the imprint on our collective public consciousness the last pandemic – the HIV-Aids epidemic – has left. It features in a number of fantastic novels – The Line of Beauty, A Vicious Circle, the Tales of the City series to name just a few – but as far as the mainstream media goes, let alone the public’s overall understanding of the emergence and defeat of “new” diseases, it has clearly not registered very deeply.

You can see this in some of the reporting and commentary around the race for a vaccine. Even a cursory acquaintance with the long fight against HIV-Aids, dotted with various false dawns, ought to have left us more aware that there are fits and starts in the fight against a new disease.

In a British political context, the government of Margaret Thatcher – thanks in large part to the leadership of her health secretary Norman Fowler – took a position on its prevention that set it apart from not only many other governments around the world, but also from the scare stories in the very newspapers that were her administration’s strongest allies. This story is remarkably absent from modern attempts by the right to argue in favour of that government.

And again, it wasn’t the emergence of a vaccine or cure that made living with HIV possible, but the emergence of reliable anti-viral treatments. One unalloyed good news story about the novel coronavirus is the steady emergence of more reliable ways to reduce the mortality rate, but this area receives little coverage nor does there seem to be much in the way of public curiosity on the topic.

And HIV-Aids is by no means unique in this regard. The polio epidemic of the early 20th century ought to be the easy go-to comparison for this pandemic. The mechanisms used to combat its spread were quarantine and isolation, required of both the infected and the at-risk – the young. But polio has similarly vanished from both the public mind and political discourse. Yes, the first polio vaccine is now 64 years old – but that is a decade closer to the present day than the Second World War, and that conflict is readily and frequently compared to the fight against the coronavirus pandemic.

Then there’s the 1918 flu pandemic, another event seemingly wiped from the public mind. The new respiratory diseases that emerged in south-east Asia – Sars and Mers – are also frequently forgotten when people write about how those countries have responded to this respiratory illness.

It’s in the common refrain about the difficulties of working out what all this means for the economy. While polio, HIV-Aids and the 1918 flu are imperfect examples, they are all useful starting points and yardsticks. Certainly we are better equipped than we are with Brexit, which represents an unprecedented political and economic event.

So there seems to be something about pandemics that causes them to slip from the collective memory. Something I’m frequently told by doctors is that they are much more likely to receive gifts and messages from patients for “saving their lives” when they have either done no such thing, or when their life-saving work involved a car accident or some other comparatively brief medical intervention. Those who recovered from long illnesses or more complex treatments were less likely to make any contact at all – let alone send gifts or letters.

I’m not saying life-saving surgery isn’t important or significant – I’m just saying that if your memory of a doctor saving your life is waking up after an accident and being told you’re going to be fine, it’s rather different from your memory of a doctor saving your life is months or even years of complex and difficult treatments.

I suspect this habit of consciously forgetting moments when our personal health is under threat also holds for nations and the world as a whole, which may account for the fact that the 20^th-century pandemics have largely vanished from public recollection. When we talk about how Covid-19 will change our politics, we should remember that the historical evidence suggests that the answer might well be: it won’t.