Monocle Reads: Mark Honigsbaum


Writer, a journalist and historian specializing in the history of science of infectious disease, previously in investigative reporter and feature writer on the broadsheets his latest book. The pandemic century looks at how despite one hundred years of medical progress with still taken by surprise. When it comes to outbreaks, it's an assertion unfortunately been proved correct over the last few months. Mark Welcome to the show. Thanks so much agreeing to join us a hundred years ago, we saw the Spanish flu pandemic now despite a century of medical progress, these viral and bacterial. Continue to take us by surprise. Why is that? I think there are lots of reasons to Gina, but the main one is what I call the cycle of panic and neglect, so what typically happens during a pandemic and we're seeing that I with covid nineteen now is of course. That's anything people can talk. About is extremely disruptive and people say we've got to stop this happening again. You know we can't have it. Be caught in the situation where we didn't have vaccines or effective medical countermeasures. But as soon as the epidemic pandemics. These slid right down the priority list, and we quickly forget cultural and easy sets in, and the result is that we fail to invest in pandemic preparedness, and all sorts sort of things that we know can help proventil mealy rate the impact of these terrible terrible events. I mean the books at one hundred years. What have been the most serious diseases over the last century? And how does Corona virus compare? Well I mean so I. Start The book in A. Little bit before nineteen eighteen, because of course, the Spanish cleanser pandemic that hits nine, hundred, eighteen, lost one, thousand, nine, hundred, eighteen, as become a template for all our pocket imaginings, so what happened nineteen eighteen walls? Respiratory virus influenza swept around the globe much like the nineteen today. We now know that. At least fifty million people worldwide died in that pandemic so I mean that walls the so called big one of the other pandemic that of course compares to that, which is still on today is the HIV AIDS pandemic. The began in the early nineteen eighties, so I think today's something like a mix of thirty five million people have died of HIV AIDS. I mean kind of forget that that's still going on. You say because although it, anyone could be infected with the virus. To think of it as disease that affects particular at risk groups, and therefore you know. Most bitten society don't think that it's something that could ever affect them, and yes, of course it, it still does. Well. Yes, it does on. We still don't have a vaccine against HIV fortunately. We do have all sorts of anti viral medications that can suppress the infection, so you can live with HIV now for for many years. So where is corona virus on a kind of a you know if there was a viral scale of seriousness? An epidemiologist would tell you that you know where they would quote the all north and say well. You know if if a seasonal influenza. Effects no point one percent of the population crater viruses at least ten times worse than that so I mean we look at say swine flu in two, thousand and nine. It's clearly many factors worse than swine flu. But I don't think it's as very land. As the Spanish food nineteen eighteen is very difficult to say, though, because of course you know these estimates of the mortality rate, go up and down depending on how much we are learning every day about the numbers of people who might be infected without really falling, ill or developing symptom. so that's the big on note. But and the other big difference of course is that today? We don't have a vaccine, but we have all sorts of things that didn't exist in nineteen, thousand nine hundred, so if you developed severe pneumonia from the Spanish flu, there was very little the doctors could have done. There was no such thing as as education. You know high-tech. Ben Slater's to to keep your lungs of oxygenated. We have things today. Thank God that can can save some people's lives. We also know that. If you develop severe Cova Disease and admitted to hospital. Something like a third of those patients will need. Integration Hightech CAP. Gazing that we as humans are as responsible as the microbes themselves for these outbreaks. Well. The idea of micro having agency is something that you know. Historically qualities would resist. So it's not the microbes that are doing this with the ones that are providing opportunities for these microbes to. Move Out of animal populations, animal reservoirs and spillover into human populations. And we know that this happens all the time particularly in these disease hotspots in Southeast Asia and southern. But. The problem is that although it happens all the time, it's actually not that easy for novel pathogen that may infect one person somewhere to actually successfully infect people and set up these transmission chains that then result in these large outbreaks and academics. For that to happen, we have to give them a helping hand, and we have been doing that by for instance building a roads into previously remote forest degree Jones you know having high-speed train links from you know. The border

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