Right throughout this year comparisons to the 1918 flu pandemic have been unavoidable, so it is instructive to consider where our knowledge stands today – that provides the tools which we use to fight this pandemic – in relation to 1918.
This is something that really should be highlighted because it is a source of much optimism which goes well beyond the rapid vaccine development.
While it is true that much of the basics of infectious disease control is similar, which is hardly surprising since learning to deal with disease impacts on us directly and in species important to us has been important in our success as a species over thousands of years, the tools that we have at our disposal now are mind-blowing even to me having retired from research science 16 years ago.
At the time of the 1918 flu pandemic we knew that there were disease agents so small as to be undetectable with the light microscope. Two decades earlier, at the end of the 19th century, researchers proved that something so small that it could pass through a filter small enough to remove bacteria was able to transmit disease (e.g. a virus of tomatoes).
From then until well into the 20th century the definition of a virus was a filterable agent of disease.
So for all of that time, including when the global community fought the last pandemic of equivalent scale to COVID-19, the 1918 flu, fighting these diseases was akin to shadow boxing or fighting a ghost.
The electron microscope which allowed examination of the world at much higher magnification than permitted by the light microscope was not developed until the 1930s. It was only then that we human beings finally began to see one of our major foes to our existence on Earth, viruses (think about all of those “pretty” photographs of coronaviruses looking like a spikey ball heading many media stories this year.)
When we combine our contemporary ability to visualise viruses in great detail, with our ability to isolate and culture them in cultured living cells (or sometimes chicken eggs) in the laboratory, together with our explosion in knowledge about the building blocks of all organisms – the nucleic acids DNA & RNA – we have truly formidible tools at our disposal in comparison to 100 years ago.
To think that within weeks of my friend, Dr Shi Zhengli, and her colleagues receiving samples from sick and dying people they had isolated the novel coronavirus and sequenced its full RNA genome and posted the sequence online so that laboratories throughout the world, with equipment and techniques very commonly in use, could promptly develop RT-PCR (reverse transcription polymerase chain reaction) assays which can detect very small amounts of the virus genome in samples from patients is honestly mind-blowing.
These assays have been invaluable in researching and managing the pandemic, including by detecting its presence on surfaces or even in waste waters drawn from thousands of households.
These findings inform our understanding of best practice for infection control, so that it has developed rapidly in the year since the virus is believed to have first jumped into humans, which benefits all of us including those in less developed countries. And in Australia and other countries that have the logistical capability and desire to aggressively manage the pandemic it informs our adaptive management (including by further sequencing detected genomes to determine how different clusters relate).
The invisibility of disease threats has always frightened human beings through the ages. But while we ordinary humans cannot physically see the agent of this disease, our contemporary scientists are blessed with tools with special powers, no less “out of this world” than those available to Antman or some other Marvel super hero, or perhaps a comparison between the 1918 first Daredevil and the contemporary cinematic hero is more instructive. They have those super powers because they stand on the shoulders of generations of humans from amongst our global community who chose to specialise in scientific research and because we in society have supported and trusted them.
Boy have we all benefitted!
After reading this, it should also be clear why it is pointless in comparing COVID-19, and patently ridiculous to downplay it, with the 1918 flu in terms of case fatality rate or total mortalities. I truly shudder to think how humanity would have coped with this agent even a few decades earlier.
Even though it might not seem it at times, we really are in a fortunate position compared with earlier times and that is something we should always remember and be confident about.
It is a critical source of optimism.
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© Copyright Brett Edgerton 2020