The Spanish Flu Didn’t Wreck the Global Economy. What Is Different About the Coronavirus Pandemic?

“In October 1918, the Spanish flu descended on Stanford University. Residents donned facemasks, football games were canceled, and students were asked to quarantine on campus. But classes and assemblies continued to meet. … Over a tenth of all students fell ill, and a dozen died…. Yet faculty and students started to abandon face coverings just a month after the initial outbreak. Football returned to campus shortly thereafter, even as the disease lingered throughout the winter.

The contrast with the current coronavirus pandemic is striking. I cannot enter my office at Stanford without special permission from the dean. Almost all undergraduates have left campus, and everyone who can is required to work online. San Francisco County has a per capita fatality rate 99.2 percent lower than that of the 1918–19 pandemic. But two full months after California Governor Gavin Newsom ordered residents to shelter in place, the prospect of even a gradual return to normalcy remains elusive at best.”

What has happened to humanity in the past hundred years? With all our technological advances, have we lost our courage? 

Walter Scheidel, Professor of Classics and History at Stanford University, says yes. 

In 1918, “Americans still inhabited a physical and mental universe that had not yet been sanitized by modern science,’ he argues. “Over the last hundred years, peace, medicine, and prosperity have steered humanity toward greater comfort, safety, and predictability. For the first time in history, the residents of the developed world have good reason to expect science to shield and heal them.”

Only one of my patients remembers the pre-antibiotic era. He is 99 years old and likes to tell me the story of how my father gave him a shot of the miracle drug penicillin 70 years ago. Maybe that’s why he wasn’t afraid to come into the office last month. On the other hand, I’ve had a couple of healthy young men so afraid of coming to the office that they show up double-masked, with gloves, tremulous, and cowering in a corner. They seem proud that they haven’t returned to their physical workplace in 4 months and they don’t plan to resume life until there is a vaccine.  

Professor Scheidel ascribes our response to the 2020 Pandemic to fear. It is a fear “unfamiliar in these times of prosperity and science.” We expect all our children to live into adulthood. It is hard for us to understand how recent this expectation is. Erik Larson wrote in “The Splendid and the Vile: A Saga of Churchill, Family, and Defiance During the Blitz” that Churchill had a formula for family size. Four children was the ideal number: “One to reproduce your wife, one to reproduce yourself, one for the increase in population, and one in case of accident.”

Some baseball players are afraid to play despite belonging to a group (young, physically fit) with little to fear from The Virus. Ryan Zimmerman of the Washington Nationals and Ian Desmond of the Colorado Rockies decided to sit out the season. According to the New York Times, Zimmerman, 35, has earned about $136 million in his career and won a World Series. Desmond, 34, has made $76 million. They can retire nicely. They are near the end of their careers anyway. It’s fine with me if they choose not to play; but though they can avoid baseball, they can’t avoid risk of Corona. In fact, they would be safer at the ballpark than in the community. Limiting contact to a group that gets tested for COVID twice a week seems safer than encountering random people at the grocery store.

Nonetheless, I can’t help thinking of their predecessors whose earnings were on a par with regular human beings. Ballplayers in the early 1900’s risked death from blood poisoning (sepsis) after getting spiked. It was believed that the colored stockings were the problem and that’s why ball players started wearing white ‘sanitary’ socks under colored stirrups. Presidents’ families weren’t immune from deadly skin infections either. Calvin Coolidge’s 16 year-old son died of blood poisoning after he got a blister on his foot from playing tennis at the White House.

Top scientists such as Nobel prize nominee and media darling Anthony Fauci didn’t anticipate the full effect of this virus. As late as Feb 28, he wrote in the New England Journal of Medicine, “overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968).” No one anticipated this novel coronavirus would put a chokehold on our economy like no other virus. To be fair to Dr. Fauci, his estimate of the case fatality rate was not wrong (the 2019-20 Wuhan coronavirus fatality rate is in the same ballpark as the 1957 Asian flu and the 1968 Hong Kong flu). The overall clinical fatality rates are similar, but the socio-economic consequences are much different.

Even though New York is in Phase 4 reopening and our cases are way down, New York has not come back to life. I was at a diner this morning (in Rockland County, which had the highest per capita death rate of all counties in NY) wasting time while my car was being serviced. I was the only customer in this large, normally crowded diner. It was just the owner, one waiter, one cook and me from 8 to 9 AM. After suffering COVID worse than any other region in the world, it is only natural for New Yorkers to be wary. However, if we follow science and data as our Governor wants, we would know that New York is the safest place in the United States right now. Its almost as if the media want to scare people. By emphasizing the worst possible scenarios, the media disrupt our economy, our way of life.

It is time for New Yorkers to come out of hiding. Wear a mask. Give each other some space. And start living life again. 

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