Stay the Course – What We’ve Learned from History


Pandemics and epidemics are nothing new. The Plague, Smallpox, Cholera, Typhoid, Diphtheria, Polio, Measles, Tuberculosis (TB), HIV/AIDS, to name a few. They impacted our collective conscious so greatly that more than likely, you already know these names and understand that they are deadly. In fact, many of you unknowingly sang songs about them as a child – Ring Around the Rosie sound familiar? They have imprinted on our collective mind.

Today though, they’re not as big of a concern. There are smaller outbreaks of Measles and TB in the United States, but we have vigorous vaccines and monitoring in place to manage them. HIV/AIDS remains a serious disease but thankfully can now be managed as a Chronic Condition. Centuries of scientific advances in medicine have worked.

Which is part of the reason COVID-19 is so scary. It’s been a long time since we’ve dealt with an infectious disease on this scale. We don’t have a vaccine. We don’t have enough testing for population monitoring. The virus itself remains a bit of an enigma.

Scientists continue working around the clock but for example, we still don’t know how long you can carry the disease without symptoms. We don’t know how many people have already been infected and may be immune. We don’t even know if you can become immune or how long that immunity lasts.

Thankfully, we do have history to reference as we navigate what seems to be uncharted waters. Personally, I have been looking back on the 1918 flu pandemic. In many ways, it has a lot of similarities to our current situation despite it being a different disease. It was novel, it was out of control, and social distancing was the primary means of prevention until vaccines were eventually developed.

With the 1918 flu, there were three unique waves of illness in the United States with the first hitting in the spring of 1918. By that summer, the peak of the first wave had passed and new infections appeared to be tapering off. As such, many of the precautions were suspended. To use a phrase we hear a lot these days, they “opened” the country back up. By the fall of 1918, after a summer of uncontrolled transmission from neighbor to neighbor, a second more deadly wave of illness hit the county. Again, precautions were suspended as it tapered off and again, several months later in 1919, a third deadly wave hit. Worldwide, 50 million people died. A toll greater than all the casualties of World War I.

I share that today because as Winston Churchill said, “Those who fail to learn from history are doomed to repeat it.”

There is a lot of talk about easing rules around social distancing and “opening” our state and country. I can understand the desire. The economic devastation is real. The impact of isolation is real. The loss of significant milestones in our lives is real. But the threat of COVID-19 is real too. The threat of second, more deadly wave, is even more real.

As healthcare professionals, I urge you to resist these arbitrary calls for normalcy. In California we have done a stellar job of flattening the curve and we know that right now the best medicine for COVID-19 is physical space. Let’s keep that momentum going and avoid the deadly pitfalls we have seen in other states and countries.

Opening up may feel good in the moment but the joy will be short lived if we do it too soon. We need to stay the course. We need to remain vigilant in our protocols and practices. We need to urge our friends and family to stay home.

Be Well.