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Despite the instinct to look to the past for ways forward, it can be unhelpful – and even harmful – to do so when it comes to pandemics

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A detail from Tionfo della morte, a 14th-century fresco in Pisa, possibly shows the bodies of plague victims piled in a mass grave as demons and angels compete for their souls above. Long thought painted shortly after the Black Death by Agnolo Gaddi or Francesco Traini, it is most recently attributed to the more obscure painter Buonamico Buffalmacco.Courtesy of Timothy P. Newfield/Courtesy of Timothy P. Newfield

Timothy Newfield is a professor of history and biology at Georgetown University.

Epidemiology has seen an influx of non-specialists in recent weeks. Armchair history, to use the parlance of the pandemic, is also “surging.” Linking COVID-19 to past plagues has become a kind of cottage industry.

There is no doubting that much of what we’re living through has, in one form or another, been lived through before. When plague epidemics were routine in Europe, so too were curfews, price gouging and quarantines – even Big Brother surveillance and health certificates. Festivals were cancelled, markets were shuttered and holidays were celebrated at home.

Xenophobia in times of disease is an age-old story, too. Before phrases such as “Wuhan virus” or “Ebola disease” (named after a Congolese river), there was the 1968 “Hong Kong flu” and the 1889 “Russian flu.” Before that, Enlightenment physicians were undecided whether Arabia, China or India was to blame for smallpox, but they somehow knew that its cradle wasn’t European. We know that scapegoating epidemics not only breeds racism, but that it can kill: After the Black Death, the pope stressed that Jews themselves were dying and couldn’t therefore be accused of poisoning wells, but pogroms continued unabated.

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A Globe headline from Oct. 5, 1918, notes the spread of 'Spanish flu' in the Ottawa Valley area.The Globe and Mail/The Globe and Mail

Blaming disease on others also misleads. The “Spanish flu” of 1918 did not emerge in Spain; as a neutral country during the First World War, Spain didn’t censor reports of the outbreak, which confused people into believing it was ground zero. Similarly, while the third plague pandemic globalized from Hong Kong in 1894, it’s often overlooked that the island metropolis was then a British entrepôt and that it was mostly European ships that spread the sickness. Further, paleogenomics has revealed that that plague was a direct descendant of Europe’s Black Death. After it spread, Chinese immigrant populations from San Francisco to Sydney suffered immensely as a result. Like colonial populations in South Asia and South Africa, thousands were segregated, their homes levelled or incinerated. Epidemics have long presented the powers that be opportunities to extend their reach and push their agendas.

We also know that one’s privilege and affluence make a big difference in such crises. Epidemics amplify cultural anxieties and economic disparities, and access to care and the means to flee have long hinged on one’s standing. The affluent wasted no time getting out of Marseilles in 1720 after plague showed up; nearly 40,000 of those left behind died.

Putting the current pandemic into a historical context has undoubtedly served a purpose. Linkages to the past can serve as warnings, and they might even offer solace: We’ve been here before, things were bad, but we made it. But while knowing some disease history can be useful in times such as this, sensationalizing the past to sell the present – or being flippant and careless with such ties – can do harm.

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Drawing linkages always requires simplification, and oversimplification can lead to anachronism. Further, if most people only know the great pandemics of history as significant, world-changing events, associations drawn between them and COVID-19 can cause anxiety and fear.

Inaccuracies have abounded. Some have claimed the Black Death itself prompted the invention of quarantines and a slew of novel public health measures, but that’s not true. Milan may have closed its doors in 1348, but proper quarantines and cordons sanitaires were developed over decades; it took longer for them to take hold north of the Alps. Moreover, before the Black Death, some aspects of public health were already up and running. And our modern quarantine experience couldn’t be more different than that of Renaissance-era Europeans.

When we hunt for similarities, we overlook everything that’s different – and that is dangerous. Sure, finding proof of our arguments is satisfying, but often, what’s most important is what we’ve had to ignore to find it. There have been, for instance, no massacres of alleged plague spreaders. Allusions to pogroms and centuries-old plague controls in COVID-19 coverage suggest the present somehow fits the past, but it doesn’t; no two pandemics are the same.

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Marseille, 1720: A painting by Spanish artist Michel Serre shows the upheaval of a bubonic plague outbreak that he witnessed firsthand. It would be Western Europe's last major encounter with bubonic plague.Marseille, Musée des Beaux-Art; public domain/Public domain

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Marseille, 2020: The lights of confined apartment-dewllers and the Basilica of Notre-Dame de la Garde shine in the darkness on March 27, after France implemented a nationwide lockdown to slow down COVID-19.ANNE-CHRISTINE POUJOULAT/AFP via Getty Images/AFP/Getty Images

The numbers of COVID-19 are staggering for our time. More than 2.5 million cases and 175,000 deaths have been confirmed across 180 countries. Worse, many cases – perhaps five times the confirmed number – have eluded confirmation, as have likely thousands of deaths.

Yet, by historical standards, even the most inflated projections by the most novice of epidemiologists don’t compare.

Black Death survivors would have dismissed our current pandemic as piddling; in less than five years, the 14th-century plague killed about 40 million of the roughly 90 million people living in Europe. That’s 45 per cent of the population lost in a few years. In southwest Asia and North Africa, millions also died. Plague may have then spread widely in Asia and Central Africa, too. How it was transmitted in the 1340s remains debated, but that it disseminated widely and killed like nothing else is not.

COVID-19 has claimed more than 25,000 lives in Italy. The country’s hardest-hit region and city have seen tragic losses: In Lombardy, at least 12,750 have died – approximately 0.12 per cent of Lombards – and the population of Bergamo has fallen by 2.5 per cent. This doesn’t compare to the Black Death: Milan, Lombardy’s capital, fared well, but the plague killed 55 per cent of the Tuscan population in one year. Cities were halved in a season. Florence lost 55,000 lives, Siena 30,000 and Bologna and Pisa 20,000 each.

The great influenza of 1918 also makes for a bad comparison for COVID-19.

Roughly a third of the planet was infected, amounting to about 575 million people. More than 25 million died; some argue the real figure is double that. Multiplying to reflect today’s populations, the more conservative estimate would equate to roughly 110 million deaths. In the United States, the great flu killed approximately 675,000 people – the equivalent of about 2.3 million now – and millions died in Europe and Africa. More than 10 million died in India alone; that’d be well more than 45 million today.

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Nuns of the Soeurs du Bon Pasteur de Québec wear masks in 1918 to care for influenza patients.Archives Soeurs du Bon Pasteur/Archives du Bon Pasteur de Quebec

Naturally, drawing these contrasts is also problematic. Plague victims centuries ago didn’t have ICUs or antibiotics. There were no vaccines or anti-virals for the great influenza. Demographics change, too: Our population is larger, older and more urban, and theirs carried an infectious disease burden none of us could imagine. Today, the plague pathogen exists on four continents, but the Black Death will not reoccur. It was a product of its time. And while major spillovers of influenzas are guaranteed, it will never be 1918 again.

Perhaps the best way to thwart causal treatments of historical plagues is with numbers. After all, COVID-19 is all about morbidity and mortality statistics, serial intervals, and case fatality and reproduction rates. For the outbreaks mentioned here, we have only a sliver of those data, but the numbers we do have warrant attention. Without them, we can’t put our current pandemic in context or understand what it is and isn’t.

As much as historical parallels can provide insight, they can also harm. Making anti-linkages clear is important, as they demonstrate the degree to which past and present pandemics are incommensurate. This is not to diminish COVID-19 as a public health crisis that will cause much tragedy. But is it a great plague? No. So, let’s not get hung up on the past.

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Courtesy of Timothy P. Newfield/Courtesy of Timothy P. Newfield

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