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Ending the Pandemic and Vaccine Resistance: Modern Questions, Long History

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Johns Hopkins School of Public Health interviews Graham Mooney, PhD, associate professor of the History of Medicine at the Johns Hopkins School of Medicine, and Jeremy Greene, MD, PhD, MA, director of Johns Hopkins’ Institute of the History of Medicine.

How do pandemics end?

Jeremy Greene: This question is often left to a relatively optimistic popular imagination that epidemics end with eradication—either [a virus] burns its way through a community and just ends through some sort of natural process, or it is blocked through successful containment strategies and the ability to actually get the reproduction quotient down.

But only a few epidemics in human history have been eradicated through intentional means. And so oftentimes when we tell stories about epidemics ending, what we’re really talking about is the point at which we stopped focusing on them. And that is located in place and in social position.

What did we learn from the 1918 Influenza Pandemic?

JG: The 1918 pandemic is thought to have gone through three major waves. But many historians who have revisited the epidemiology suggest that there are a higher number of deaths from flu and flu-like illnesses that happened in 1919 and 1920. And it may well be that there was a fourth wave and a fifth wave, and they just weren’t perceived. So even pinpointing exactly when the 1918 pandemic ends, it’s easier to pinpoint the moment in which we stopped attending to it as a pandemic than the moment in which there was an absolute freedom from this particular biological scourge throughout the world.

What have we learned from HIV/AIDS?

JG: The HIV/AIDS pandemic, which clearly was understood as a new, emergent threat of infectious disease of global importance when it was first detected in the early 1980s, was described in terms very similar to the way that COVID-19 is described: a new, lethal, frightening infectious agent of significant epidemic spread.

So at what point did the AIDS epidemic stop being an epidemic in the popular imagination? It still kills millions of people each year. We have not cured it. We don’t have a vaccine for it. But it’s become something that we have learned to live with, such that when people talk about AIDS in epidemic terms, they often talk in past tense.

What about polio?

JG: The same could be said even for polio, which we’ve had much more success in developing a vaccine with. But if you look at the question of when the polio epidemics ended, the real question is, for whom, and where?

My colleague Dora Vargha points out that many people still live with the complications of polio, and there are still polio epidemics breaking out in certain parts of the world. So to talk about the polio epidemic in the past tense is not actually historically true. Polio epidemics continue.

When we think about what this means for COVID-19, the real question is, what will happen when enough people are vaccinated within countries like the United States that the attention begins to shift away from calling a pandemic a pandemic, even though it’s still ravaging many parts of the world? And we don’t have a good answer to that question yet.

Can history help explain vaccine resistance?

Graham Mooney: One of the biological ways a pandemic ends is . . .

Continue reading.

Written by LeisureGuy

2 April 2021 at 10:14 am

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