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Monday, February 26, 2024

A Pandemic Historian Warns Us All to Stop Looking at the Past

Thirty-three years after first becoming a historian of quarantine and two years into a pandemic that many of us thought quarantines, social distancing, and vaccines would have helped end some time ago, I found myself in one this past week. Before beginning a long-delayed year of research at Cambridge University’s Clare Hall, I was required to spend two days in voluntary isolation, a new protocol amid the surging Omicron variant. As two days turned to six—between mailing my PCR test and awaiting delayed results—I kept asking myself that one incessant (and tiring) question: When will it all end? I grew even wearier of my answer: I don’t really know. Not only are historians generally lousy at predicting the future, the history of pandemics can only tell us so much about when a pandemic in our modern, hyperconnected world might become history.

Though I’ve had three vaccinations and took every precaution to travel as safely as possible, each airport between Detroit and Heathrow was teeming with utter confusion and potential contagion. People doubtlessly out of patience, in another wave of the endless pandemic, were wearing (predominantly cloth) masks with their noses exposed, others bumped into one another without concern, and there was no personal space at all, let alone 3 to 6 feet. By the time I was in the car on the way to my new apartment I was treading in a puddle of sweat and anxiety, with the notion of quarantine rapidly shifting from an academic subject to an uneasy reality.

As I remained locked in my room, my knowledge of 700 years of quarantines far worse than the one I found myself in failed to comfort me. For centuries, beginning in 1348 with the quarantining of ships in the port of Venice to fend off the Black Death, the whole thrust of public health intervention for smallpox, diphtheria, cholera, influenza, and many other epidemic diseases boiled down to little more than capturing the infected and placing them far away. Quarantine islands in the US and abroad well into the 20th century were prison-like, with a shortage of nurses and doctors, not to mention kindness, warmth, or food. Patients there either conquered the microbe with their own immune systems or died from the infection.

I, meanwhile, had all the conveniences of a luxurious modern quarantine: a lovely apartment, personal computing, internet, food delivery, central heat, a smartphone, and access to every season of The Crown (which I binged), alongside almost every other show and movie ever made. Nonetheless, being formally isolated, especially when it's long after one thought isolation would be necessary, is, well, terribly isolating. Just 12 hours after moving into my new digs, as dusk turned to darkness, I had an incredibly strong desire to take a long walk.

Who would know? I thought. It’s so dark out, and I’m wearing a mask, so who would be able to identify me?

The desire to break the rules and go outdoors is an aspect of almost every quarantine I’ve studied. For example, in 1892 the New York Commissioner of Health complained to the press how immigrant Russian Jewish children quarantined for typhus fever were climbing out the windows and fire escapes to play with their friends, potentially spreading a deadly disease and prolonging the outbreak. Locked away 22 months after I first locked myself away with the rest of the world in March 2020, I empathize with these children, just as I have some empathy for the millions of beyond fed-up people who are essentially declaring the pandemic over themselves by flouting rules designed to staunch the spread of Omicron. Still, that empathy has worn quite thin over the past several weeks of the widely circulating Omicron variant, which will continue to prolong the pandemic’s ending.

Public health experts maintain that after the epidemiological curve plummets from hundreds (or more) cases and deaths per day per 100,000 people to fewer than 5 cases and deaths per day, for many successive days, officials will have a pretty good chance of declaring that Covid is no longer a pandemic. But as Omicron continues to swell, we’re not even close to that. As long as the virus circulates widely, and so many people around the world remain unvaccinated, more will sicken and die. Wanting to contribute to the end, I finally listened to my conscience and gave up on my walk, locked the door, and went to bed.

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Dismaying as it is that individuals and nations alike are unwilling to reimpose the measures necessary to help end this pandemic, the comforting fact is that we know more about how to end this pandemic than we’ve known about ending any other pandemic in history. On a scientific level, the specificity of genomic composition—for determining the Covid virus’s variation—was unimaginable for influenza in 1918, an era when doctors did not yet know the causative organism behind the pandemic. In fact, the four waves of the 1918 pandemic may well have been different variants of influenza or even another virus—we simply do not know because the pathological tissue has been buried and decomposed; only those reposing in permafrost have a chance of producing such answers.

We now know that social distancing, no matter how boring, tedious, or difficult, works to help prevent the spread of this illness and ultimately end the pandemic. This statement is based on the billions of data points collected during the past two years.

Although I hate to put myself out of business as a historian of quarantines, I must insist that in managing our contagious future, in ensuring that future pandemics end sooner than our current one, we will no longer look to our distant past for pandemic control because those eras no longer reflect our hyper-connected world, where news, information, disinformation, and scientific data travel at the speed of electrons. That is why this is the pandemic I will be studying and teaching in the years to come. This is the first pandemic where we have had so many tools for surveillance, identification, and means to determine the virus’s ever-changing genome and viral dynamics. The public health problems that have emerged during this pandemic are 21st-century problems and demand 21st-century approaches. The other epidemics still have much to teach us, but studying Covid is our best hope for succeeding when the next pandemic strikes.

After watching the clock in my apartment for six days, I received a reminder of the problems that need to be studied: The laboratory processing my test told me they had lost my specimen. Off to a mall with hundreds of maskless people I went to take a £79 ($108) rapid test—which, happily, came back negative. I walked out of my quarantine and into an uncertain present, which, if we take the pains to study and learn from it, will better inform our future.


More From WIRED on Covid-19📩 The latest on tech, science, and more: Get our newsletters!As Omicron surges, the youngest kids wait for vaccinesThe world must decide what “endemic” means for CovidRapid at-home Covid tests—and where to find themHow to put a vaccine card on your phoneHow to find a vaccine appointment and what to expectNeed a face mask? Here are ones we like to wearRead all of our coronavirus coverage here

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