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Photos From a Century of Epidemics Photos From a Century of Epidemics
(about 20 hours later)
By Alan CowellBy Alan Cowell
LONDON — There are times when the planet resets its course with a cruelty that seems as capricious as it is implacable. The coronavirus pandemic, spreading octopus tentacles into every crevice of society, is one of them, pitting the vanity of human assumptions against nature’s almost casual ability to destroy them. It is not the first time.LONDON — There are times when the planet resets its course with a cruelty that seems as capricious as it is implacable. The coronavirus pandemic, spreading octopus tentacles into every crevice of society, is one of them, pitting the vanity of human assumptions against nature’s almost casual ability to destroy them. It is not the first time.
Calamities and the mass destruction of populations and lives stretch back to biblical times and on through the days of plague in medieval Europe. Wars, too, have brought a Darwinian pruning of entire societies. Technological advance, from siege engines to long bows, from gas chambers to weapons of mass destruction, has magnified the process, culminating in the Cold War’s calculations of mutually assured destruction.Calamities and the mass destruction of populations and lives stretch back to biblical times and on through the days of plague in medieval Europe. Wars, too, have brought a Darwinian pruning of entire societies. Technological advance, from siege engines to long bows, from gas chambers to weapons of mass destruction, has magnified the process, culminating in the Cold War’s calculations of mutually assured destruction.
But, as these photographs show — and as the pre-photographic chronicles of history, faith and mythology confirm — the Earth and its people have long been prey to the invisible pathogens that bring their victims low with equal efficiency.But, as these photographs show — and as the pre-photographic chronicles of history, faith and mythology confirm — the Earth and its people have long been prey to the invisible pathogens that bring their victims low with equal efficiency.
In the annals of conflict, dating to the Plague of Athens from 430 to 426 BC during the Peloponnesian War, disease molded national fates as much as — sometimes more than — competing armies.In the annals of conflict, dating to the Plague of Athens from 430 to 426 BC during the Peloponnesian War, disease molded national fates as much as — sometimes more than — competing armies.
The fears from the latest pandemic are rooted deep in history. Plague in medieval Europe took millions of lives even at a time when globalization was in its infancy, slashing national and continental populations by staggering amounts in the mid-14th century.The fears from the latest pandemic are rooted deep in history. Plague in medieval Europe took millions of lives even at a time when globalization was in its infancy, slashing national and continental populations by staggering amounts in the mid-14th century.
Across millenniums, cholera, smallpox, typhus and other diseases have changed history’s course and reinforced human perceptions of frailty. The catalog ranges over swine flu and avian flu, leprosy, measles and malaria.Across millenniums, cholera, smallpox, typhus and other diseases have changed history’s course and reinforced human perceptions of frailty. The catalog ranges over swine flu and avian flu, leprosy, measles and malaria.
Reaching much further back, the sacred texts that define belief and identity to this day chronicled the ninth plague in the book of Exodus, which now seems to be a harbinger of the quarantine, self-isolation and social distancing that stretches ahead of many of us for months, if not years, to come.Reaching much further back, the sacred texts that define belief and identity to this day chronicled the ninth plague in the book of Exodus, which now seems to be a harbinger of the quarantine, self-isolation and social distancing that stretches ahead of many of us for months, if not years, to come.
“And total darkness covered all Egypt for three days,” it reads. “No one could see anyone else or leave his place for three days.”“And total darkness covered all Egypt for three days,” it reads. “No one could see anyone else or leave his place for three days.”
Inevitably, this latest pandemic finds echoes in the near and ancient past.Inevitably, this latest pandemic finds echoes in the near and ancient past.
1918-19191918-1919
The word pandemic derives from ancient Greek, meaning literally “all people,” but it does not apply universally.The word pandemic derives from ancient Greek, meaning literally “all people,” but it does not apply universally.
Perhaps the most relevant antecedent to the current circumstance is the Spanish Flu, which spanned the globe between 1918 and 1919. It killed more people than those who died in World War I’s trenches and battlefields, where the malady in part germinated. The estimates run to in excess of 50 million fatalities.Perhaps the most relevant antecedent to the current circumstance is the Spanish Flu, which spanned the globe between 1918 and 1919. It killed more people than those who died in World War I’s trenches and battlefields, where the malady in part germinated. The estimates run to in excess of 50 million fatalities.
Accounts link the spread of the disease to the trans-Atlantic deployments of American forces in the final days of World War I, and to the victorious return home of Allied forces after November 1918.Accounts link the spread of the disease to the trans-Atlantic deployments of American forces in the final days of World War I, and to the victorious return home of Allied forces after November 1918.
19681968
That pandemic managed to spread in an era even before the jet engine offered mass mobility. Since then, the world has become much more footloose.That pandemic managed to spread in an era even before the jet engine offered mass mobility. Since then, the world has become much more footloose.
Many surges in the rate of infection came from increases in human mobility, enabling people to carry pathogens with them in their pursuit variously of war and commerce.Many surges in the rate of infection came from increases in human mobility, enabling people to carry pathogens with them in their pursuit variously of war and commerce.
Migration itself, for leisure, economic necessity or in flight of war, alternately unites humanity even, or especially, in times of pandemic, while stirring fears real or exaggerated.Migration itself, for leisure, economic necessity or in flight of war, alternately unites humanity even, or especially, in times of pandemic, while stirring fears real or exaggerated.
When President Donald Trump referred to the “Chinese Virus,” appealing to the xenophobia of those seeking a target of blame, some people recalled an image from 1968 during the so-called Hong Kong Flu that caused over 100,000 deaths in the United States, out of a global total in excess of one million.When President Donald Trump referred to the “Chinese Virus,” appealing to the xenophobia of those seeking a target of blame, some people recalled an image from 1968 during the so-called Hong Kong Flu that caused over 100,000 deaths in the United States, out of a global total in excess of one million.
The photograph showed a billboard with the words: “Hong Kong Flu is Un-American. Catch Something Made in the USA.”The photograph showed a billboard with the words: “Hong Kong Flu is Un-American. Catch Something Made in the USA.”
ONGOINGONGOING
Stigma has nearly always accompanied disease.Stigma has nearly always accompanied disease.
Perhaps the most stubborn viral assault of modern times has come from H.I.V./AIDS, its early associations with homosexuality adding to the marginalization of victims and treatment.Perhaps the most stubborn viral assault of modern times has come from H.I.V./AIDS, its early associations with homosexuality adding to the marginalization of victims and treatment.
The disease itself proved to be less discriminating than the societies it afflicted, becoming widespread. Yet even if it was once defined as a pandemic, it is now often depicted as a chronic or endemic condition, albeit of epidemic proportions.The disease itself proved to be less discriminating than the societies it afflicted, becoming widespread. Yet even if it was once defined as a pandemic, it is now often depicted as a chronic or endemic condition, albeit of epidemic proportions.
By the end of 2018, according to the World Health Organization, 32 million people had died of H.I.V. since its recorded inception in the late 1960s, and 37.9 million people were living with the illness as a result of advances in treatment and care.By the end of 2018, according to the World Health Organization, 32 million people had died of H.I.V. since its recorded inception in the late 1960s, and 37.9 million people were living with the illness as a result of advances in treatment and care.
“Infection has become a manageable chronic health condition, enabling people living with H.I.V. to lead long and healthy lives,” the W.H.O. said.“Infection has become a manageable chronic health condition, enabling people living with H.I.V. to lead long and healthy lives,” the W.H.O. said.
2002-20032002-2003
Covid-19 seems a long way from such hopeful assessments.Covid-19 seems a long way from such hopeful assessments.
It belongs to “a large family of viruses which may cause illness in animals or humans,” called coronaviruses, according to the World Health Organization.It belongs to “a large family of viruses which may cause illness in animals or humans,” called coronaviruses, according to the World Health Organization.
They range “from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS),” it says.They range “from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS),” it says.
But those epidemics were far more limited in scope than the Covid-19 disease caused by the latest coronavirus.But those epidemics were far more limited in scope than the Covid-19 disease caused by the latest coronavirus.
SARS in 2003 claimed almost 800 deaths from 8,000 reported cases mainly in mainland China, Hong Kong, Taiwan and Singapore.SARS in 2003 claimed almost 800 deaths from 8,000 reported cases mainly in mainland China, Hong Kong, Taiwan and Singapore.
2009-20102009-2010
In many ways, those earlier outbreaks of coronaviruses provided Asian countries, in particular, with a far more limited rehearsal for Covid-19, and the world with a warning of the potential for more widespread and more lethal contagions.In many ways, those earlier outbreaks of coronaviruses provided Asian countries, in particular, with a far more limited rehearsal for Covid-19, and the world with a warning of the potential for more widespread and more lethal contagions.
The same can be said of the swine flu outbreak of a decade ago, an H1N1 virus in the category of the Spanish flu that infected hundreds of millions worldwide, the young and otherwise healthy not excluded, but with a far less severe impact than that of previous pandemics.The same can be said of the swine flu outbreak of a decade ago, an H1N1 virus in the category of the Spanish flu that infected hundreds of millions worldwide, the young and otherwise healthy not excluded, but with a far less severe impact than that of previous pandemics.
20132013
Other diseases pointed to the potential for pandemic, too, even if more geographically contained and falling short of the scientific definition.Other diseases pointed to the potential for pandemic, too, even if more geographically contained and falling short of the scientific definition.
Updated June 22, 2020 Updated June 24, 2020
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
The murderous explosion of the Ebola virus that swept through parts of West Africa between 2014 and 2016 killed 11,300 people, according to the World Health Organization. It is referred to by specialists only as an outbreak or epidemic, even if it did cross frontiers between Guinea, Liberia and Sierra Leone.The murderous explosion of the Ebola virus that swept through parts of West Africa between 2014 and 2016 killed 11,300 people, according to the World Health Organization. It is referred to by specialists only as an outbreak or epidemic, even if it did cross frontiers between Guinea, Liberia and Sierra Leone.
The Ebola outbreak also showed that, for Europe and the United States, possessed of a sense of entitlement and prosperity, much of Africa remained remote, or even in the realms of the imagination, defined in the writings of Conrad and Naipaul.The Ebola outbreak also showed that, for Europe and the United States, possessed of a sense of entitlement and prosperity, much of Africa remained remote, or even in the realms of the imagination, defined in the writings of Conrad and Naipaul.
For many, so did the prospect of more widespread disease. Covid-19, however, is emerging as the great leveler.For many, so did the prospect of more widespread disease. Covid-19, however, is emerging as the great leveler.
Ebola did not upend Western lives. It did not shutter theaters and bars from Los Angeles to Rome, or halt flights across the Atlantic, or close businesses and subways and schools, or leave many Americans and Europeans suddenly aware of their fragility and vulnerability to changed rules of mortality.Ebola did not upend Western lives. It did not shutter theaters and bars from Los Angeles to Rome, or halt flights across the Atlantic, or close businesses and subways and schools, or leave many Americans and Europeans suddenly aware of their fragility and vulnerability to changed rules of mortality.
It did not lead inexorably to the conclusion that, henceforth, the assumptions and expectations of what constitutes Western normalcy would longer apply.It did not lead inexorably to the conclusion that, henceforth, the assumptions and expectations of what constitutes Western normalcy would longer apply.
20152015
By now, no region has proved itself immune to penetration from disease, to its terrible persistence, or to the potential to become the source of pandemics, despite the temptation to assign blame, as with the Covid-19 contagion.By now, no region has proved itself immune to penetration from disease, to its terrible persistence, or to the potential to become the source of pandemics, despite the temptation to assign blame, as with the Covid-19 contagion.
For instance, MERS claimed some 858 lives from 2,494 reported infections, mainly in 2012, and mainly in the Arabian Peninsula, according to the World Health Organization.For instance, MERS claimed some 858 lives from 2,494 reported infections, mainly in 2012, and mainly in the Arabian Peninsula, according to the World Health Organization.
The outbreak then reoccurred in South Korea three years later. This time a coronavirus has gone global, nearly everywhere at once.The outbreak then reoccurred in South Korea three years later. This time a coronavirus has gone global, nearly everywhere at once.
“We have never before seen a pandemic sparked by a coronavirus,” Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, said of Covid-19 on March 11. “This is the first pandemic caused by a coronavirus.”“We have never before seen a pandemic sparked by a coronavirus,” Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, said of Covid-19 on March 11. “This is the first pandemic caused by a coronavirus.”
“And we have never before seen a pandemic that can be controlled, at the same time,” he added.“And we have never before seen a pandemic that can be controlled, at the same time,” he added.
20202020
Covid-19, then, presents a new threat to globalization, challenging humanity to come together or pull apart.Covid-19, then, presents a new threat to globalization, challenging humanity to come together or pull apart.
Globalization may have bound humanity in uneven chains of trade and profit, but it did not dissolve the primal fear of uncontrolled pestilence that has burrowed into human consciousness over millenniums.Globalization may have bound humanity in uneven chains of trade and profit, but it did not dissolve the primal fear of uncontrolled pestilence that has burrowed into human consciousness over millenniums.
The alarms and lockdowns over coronavirus have reversed the West’s perceptions of its own place in history. Claiming a leader’s mantle that might once have been America’s, China is now offering aid to European lands, including Poland and Italy. After decades of dismantling the barriers between them, European nations are rebuilding them, retreating to national sovereignty.The alarms and lockdowns over coronavirus have reversed the West’s perceptions of its own place in history. Claiming a leader’s mantle that might once have been America’s, China is now offering aid to European lands, including Poland and Italy. After decades of dismantling the barriers between them, European nations are rebuilding them, retreating to national sovereignty.
Across Europe, which once prized free movement, frontier posts and checks are being re-established. Yet, as Ian Goldin, a professor at Oxford University, noted in an Op-Ed article in The New York Times, those efforts may be just our latest vanity.Across Europe, which once prized free movement, frontier posts and checks are being re-established. Yet, as Ian Goldin, a professor at Oxford University, noted in an Op-Ed article in The New York Times, those efforts may be just our latest vanity.
“No wall is high enough to keep out the threats to our future,” he wrote, “even for the mightiest countries.”“No wall is high enough to keep out the threats to our future,” he wrote, “even for the mightiest countries.”