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Knowledge and epidemics

December 30, 2020

Two decades before the Spanish flu, the world was struck by the Russian flu. Doctors at the time did not know about viruses, much less have clinical tests to detect them. Diseases were identified by their presentation. So the Russian flu might have been a caused by a pathogen that future physicians would not label a flu virus. Perhaps it was a coronavirus that jumped from animals — maybe cows — to people? The evidence for that is circumstantial. But quite a few pieces fit:

Observers have pointed out that many 1890 patients suffered central nervous system damage – a relatively rare symptom for influenza but common in the Covid-19 pandemic. Another striking feature of the 1890 disease was the observation that men were far more vulnerable than women, another feature shared with Covid-19.

The Russian flu returned for two years after its initial appearance. We know the Spanish flu was caused by an H1N1 flu virus only because doctors at the time preserved lung samples. Eight decades of subsequent technical advance would lead to the virus’s sequencing from those. I don’t know why no doctors during the Russian flu thought to preserve lung samples from some of its victims. Perhaps some did, but they were since lost.

Unsurprisingly, the epidemiologists who investigate virus transmission have had a busy and productive year. Most people don’t deal well with issues that involve both uncertainty and probability. This is an area steeped in both, as example, what is known about masks to slow transmission. Which may partly explain why it drives so many to nonsense and conspiracy theories.

I continue to think mRNA technology holds vast promise, not just for viruses but for a host of other diseases. The ability to program human cells to create specific proteins comes pretty close to a biology magic wand. Bert Hubert walks through the content of the mRNA in the Pfizer vaccine. That is both a fun and interesting read for science nerds.

One Comment leave one →
  1. Michael Grossberg permalink
    December 30, 2020 12:01 pm

    This is an especially fascinating bit of epidemic history. I hadn’t heard about the 1890 Russian epidemic before, and it does seem relevant.
    If we don’t learn from the past, we’re doomed to repeat it – or make similar mistakes. (And even if we learn from the past, we’re still not immune from being fallible or from the next “unexpected” disease to emerge.)

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