This Isn't the First Time!

 

It Isn’t the First Time

 

        In 1772, Daniel Dafoe wrote an alleged eye-witness account of the great Bubonic plague which ravaged England in 1664 and 1665. In fact, he was just 5 years old at the time, so most of the book, A Journal of the Plague Year is secondary sourced, vice eyewitness. Told as a narrative by an imaginary Londoner, it was written to be readable, and was successful in its time.

        Closer to the bone is the first person (ergo more accurate) A Diary of the Plague Year, which consists of selections from the diary of Samuel Pepys. During the same pandemic, Pepys, a 17th-century British naval administrator fastidiously kept a diary from 1660 to 1669 – a period of time that included the same severe outbreak of the bubonic plague in London.

 Pepys wrote:

[1665-08-12] The people die so, that now it seems they are fain to carry the dead to be buried by daylight, the nights not sufficing to do it in. And my Lord Mayor commands people to be inside by nine at night that the sick may leave their domestic prison for air and exercise.

And: [1665-08-31] Up, and after putting several things in order to my removal to Woolwich, the plague having a great increase this week beyond all expectation, of almost 2000 - making the general Bill 7000, odd 100 and the plague above 6000 .... Thus this month ends, with great sadness upon the public through the greateness of the plague, everywhere through the Kingdom almost. Every day sadder and sadder news of its increase. In the City died this week 7496; and all of them, 6102 of the plague. But it is feared that the true number of the dead this week is near 10000 - partly from the poor that cannot be taken notice of through the greatness of the number, and partly from the Quakers and others that will not have any bell ring for them. As to myself, I am very well; only, in fear of the plague, and as much of an Ague, by being forced to go early and late to Woolwich, and my family to lie there continually.

        In truth, there was no singular plague which came and went never to resurface, but more like three centuries of intermittent waves of diseases which ravaged Europe to varying degrees from the 1300s to the Great Plagues (the Black Death/Bubonic Plague) which ravaged European cities in the mid-1600s. Reconstructing from contemporaneous records, such as survive, it is likely that multiple Italian cities had at least 50% death figures!)

        American parallels to this were played out over several centuries and included:

1633-1634: Smallpox from European settlers (half the population of Boston was infected and about 9% of the city died!)

1793: Yellow fever from the Caribbean (refugees fleeing a yellow fever epidemic in the Caribbean Islands sailed into Philadelphia, carrying the virus with them. Estimates of fatality range as high as 10%. Others fled the city to avoid it, and did)  

1832-1866: Cholera in three waves between 1832 and 1866. (the pandemic began in India and swiftly spread across the globe through trade routes. New York City was the first U.S. city to feel the impact. Between 5 and 10 of the total population died in large cities.)

1918: H1N1 flu. (In 1918, it was the type of flu behind the “Spanish” influenza pandemic, though it didn’t actually from come from Spain. Lasting from February 1918 to April 1920, it infected 500 million people – about a third of the world’s population at the time – in four successive waves. Killing 50 million worldwide and 675,000 in the US.)

1921-1925: Diphtheria epidemic, peaking in 1921  with 206,000 cases.

        So why the history lesson? I guess it stems from my frustration from reading all the false data and allegations related to the current pandemic. Looking backward at previous global and/or continental pandemics, several factors emerge:

Etiology: the great plagues of the 1600s might as well have been caused by lightning as far as anyone knew. The isolation of germs and their relationship to disease causality was 200 years away. Even more distant was the 1892 recognition of viruses, and, even then, they were not immediately identified as causative factors in human disease.

        Conversely, the viral causative factor in the current pandemic was identified early on. It was also immediately apparent that transmission reflected the type of contagion we had seen 100 years earlier in the 1918 flu pandemic.  

Response: Even though the agents of transmission were a mystery and would remain so for some time, those who called themselves doctors came to realize that no matter what was tried, it was futile, be it bleeding, purging, or, for the Black Death, such “cures” as: Rubbing onions, herbs or a chopped-up snake (if available) on the boils or cutting up a pigeon and rubbing it over an infected body (yuck). Drinking vinegar, eating crushed minerals, arsenic, mercury (a really bad idea!) or even ten-year-old treacle were other, also useless, treatments.

        About the same time, smallpox treatment was almost as bizarre: Bloodletting (as much as 20 ounces at a time!), Purging (induced vomiting), Confinement to bed, no heat allowed in the room, windows constantly open, bed clothes no higher than the waist. Also prescribed was “12 bottles of small (low alcohol) beer, acidulated with Spirit of Vitriol (diluted Sulfuric Acid!), every twenty-four hours.”

        Yellow fever treatment was simpler. You either died, or you didn’t. No one had yet identified the mosquito as a disease vector. However, even that disease gave hints regarding acquired immunity. In New Orleans, where yellow fever was frequently epidemic in summers, White society evolved into two strata, those who had survived the disease and were “acclimated” and those who were “unacclimated”. Rich whites frequently went north of Lake Pontchartrain to (only slightly) higher and dryer ground through the worst summer months, even though the mosquito as vector wouldn’t be identified until 1900.    

        However, in every single one of these, save the mosquito borne illnesses, one early response was apparent – get away from those infected. Yeah, Social Distancing. As early as the 1600s, Londoners who could afford to do so went to the country and avoided crowds because, even though they had no idea what caused the plague, they on some level, apparently invisible to a sizeable portion of US Conservatives, realized that removing oneself from close contact with potentially infected individuals was a good idea. Sadly, for poor Londoners (most of the population) that simply wasn’t an option. Second, although less effective, don’t share fluids with a sick individual, because their cooties can make you sick, Even wear a mask!

        It was in England in 1665 during the Great Plague/Black Death that Cambridge University sent students home as a precautionary measure. One of them returned to his family estate 60 miles northwest of Cambridge, where he then thrived. The year 1666, which he spent away from Cambridge at his family’s estate, is when and where Isaac Newton began work on his discoveries in the fields of calculus, motion, optics and gravitation. The mathematical papers he wrote during this time went on to form the early foundations of calculus. He experimented with prisms, going so far as to punch a hole in his shutters for a small light beam to come through. This led to his theories in optics. Outside his window was ‘the apple tree’ that (allegedly) led to the discovery of gravity. While Newton practiced Social Distancing, 100 miles to the southwest, a quarter of London’s population perished in the Great Plagues of 1665 and 1666.

Treatment/prevention: While some early efforts at treatment of pandemic communicable diseases seem like “witch doctor specials” there were some who made several observations which laid the groundwork for later immunological advances. One seemingly inexplicable statistic was that the urban rich seemed to suffer and die in greater numbers from Smallpox than the poor in the countryside. It was also common knowledge that survivors of smallpox became immune to the disease. As early as 430 BCE, survivors of smallpox were called upon to nurse the afflicted. Although the exact dates are unknown, it is now generally accepted that variolation (the act of taking matter from an existing pox sore and inducing it into another via small incision) was practiced in India and China long before it was ever heard of in England. It came to the attention of the Royal Society in London in a 1714 letter from a diplomat in Istanbul, but English doctors were resistant to the idea.

          In 1717, Lady Mary Montague's husband, Edward Wortley Montague, was appointed ambassador to the Ottoman Empire. She had been facially disfigured by smallpox two years earlier and upon hearing of variolation at the Ottoman court, asked that her young son be variolated by the embassy surgeon. Although most of the world reveres the name Edward Jenner as the “discoverer of vaccination” it was embassy surgeon, Charles Maitland, who performed the first known immunological procedure on a European, a 5-year-old boy, Lady Montague’s son. Returning to England, Lady Montague became an advocate whose experience reached the royal family. In 1722, Maitland was allowed to perform vaccination on six prisoners all of whom became immune to smallpox.

          In fact, the first actual statistical analysis of the effects of variolation, was performed in Boston, not England. When a ship with active smallpox cases landed in Boston in 1721, Cotton Mather, a Harvard grad and interested in medicine although a  pastor by vocation, recommended immediate variolation of the entire populace. Some of the residents violently resisted and, in a prelude to the incredibly ignorant anti-vaxx movement of today, a bomb was thrown at Mather’s house. But, as the plague burnt out, analysis of the effects of variolation showed that untreated citizens had a death rate 700% higher than those who had been immunized. It is significant that this was accomplished with scrapings from active smallpox victims.

        It was English doctor Edward Jenner who, in 1796, noted that milkmaids who contracted cowpox (a minor rash generally limited to hands and arms and not fatal) were immune to smallpox. On May 14, 1796, using scrapings from cowpox lesions, he inoculated an 8-year-old boy, James Phipps. The lad developed very mild fever. Nine days after the procedure he felt cold and had lost his appetite, but on the next day he was much better. In July 1796, Jenner inoculated the boy again, this time with matter from a fresh smallpox lesion. No disease developed, and Jenner concluded that protection was complete Since this immunity was apparently obtained from cowpox (Vacca is the Latin for cow) Jenner called his process of intentional transmission “Vaccination.”  

        Yeah, I know, that’s a lot of verbiage, so what? Well, Jethro, because what those early inoculators discovered, although the reasons remained to be discovered, was the concept of acquired immunity. While the vaccine delivered today is far more sophisticated and less likely to cause side effects, the principle remains the same. All the plagues described earlier are non-existent in most of the world where vaccination is common. If travelling to regions less developed where Cholera or Yellow fever are still to be found, vaccines are available.    

        Obviously, Voodoo priestesses, pillow salesmen and Presidents notwithstanding, there is, as of yet no curative for COVID 19. There are medically therapeutic treatments for symptoms, but the only “cure” is don’t get sick, and by far the best way to do that is remain masked and/or distanced until you can get the vaccine. That also means, in plain speak, get vaccinated when possible or shut the hell up. Ignore the science bashing gobbledy-gook and help relegate COVID 19 to the same status as Smallpox. If you choose to still believe that vaccination is unwarranted, look at the childhood measles clusters in those anti-vaxxer strongholds in Oregon, where pre-public school vaccinations are not mandatory. (A 30 year high!) As of Tuesday, April 23^rd of last year, 680 cases of measles had been reported in the U.S. This was the highest level of measles infections in 25 years, and the resurgence is largely attributed to misinformation turning parents against vaccines, according to the Associated Press.