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Some thoughts about my week of lectures in the UK. I presented on Tuesday at Durham, on Wednesday at Newcastle, & on Thursday at Edinburgh. All three lectures had different themes, but all circled around the common fact that we are in a new era of medical history (#histmed). 1/n
In Durham, my topic was "Are Pandemics Comparable? The Present State of Research in Justinianic Plague and Black Death Studies." For my 2014 volume on the Black Death as a (semi-global) pandemic, I had used the definition of Morens et al. 2009. It still holds now, I think. 2/n
Which means, of course, that contrary to the BBC's headline, we are not in "uncharted territory" in an absolute sense. The work I've been doing the past 12 yrs to develop a new kind of epidemiological history has taken the insights of the field of Emerging Infectious Diseases 3/n
... and argued that there have *always* been emerging diseases. Every infectious disease has a history. And as they say, History may not repeat itself, but it rhymes. My argument is that we now have some new powerful methods to parse those rhymes, to see the common patterns. 4/n
And the most powerful of those new methods is genetics. Phylogenetics reconstructs the evolutionary history of organisms (in this case, pathogenic microbes). Here's the latest phylogenetic tree for plague (#YersiniaPestis, from Zhou et al. 2020: genome.cshlp.org/content/30/1/1…). 5/n The phylogenetic tree of Yersinia pestis evolution. From Zhemin Zhou, et al.,
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And here's how that evolutionary narrative in the phylogenetic tree breaks down to tell us the history of plague's impacts on human populations over the course of the past 5-6 millennia. 6/n
But (& it is a big BUT), genetics is only telling the story of the single-celled bacterium, Yersinia pestis. For the rest of the story--the story of what infectious diseases really do to human populations--we need a bigger army of investigators. We need to work across species 7/n A slide showing the cover of the 2015 book, Pandemic Disease in the Medieval World: Rethinking the Black Death, and silhouettes to represent the four species involved in plague outbreaks: the bacterium, Yersinia pestis; fleas; rodents; and humans. Each is studied by different researchers.
I talked about a lot of other developments in plague's history in my Durham talk, including my (hopefully forthcoming) work identifying the place, time, & circumstances of plague's reemergence in the context of the Black Death. Those are historical specifics. Contingencies. 8/n
What are the commonalities of pandemics? In every case where we can identify specifics, the biggest commonality in disease emergence is that humans themselves are involved. Usually because of food-seeking behaviors. We disrupt local environments & create circumstances for ... 9/n
... spillover events. That, I argue, is how we got the Black Death. I suspect that's what we will eventually conclude about the current coronavirus outbreak. And then, human networks take over to spread the disease to new communities. It's really as simple as that. 10/n
In conversation with a group over dinner after my talk at Newcastel (title: "Plague Work: Reconnecting with a Forgotten Disease to Forge New Connections in Public Health"), I floated the idea that we need an equivalent term in #GlobalHealth to the Anthropocene. A colleague 11/n
suggested that, no, maybe a better concept was "The Great Acceleration": the notion that everything simply has been speeded up since the mid-20thC. And that is certainly what has happened w/ disease emergence: aviation + a just-in-time economy means constant daily world-wide 12/n
... traffic. My concluding argument for all three talks (including the final one at Edinburgh, in support of the @UCU industrial action, on the theme "Coronavirus: what can study of historical pandemics teach us?") is that we need deep, robust interdisciplinary research ... 13/n Titlepage of the talk
... to reconstruct the specific, contingent factors of past pandemics. Out of those specifics, we can then draw conclusions about the common factors: the situations primed for spillover events, the circumstances that allow amplification, the interventions that did/did not work.
The genetics science is doing amazing things in our current crisis (h/t to the @nextstrain team & everyone else contributing data). The urgent need is to support HCW & caregivers everywhere. But afterwards, we will have some hard thinking to do about "pandemic preparedness." 15/n
As I said upthread, I question the idea that we're in "uncharted territory"--or at least in any respect beyond figuring out the characteristics of this new coronavirus. We're tracking it, studying it, fighting it. But we also need to learn our own pandemic histories. 16/end
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