In the 19th century Ignaz Semmelweis was vilified and ostracised when he tried to make doctors wash their hands after doing autopsies on women who had died from childbirth fever before going straight upstairs to deliver more babies. We have come a long way since then in public health, but we can go much further still.
The Covid-19 coronavirus must change the way we behave – whether it kills millions or not. The vulnerability to pandemic-panic of world stock markets, the tourism industry, international sport and global trade, even before there is an actual pandemic, tells us that global society, for all its medical know-how, is vulnerable.
Pandemics are frankly more likely to kill millions or disrupt the world economy than climate change. But if we learn the lesson that we must be more authoritarian, we’ll have got it wrong. Culture and practice can change without putting Big Brother in charge.
Covid-19 may yet peter out, but it looks unlikely after what has happened in Italy and Iran. It seems to be killing mainly old people and its mortality and infectivity may eventually be no higher than flu, but that is cold comfort.
Flu kills thousands a year, yet we treat respiratory infections fatalistically as an inevitable risk, the way our ancestors thought of consumption or smallpox. It should not be like this: we can do much more to stop these viruses spreading.
China has apparently got Covid-19 under control with brutal measures: drones shouting at people in the street; violent arrests; and a total ban on travel.
This has gained admirers among the instinctively bossy. “China’s uncompromising and rigorous use of non-pharmaceutical measures to contain transmission of the Covid-19 virus in multiple settings provides vital lessons for the global response,” said the World Health Organisation this week.
There has long been a streak of China envy among those on the statist Left who yearn for authoritarian measures to bring in population control and renewable energy, bypassing inconveniences of democracy.
But autocracy has its drawbacks too. Lack of challenge from civil society allows live, wild animals to be sold in markets in China, providing a way for new viruses to jump into the human species. Besides, violent enforcement of public health would not survive legal and political challenge here and might prove counterproductive.
It should not be necessary anyway. Society is already reacting: conferences and rugby matches are being cancelled and people are self-isolating voluntarily. For those who refuse to go along (a doctor friend mentioned a patient who ignored advice not to board a connecting flight after falling ill on a flight from China), shame will be a powerful weapon.
I hope that what emerges from this episode is a cultural shift to change our habits so as to defeat not just future lethal diseases, but also ones as harmless as the common cold. It’s outrageous that we treat viruses as acts of God to be borne with patience, and mock as wimps those who stay at home.
It’s mad that we send our children to nurseries with runny noses where they amplify infections. It’s idiotic that many persist in believing you only get a cold because you’re “run down”, as if Louis Pasteur had never lived and the germ theory of disease was still up for discussion. It’s silly that people with colds go to parties and not only shake hands with but – increasingly, if they are under 30 – kiss strangers on first meeting.
A few weeks ago I had a bad cold so I delayed a trip to London, then refused to shake hands with anybody for 10 days. It was hard. People kept saying things like “Oh, I don’t get colds, I take vitamins”, or “I’ve had it already”, when there are 200 kinds of virus that cause the common cold and immunity is often temporary anyway.
Wearing a face mask when you have a cold or flu should become the norm as it is in Japan.
Let’s use this epidemic, however bad it gets, to change our habits not just temporarily but for good.
With 7.7 billion people on the planet, we are a very tempting target for new viruses and although we have interrupted many of the ways that they would like to spread, and are good at making vaccines, we are still subject to lots of respiratory infections that can occasionally kill us and will always inconvenience us.
We don’t need Big Brother to force cultural change on us; better that we do it voluntarily.