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Closing borders would be of no benefit either. It would be impossible to shut down trade, prevent citizens from returning to the country etc. That would shut down the entire economy and magnify any supply chain problems – including health-related goods (PPE!). Barry’s statistics suggest that 90% efficiency of a border closure delays the pandemic by a few weeks, and a 99% efficient closure by about a month. (Obviously, governments have put the economies into an induced coma, thereby causing a demand and supply shock. They now need to resuscitate the patient and hope that not too much damage has been done).


That leaves the individual the task of washing their hands (we’ve heard that one and it still seems a key defence!). He says, discipline on this across society does make a large difference. Surgical masks are next to useless except in very limited circumstances. Putting a mask on a sick person is most effective as it contains droplets otherwise expelled. N95 masks for professionals do help, assuming they are worn properly (This seems in line with current guidance). Other recommendations are simple. Keep sick children away from school and sick workers at home. Exercise ‘cough etiquette’ – cough and sneeze into your elbow and not the hands. Use of telecommuting is sensible, where viable.


In a truly lethal pandemic, authorities might take more aggressive steps – closing theatres, bars, restaurants and maybe banning sports events (the actions of current Governments in these areas will be the subject of scrutiny and argument for years, I suspect).


The most controversial NPI is closing schools. The argument for closure is that children are careless with regards cross-contamination protocol. They spread it amongst themselves and then on to adults. However, closing schools places an economic burden on working parents, as it has to be sustained for weeks. This might make sense in a lethal pandemic, but not in a mild one.


Data from 1889, 1918 and 1920 undermines the belief that children are ‘super-spreaders’ of influenza. It showed that the first cases in 80-85% of households were adults. The data also suggested that it was adults who spread the disease to children. CDC investigators, when presented with this said, ‘I don’t believe the data’ even though the data was collected by solid epidemiologists.


Finally, for NPIs to be effective the public has to comply with recommendations and sustain this for a period. That will be difficult. Surveillance and monitoring of the virus remain critical throughout.


Problems presented by a pandemic are immense, but the biggest problem lies in the relationship between governments and the truth! This requires political leaders to understand the truth and then to be able to handle the truth. The lesson from 2009 is that too many governments were incapable of doing this.


Most governments worldwide had prepared plans for a pandemic, as did the WHO. They were reasonable plans and tried to limit the role of ‘personality’ by laying out explicit steps. Too many political leaders ignored the plans (Mexico, China, Egypt, France all made irrational moves). Emotion is not the absence of reason; emotion corrupts reason. The human factor, the political leadership factor, is the weakness in any, and every, plan.


There was real terror afoot in 1918 as the randomness of death hit home. So did its speed. But it was public officials and the media that helped to create that terror, not by exaggerating the disease but by minimizing it – by trying to reassure. The dominant lesson from 1918 is that governments need to tell the truth in a crisis. Current fads for ‘risk communication’ imply managing the truth.


Terror rises in the dark of the mind. Horror movies build upon fear of the unknown, the threat we cannot see and cannot hide from. But once the monster appears, the terror diminishes. Fear remains but the edge of panic from the unknown dissipates. The power of imagination dissipates.


In 1918 the public could trust nothing and so they knew nothing. Society is ultimately based on trust. As trust broke down people became alienated from each other and authority (this perhaps starting to happen in the USA during COVID19).


So, the final lesson of 1918, a simple one yet one most difficult to execute, is that those who occupy positions of authority must lessen the panic that can alienate all within a society. Society cannot function if it is every man for himself.


Graham Pattle E: graham.pattle@outlook.com


Published June 2020


(Copyright © John M. Barry, 2004, 2005, 2009, 2018. Barry, John M. The Great Influenza. Penguin Publishing Group.)


35 | ADMISI - The Ghost In The Machine | Q2 Edition


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