 I'm Jay Fidel. This is Think, Take, Away. And we're doing a lot of shows about important things these days. Today, we're going to do a show about the history of epidemics, which is very relevant to our time with our historian, our chief historian, if you will, John David Ann of HPU. Hi, John. Welcome back to the show. Hey, Jay. Great to be back. Yes. How are you feeling, Jay? I'm feeling fine. I have no temperature. I do not have a dry cough. And my lungs are just dandy fine. How about you, John? I'm feeling okay. I'm actually fighting a cold, but I'm pretty sure it's not the coronavirus. Yeah, don't breathe on the microphone, if you don't mind. And after the show, we're both going to wash our hands. Hey, this is the advantage of remote broadcasts. We invented it just every time. Everything is remote. Well, anyway, let's talk about history, because I think we forget sometimes, and it hits us in the eye like a pizza pie, and we don't realize that a lot of the strains and aggravations and frustrations and fears that we experience now with coronavirus have been present in other epidemics before. In fact, the history of humanity is rife with epidemics, academics and epidemics, all of them. Let's not confuse those two. There is a difference, I hope. Anyway, John, tell us about some of the early epidemics. Right, right. So the current, what is it? I saw a 60-minute show on the coronavirus last night, and one of the experts said, yes, we are in a pandemic now. The difference between an epidemic and a pandemic as an epidemic is regional or national, and a pandemic is global. So I think we are in a pandemic situation. You know, it's the coronavirus is quite contagious, death rates at, sorry, not to be crude about it, but mortality rates of anywhere between 0.4% and 4%. And so it seems terrible, right? It is, it's frightening, actually. There's no doubt about it, that it's frightening, and we're all scared. But when we look at the history of epidemics, then it's not that we take comfort in other people dying in the history of death from these epidemics. But honestly, I think it can kind of tamp down some of the fear that human beings survived some of the worst epidemics, the worst epidemics in the history of the world. Yeah, there must be a word for it. You take solace in the notion that there are others who have the same problem. It's like shot in Freud, but it's not quite, it's a little different than shot in Freud. It's like a historical empathy or something. You know, if we have more historical empathy, I think what we'll see is this is a true crisis, but we've been through a lot worse than this. So I think that the most famous of the epidemics, at least among historians, of course, is the Black Death. And the Black Death is otherwise known as the plague. And it was caused by a bacteria called pestis. And the plague was transmitted, I mean, it's very different from the coronavirus. Coronavirus is transmitted. It's a virus, first of all, that's transmitted in the air, and by germs sitting on tables and shaking hands, that kind of thing. The Black Death of the plague was caused by a flea, which had this bacteria on it. And the flea was transmitted by rats. The fleas would jump onto rats. And then when the rats got close to humans and the fleas would jump off the rats and jump onto human beings. And that's how human beings were infected with the plague. So, and of course, the origin of the plague is in the step region. We used to think it was China, but scholars have more information about this. They've actually been able to exhume plague-infested corpses in France, do DNA testing on them, get a better handle on what this bacteria actually looks like. And they've concluded that actually the plague started in somewhere in the steppe, the Eurasian steppe. This is the area today, Kazakhstan, Uzbekistan, the former Mongol Empire, which became a series of Khanates that run by the Genghis Khan's sons. So we think the plague originated there, and then it traveled with trade. And so the Silk Road actually became the major pathway for the plague to enter into the Middle East and then into Europe. So the plague came through the steppe region, ended up in Crimea, in the city of Kaffa. That's where the first major plague outbreak was. And the, believe it or not, the Mongols were actually laying siege to the city of Kaffa. And the plague broke out in their camp. And they, then, this is kind of gross, sorry, but they actually put their own corpses onto catapults and catapulted them into the city, beyond the city walls inside the city. And then the residents of the city got sick and they were able to conquer the city this way. Oh, that is gross. Yeah, that's disgusting. Man's humanity to man, for sure. And actually we've seen this over history that, especially in warfare, that conquistadors and soldiers have actually used things like smallpox-infested blankets and used them as kind of part of a military strategy to conquer these, conquer indigenous populations. So it happens again and again, and history is now it's not widespread. So there you see a picture, and this is one example of it. Actually, we don't know that the conquistadors, the Spanish conquistadors, including Cortez, actually used blankets that were infested with smallpox deliberately. But this is a picture of Aztecs who have been infected with smallpox, and you can see there in the picture the people are, they've got these big blotches on their skin and blisters, and your whole body develops blisters. You get blistered inside your mouth, and it's a very painful disease. And we think with smallpox that death rates were somewhere between 50 and 80 percent of, sorry, 30 and 80 percent, maybe even 90 percent of people died of smallpox, depending upon all kinds of conditions. So how did it come to an end? Were affirmative steps taken to stop it? Did we learn anything? Yeah, so with smallpox we developed a vaccine. And today, actually, there's hardly any smallpox because people get vaccinated against the disease. But the disease still exists. And astonishingly, some people have decided not to get the vaccine. And so the smallpox is kind of having a little bit of a comeback because people are worried about getting these vaccines. And you know, this is how you prevent epidemics is with these vaccines. But back to the Black Death. So when we look at the smallpox, it's 30 to 80 percent death rate. It's similar, actually, for the Black Death. So the Black Death actually comes into Europe through the port of Kaffa. And then rats, of course, there's lots of shipping going on between Kaffa and other parts of the end of the Silk Road, the European end of the Silk Road. And so these ships sail into European ports. They sail into Genoa. They sail into, so the plague gets into Italy. They sail into the ports in Spain and Portugal. And so the Spanish get the plague. And then there are ships that go to England and France. And then it spreads. So it spreads really being. What are we talking about, the 14th century? That's correct. 1349 is really when the plague decimates Europe. And so it spreads via shipping routes. And then it also spreads from shipping from port cities into countryside areas, because there's lots of trade going on between these large cities and small towns and villages in Europe. And interesting, so we're talking about maybe up to 60 percent of the population of Europe dies from the plague between 1349 and 13, about 1351-52. Why not everybody? Well, so not everybody was exposed to the rats and the fleas, right? Not everybody had the fleas jump onto them. That was really the primary transmission route. So if you didn't have fleas, if you were clean yourself very well, then you were not likely to get the plague. So 90 percent of the population of Europe is rural in this time period. And that means that most of the deaths took place, not in cities, but in the countryside. So this is kind of a surprise. We usually, we assume it was about contact, right? And so in crowded cities, then you'll have more contact. And this is how the plague spread. Well, that's not the way the plague spreads. So, and in fact, Europeans in cities thought this might be how it spread. And so shopkeepers closed up their shops and, you know, this kind of thing, kind of contact-oriented and isolation-oriented measures like we're doing today with, some places are doing today with the coronavirus, but it really didn't work with the plague because people didn't understand the mode of transmission. Now, there were some people who understood it better and they, for instance, corpses were burned. The clothing that sick people wore was burned. But, you know, those who treated patients, of course, the fleas could jump onto you and then you're going to get the plague and you're probably going to die from this. So, but the plague, of course, it's the worst. I mean, it sets Europe back by maybe 300 years. Europe at that time in the 1300s is actually experiencing a population explosion. There was the rise of kind of merchant cities and then small towns and tradesmen and farmers who were actually beginning to sell their products to commercial areas. All of this stopped with the plague. There were maybe a thousand villages in England that were decimated and actually just basically depopulated completely. So, so the plague is very interesting. One might ask the question, well, how do I know this? I mean, you know, it was a long time ago. Actually, there were, we know this from censuses that were taken in that time period. And also in the countryside, manorial registers were done, birth records, this kind of thing. So, the data is actually better than one would assume in terms of this, the black death of the 1340s. Well, you know, I can imagine it's hard to put us back there, you know, real time. But, you know, right now, I came from a lunch where everybody in the restaurant was talking about coronavirus. I mean, really. Right, right. Not even politics came close, everything as coronavirus. And I suppose back in the day, in the plague day, they talked about the plague all day. It was the one thing that dominated their lives. They had to figure out what was going on. They had to survive. They had to commiserate over those who didn't survive. So, I'm sure it occupied the same, you know, 99% of your conscious thought than as it does now. Yeah, I think so. But maybe the big difference is, you know, the question of why, right? The question of the cause of it. Yeah. Since Europeans really didn't understand the cause of the plague, they didn't have any concept of bacteriology at that point in time. I mean, you know, their cure for illness was, well, let's, let's bleed the person, right? So, which caused a lot more misery than, you know, solve the problem. But it probably motivated at least some people to make inquiry, maybe not immediately because the technology wasn't up to it. But as time went on, people could remember well enough what happened with the plague so that they, you know, put some effort into trying to figure out more about medicine in general. Yes, of course, this happens eventually. I'm not sure it's the plague so much. I mean, honestly, the most people in Europe in this time period put the plague up to an act of God. God's angry with us. Therefore, he's punishing us. Why don't Eric, why don't we bring up the picture of the dance of death? There it is. So, Jay, this was a common representation of the plague. There were a number of these drawings that were done. And, of course, the thing about the plague is that it affected everyone. It killed aristocracy, it killed kings, and it killed commoners. And this image is known as the dance of death. And in the dance of death, everyone was equal. Yeah. Well, that still exists today with the coronavirus. Everybody's subject to it. But what I find interesting is a vice president, you know, suggests that the power of prayer, you know, we can deal with this through the power of prayer. And that goes back to the dance of death, doesn't it? It's really fundamentally no different than explanations for the Black Death in the 1300s that was put up to the God's punishment for misdeeds. So yeah, I mean, some of this, you know, when people get afraid, I wouldn't depend upon their rationality at this point, right? Fear is its own thing and it produces some pretty crazy outcomes. But what's your next epidemic? Let's talk about your next one, because certainly it doesn't stop at the plague. Right. So the Black Death is really horrible for Europe and it sets Europe back this tremendous amount. But really smallpox, when we look at smallpox historically, smallpox is a disease that Europeans develop immunity to. And then when the Europeans begin to travel in the late 1400s, Columbus in 1492, and then lots of Europeans in the 1500s, then the smallpox is one of those diseases which is transmitted to the New World. And as we saw in the picture, and there it is again, the victims of the Aztec victims of smallpox. And so, and New World peoples have very few diseases. They don't, we think they've lacked even the common cold. So when their immune systems are exposed to the smallpox, they have no defense to this smallpox, measles, other kinds of diseases, and the flu, which Europeans would survive pretty easily. But honestly, the Native Americans died in droves. So we're talking about over, over about a century, we're talking about a depopulation of up to 90% in the New World. So we think the New World population was enormous. The indigenous peoples of North and South America might have been in the range of 80 to 100 million people. And, and within a century, they're that population is down to less than 10 million. So this is, you know, when we think about the European conquest of the New World, we usually think about it in military terms or, you know, cultural terms, economic terms, actually disease is the biggest factor in this conquest. When the Aztecs began their fight against Cortez, about three months after they began the active military, you know, action against Cortez, the small, smallpox broke out in their, in, in Tenochtitlán, the big city that they were trying to defend. And sure enough, you know, they were decimated by it was probably the biggest reason why Cortez was so easily able to overcome the Aztecs. I mean, he had 200 warriors for heaven's sakes. And they had, you know, they had armies in the thousands. So it's disease. I mean, it's a simple explanation, but it's a really powerful explanation. So a small note to that is a wasn't smallpox one of the diseases, perhaps the main disease that raged through the native Hawaiian community and population in the 19th century brought from Europe and the East Coast. Exactly. So it's not like these disease vectors end, you know, with, with Cortez or with, or a century later, you know, with the depopulation of North and South America, that Europeans can continue to spread these diseases. And, you know, it's devastating, you know, and yes, in the, you know, in the Pacific, the 19th century is well, there's actually we have some evidence that even at the time of Captain Cook, there are diseases, especially venereal diseases. And so they're spreading. And then in the 19th century, you have these other European diseases that that decimate the Pacific population here in Hawaii. We think there were up to maybe half a million, maybe 400,000 native Hawaiians who lived in the Hawaiian Islands. And by the late 19th century, this number is minuscule by comparison. It's maybe it's under, I think it's under 20,000 at this point. So yeah, yeah, yeah, it's, it's, this is a, it's kind of an it's, it's, it's a topic, it's a topic that has a lot of study among historians. But honestly, I think the general public doesn't think about it much. So I think when I get out of this, at least so far in your discussion, is the word endemic occurs to me, which is, which means after you've finished with the pandemic, and now it's like inculcated into the species, it goes on and on and on forever. And we, we as a species learn to deal with it. And I, and I think that's where we are today, isn't it? We have learned from each one of these epidemics. Right. So I mean, in the 19th century, then Europeans begin to figure out that these diseases are caused by pathogens, bacteria, viruses, you have the development of knowledge about these things. And this makes a huge difference. The beginnings of this actually, you can kind of date this to the 1850s in London, which had a massive cholera outbreak. And a doctor there named John Snow rejected the prevailing assumption which was cholera was caused by bad air. A miasma is what it was called. And, and this was, this was the most widely accepted explanation for cholera. Snow said, no, that doesn't make sense to me. So he actually did a study of the households where people died, linked them to a water pump, a well that was right in the middle of this square. And then they dug up the well, found that there were some bricks missing from the well, and there had been intrusion from a house next door in which a sailor from India had come, had brought cholera and had died from cholera in that house. And of course, the house had its own septic system within the house. And that had leaked into this well and caused this cholera outbreak. So Snow is actually instrumental in helping us to understand how he was an early, maybe the earliest epidemiologist helped us to understand how this disease spread. And of course, this is crucial for our understanding of all kinds of diseases today, including the coronavirus. How do these things spread? How can you, you know, identifying those who have become sick is baseline. And this is what John Snow did in the 1850s cholera outbreak in London. It sounded like a repeating pattern, though, John. In other words, here we are with coronavirus and everybody says, you know, the common person says, wait a minute, this is the 21st century. We have science. We can deal with this. We have, we can, we can splice the genes. We can, you know, do, we can, we can learn everything and make chemistry that nobody could make before. Why are we having this? We shouldn't be having this. But you know what? I think back in the old day for all these earlier epidemics, it was a similar process. We've had this before. Let's try out what we did before and see if we can stop this one. But it was always different. That's the problem. It's always different and science at the time cannot necessarily catch it. Well, look, we're a lot better prepared now than they, than, for instance, Londoners were prepared in the 1850s. So, so, you know, it's, it's kind of hard to compare that. But, but so our preparation is much better, but we're still humans. We still react in strange ways. I mean, you know, I'll admit myself when I, when this first started thought, ah, let's not worry about, we're overreacting to this, right? And actually, now I think, maybe we're not overreacting to this in the public health community is right, that we should have, we should have had more testing in the United States earlier. We should have had more rigorous identification of folks who are coming into the country and more, you know, kind of trying to stop it at the borders kind of thing. Well, that's another historical thing that seems to repeat itself. Most of these epidemics, they have their way with us. They have their way and they, they kill a lot of people before they really get our attention. Only when they get our attention, you know, and then they either, you know, burn themselves out by some sort of magical process, which we don't fully understand. Or we, we finally, after being frightened for our lives, we finally developed the medicine. I mean, you could probably find this path, this combination of phenomenon, a phenomenon on every one of these things, same kind of thing. First, they burn themselves out, then we figure it out later. Well, Jay, let's, let's do a 20th century example. For instance, the Spanish flu of 1918. Now, this is the flu, which is maybe similar to the coronavirus. But the thing about the Spanish flu is it happened during World War I, and you have lots of camps with soldiers in them, and you have soldiers at the front. So you have these natural breeding grounds for the Spanish flu. So the Spanish flu was devastating. We think that up to 50 million people died from the Spanish flu. Made somewhere between, well, at a low, maybe 5% at a high, maybe even 20% of, of those who contracted the flu actually died. So, and the difference with the Spanish flu is that it affected young people and infants, as well as, you know, middle-aged people. And it didn't affect older people as badly. But so, you know, part of it is, as a community, what do we know, and how do we respond to what we know? Well, at least, at least we're not, you know, at least we know enough now that we don't, we're trying to prevent people from congregating in, in spaces where there's a lot of people in very tight places, which is what happened in the Spanish flu. But, you know, as I said, people get afraid that, you know, that, you know, the president, of course, is worried about economic consequences. So he downplays it. I mean, but it's a, it's, it was unfortunate. Look, it's, when the president says, oh, it's a hoax, you know, made up by the Democrats, this is not good. This is, this is actually bad for those who are actually, you know, public health officials and those who are actually trying to prevent and slow down this epidemic. So that actually is how epidemics happen is when people don't take it seriously enough. Well, there's a takeaway and we're almost out of time. So we, we should deal with the takeaway here. Given all the historical background we have, which is not complete, I think, some of these things happen, you know, way back before it was possible to write them down. But given all the background we have, what, what is the best, the best state of mind, the best approach from all that we've learned by the government, those who lead us and by the individuals who are ultimately the victims. Right. So, you know, I think what we can learn from the history is that, hey, we've been through this before and fear doesn't help. And we've been through a lot worse than this and we survived it. So we're going to survive this. I think, you know, let's, let's work on our common sense. Let's listen to the experts. We live in an age of science. So thinking that somehow this is an act of God, that's, you know, that's nonsense thinking. Okay. So let's, let's let the scientists do the, you know, the experts do the talking and, and follow their advice and, and we'll get through this. So to me, that's the biggest thing is that, you know, we have to understand that we've been through this before. And, and we've made a lot of those same mistakes before. And, and we really need to pay attention to our public health community. So yeah. And to rise above it, because you keep using the term we, and I think you mean in that context, we the, the species, we the community, we the, the nations of the world. And we may not include you and me because we could be victims. And so you have to think larger than your own self. Yeah, let's not use this for political game. Okay. This is going to affect Democrats and Republicans the same way. Let's, let's not do that. Let's actually treat this for what it is. It's a very serious virus and, and we want to protect people. And, and, and, you know, I think we can get through this thing if we work together. Here, here. Thank you, John, David and always appreciate your perspective and, and your lens of history. Thank you so much. You are welcome, Jake. Aloha. Now go wash your hands.