Pandemics: Historically Slow "Learning Curve" Leading to Biomedical Informatics and Vaccine Breakthroughs.

BACKGROUND: The worldwide tragedy of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic vividly demonstrates just how inadequate mitigation and control of the spread of infectious diseases can be when faced with a new microorganism with unknown pathogenic effects. Responses by governments in charge of public health, and all other involved organizations, have proved largely wanting. Data infrastructure and the information and communication systems needed to deal with the pandemic have likewise not been up to the task. Nevertheless, after a year of the worldwide outbreak, hope arises from this being the first major pandemic event in history where genomic and related biosciences - relying on biomedical informatics - have been essential in decoding the viral sequence data and producing the mRNA and other biotechnologies that unexpectedly rapidly have led to investigation, design, development, and testing of useful vaccines. Medical informatics may also help support public health actions and clinical interventions - but scalability and impact will depend on overcoming ingrained human shortcomings to deal with complex socio-economic, political, and technological disruptions together with the many ethical challenges presented by pandemics. OBJECTIVES: The principal goal is to review the history of biomedical information and healthcare practices related to past pandemics in order to illustrate just how exceptional and dependent on biomedical informatics are the recent scientific insights into human immune responses to viral infection, which are enabling rapid antiviral vaccine development and clinical management of severe cases - despite the many societal challenges ahead. METHODS: This paper briefly reviews some of the key historical antecedents leading up to modern insights into epidemic and pandemic processes with their biomedical and healthcare information intended to guide practitioners, agencies, and the lay public in today's ongoing pandemic events. CONCLUSIONS: Poor scientific understanding and excessively slow learning about infectious disease processes and mitigating behaviors have stymied effective treatment until the present time. Advances in insights about immune systems, genomes, proteomes, and all the other -omes, became a reality thanks to the key sequencing technologies and biomedical informatics that enabled the Human Genome Project, and only now, 20 years later, are having an impact in ameliorating devastating zoonotic infectious pandemics, including the present SARS-CoV-2 event through unprecedently rapid vaccine development. In the future these advances will hopefully also enable more targeted prevention and treatment of disease. However, past and present shortcomings of most of the COVID-19 pandemic responses illustrate just how difficult it is to persuade enough people - and especially political leaders - to adopt societally beneficial risk-avoidance behaviors and policies, even as these become better understood.

Unmasking the unmasked.

Facial maskings have been part of the human story since time began, and the reasons for their needs and the materials that went into their making would vary according to the reasons and materials available. The health-related needs took centuries to become established, but not until the germ theory of disease became recognized. The facial mask, seen as an essential defensive tool for prevention of respiratory transmitted disease continues to be the prime personal protective piece of equipment. With air-born contaminations, such as the present pandemic SARS- CoV-2 viral infestation, why would there be opposition to the use of this personal protective cover of our airways, when until an immunologic answer is available, it is the best single prevention we have. When supported with other measures, like distancing, washing and non-crowding, society would be much safer and secure, with probable less acute and drastic outcomes due to the spread of this virus.

Protection against severe infectious disease in the past.

Before the 20th century many deaths in England, and most likely a majority, were caused by infectious diseases. The focus here is on the biggest killers, plague, typhus, smallpox, tuberculosis, cholera, typhoid, dysentery, childhood infections, pneumonia, and influenza. Many other infectious diseases including puerperal fever, relapsing fever, malaria, syphilis, meningitis, tetanus and gangrene caused thousands of deaths. This review of preventive measures, public health interventions and changes in behavior that reduced the risk of severe infections puts the response to recent epidemic challenges in historical perspective. Two new respiratory viruses have recently caused pandemics: an H1N1 influenza virus genetically related to pig viruses, and a bat-derived coronavirus causing COVID-19. Studies of infectious diseases emerging in human populations in recent decades indicate that the majority were zoonotic, and many of the causal pathogens had a wildlife origin. As hunter-gatherers, humans contracted pathogens from other species, and then from domesticated animals and rodents when they began to live in settled communities based on agriculture. In the modern world of large inter-connected urban populations and rapid transport, the risk of global transmission of new infectious diseases is high. Past and recent experience indicates that surveillance, prevention and control of infectious diseases are critical for global health. Effective interventions are required to control activities that risk dangerous pathogens transferring to humans from wild animals and those reared for food.

Pandemics in New South Wales prisons: the more things change .

BACKGROUND: The current COVID-19 pandemic is not the first time New South Wales prisons have faced contagion. This paper examines the current responses in New South Wales prisons to the threat of COVID-19 to prisoner health, by contrasting contemporary activities with actions and policy developed during two historical epidemics: the influenza epidemic of 1860 and pandemic of 1919. METHOD: Epidemiological information relating to cases of disease in NSW prisons during the 1860 and 1919 influenza epidemics was obtained from the Comptroller-General's reports for the specific outbreak years and for the preceding and succeeding five-year periods. Additional archival sources such as digitised newspaper reports and articles available through the National Library of Australia were analysed for closer detail. The management of these outbreaks was compared to current strategies to mitigate against risk from the COVID-19 pandemic in the NSW prison system. RESULTS: Interesting similarities were discovered in relation to the management of the historic influenza outbreaks in NSW prisons and in the management of the current COVID-19 pandemic. An outbreak of influenza in mid-1860 impacted seven penal institutions in Sydney and Parramatta. Infection rates at these institutions were between 3.1% and 100%; the mean rate was 41.8%. The public health measures employed at the time included allowing 'air circulation freely night and day', and treatments that were 'tonical and stimulatory'. DISCUSSION: While the past 100 or more years have brought huge progress in scientific knowledge, public health approaches remain the mainstay of outbreak management in prisons; and, as in 1919, the opportunity for Australia to observe the rest of the world and plan for action has not been wasted. Prisons pose a potential risk for pandemic spread but they also present a unique opportunity for reducing disease risk by ironic virtue of the 'separate system' that was recognised even 100 years ago as characteristic of these institutions.

Public Health Interventions, Epidemic Growth, and Regional Variation of the 1918 Influenza Pandemic Outbreak in a Swiss Canton and Its Greater Regions.

Public health interventions implemented during the coronavirus disease 2019 (COVID-19) pandemic are based on experience gained from past pandemics. The 1918 influenza pandemic is the most extensively researched historical influenza outbreak. All 9335 reports available in the State Archives on 121 152 cases of influenza-like illness from the canton of Bern from 473 of 497 municipalities (95.2%) were collected; the cases were registered between 30 June 1918 and 30 June 1919. The overall incidence rates of newly registered cases per week for the 9 greater regions of Bern for both the first and second waves of the pandemic were calculated. Relative incidence rate ratios (RIRRs) were calculated to estimate the change in the slope of incidence curves associated with public health interventions. During the first wave, school closures (RIRR, 0.16 [95% CI, 0.15 to 0.17]) and restrictions of mass gatherings (RIRR, 0.57 [CI, 0.54 to 0.61]) were associated with a deceleration of epidemic growth. During the second wave, in autumn 1918, cantonal authorities initially reacted hesitantly and delegated the responsibility to enact interventions to municipal authorities, which was associated with a lack of containment of the second wave. A premature relaxation of restrictions on mass gatherings was associated with a resurgence of the epidemic (RIRR, 1.18 [CI, 1.12 to 1.25]). Strikingly similar patterns were found in the management of the COVID-19 outbreak in Switzerland, with a considerably higher amplitude and prolonged duration of the second wave and much higher associated rates of hospitalization and mortality.

Quarantine as a tool of epidemic fight.

Until the 19th century, the factor causing epidemics was not known, and the escape from a place where it occurred as well as isolation of patients was considered to be the only effective way to avoid illness and death. Quarantine in a sense similar to modern times was used in 1377 in Ragusa, today's Dubrovnik, during the plague epidemic. It was the first administratively imposed procedure in the world's history. It was later used in Venice and other rich port cities in the Mediterranean. On the territory of today's Poland, quarantine measures were used by the so-called Mayor of the Air - LukaszDrewno in 1623 during the plague epidemic in Warsaw. The quarantine left its mark on all areas of human activity. It affected all humanity in a way that is underestimated today. Throughout history, it has been described and presented visually. It is omnipresent in the world literature, art and philosophy. However, the isolation and closure of cities, limiting trade, had an impact on the economic balance, and the dilemma between the choice of inhabitants' health and the quality of existence, i.e. their wealth, has been the subject of discussions since the Middle Ages. Since the end of the 19th century, quarantine has lost its practical meaning. The discovery of bacteria and a huge development of medical and social sciences allowed limiting its range. In the 20th century isolation and quarantine no longer had a global range, because the ability to identify factors causing the epidemic, knowledge about the incubation period, carrier, infectiousness, enabled the rational determination of its duration and territorial range. The modern SARS COV 2 pandemic has resulted in a global quarantine on a scale unprecedented for at least three hundred years. The aim of this paper is to present the history of quarantine from its beginning to the present day, including its usefulness as an epidemiological tool.

Fatal Infectious Epidemics in Iran in the Last Two Centuries; What Lessons Can We Learn from Preceding Outbreaks? A Brief Historical Review.

In the past two centuries, several fatal infectious outbreaks have arisen in Iran. Presented here is a brief historical account of four fatal epidemics including cholera, plague, Spanish influenza of 1918 and smallpox between1796 and 1979. The lessons from these outbreaks could be helpful for better combatting other deadly epidemics including the present-day disastrous COVID-19 pandemic.

A brief introduction of Xiangya's anti-epidemic history in a century. / ç™¾å¹´æ¹˜é› æŠ—ç–«ç®€å².

Based on archival materials, the Xiangya's anti-epidemic history in a century from its establishment to 2020 is divided into 4 stages. The first stage (1906-1926), Edward Hicks Hume and YAN Fuqing, the founders of Xiangya, prevented and controlled smallpox and plague. The second stage (1929-1953), during the resumption of Xiangya, students prevented and controlled cholera, plague, dysentery, typhus, and other infectious diseases. In the third stage (1953-1999), in a peacetime, Xiangya actively fought against schistosomiasis, hydatidosis, malaria, leprosy, tuberculosis and other epidemics. The fourth stage (2000-2020), the era of Central South University. Medical staff in Xiangya fight SARS, influenza A (H1N1) flu, Ebola hemorrhagic fever, coronavirus disease 2019, etc. Over the past hundred years, Xiangya people joined together to spread benevolence and love, apply medical knowledge and skills, combat the epidemic and rescue people in difficulties, which made a great contribution to the motherland and the people.

What Went Wrong: Corona and the World after the Full Stop.

This article examines the global response to the Covid-19 pandemic. It argues that we urgently need to look beyond the virus if we want to understand the real seriousness of what is happening today. How did we end up in a space of thinking, acting, and feeling that has normalized extremes and is based on the assumption that biological life is an absolute value separate from politics? The author suggests that today's fear is fueled by mathematical disease modeling, neoliberal health policies, nervous media reporting, and authoritarian longings.

Pandemic COVID-19 Joins History's Pandemic Legion.

With great apprehension, the world is now watching the birth of a novel pandemic already causing tremendous suffering, death, and disruption of normal life. Uncertainty and dread are exacerbated by the belief that what we are experiencing is new and mysterious. However, deadly pandemics and disease emergences are not new phenomena: they have been challenging human existence throughout recorded history. Some have killed sizeable percentages of humanity, but humans have always searched for, and often found, ways of mitigating their deadly effects. We here review the ancient and modern histories of such diseases, discuss factors associated with their emergences, and attempt to identify lessons that will help us meet the current challenge.