A box, a trough and marbles: How the Reed-Frost epidemic theory shaped epidemiological reasoning in the 20th century.

The article takes the renewed popularity and interest in epidemiological modelling for Covid-19 as a point of departure to ask how modelling has historically shaped epidemiological reasoning. The focus lies on a particular model, developed in the late 1920s through a collaboration of the former field-epidemiologists and medical officer, Wade Hampton Frost, and the biostatistician and population ecologist Lowell Reed. Other than former approaches to epidemic theory in mathematical formula, the Reed-Frost epidemic theory was materialised in a simple mechanical analogue: a box with coloured marbles and a wooden trough. The article reconstructs how the introduction of this mechanical model has reshaped epidemiological reasoning by shifting the field from purely descriptive to analytical practices. It was not incidental that the history of this model coincided with the foundation of epidemiology as an academic discipline, as it valorised and institutionalised new theoretical contributions to the field. Through its versatility, the model shifted the field's focus from mono-causal explanations informed by bacteriology, eugenics or sanitary perspectives towards the systematic consideration of epidemics as a set of interdependent and dynamic variables.

Imagination and remembrance: what role should historical epidemiology play in a world bewitched by mathematical modelling of COVID-19 and other epidemics?

Although every emerging infectious disease occurs in a unique context, the behaviour of previous pandemics offers an insight into the medium- and long-term outcomes of the current threat. Where an informative historical analogue exists, epidemiologists and policymakers should consider how the insights of the past can inform current forecasts and responses.

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.