Ever since the devastating 1918–1919 influenza pandemic, policy makers have employed mathematical models to predict the course of epidemics and pandemics in an effort to mitigate their worst impacts. But while Britain has long been a... more
Ever since the devastating 1918–1919 influenza pandemic, policy makers have employed mathematical models to predict the course of epidemics and pandemics in an effort to mitigate their worst impacts. But while Britain has long been a pioneer of predictive epidemiology and disease modellers occupied influential positions on key committees that advised the government on its response to the coronavirus pandemic, as in 1918 Britain mounted one of the least effective responses to Covid-19 of any country in the world. Arguing that this ‘failure of expertise’ was the result of medical and political complacency and over-reliance on disease models predicated on influenza, this paper uses the lens of medical history to show how medical attitudes to Covid-19 mirrored those of the English medical profession in 1918. Rather than putting our faith in preventive medicine and statistical technologies to predict the course of epidemics and dictate suppressive measures in future, I argue we need to c...
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420 www.thelancet.com Vol 391 February 3, 2018 These days you would have to be peculiarly immune to public health messaging not to know that the world is on the brink of an antibiotic apocalypse. From the back of pill packets to the... more
420 www.thelancet.com Vol 391 February 3, 2018 These days you would have to be peculiarly immune to public health messaging not to know that the world is on the brink of an antibiotic apocalypse. From the back of pill packets to the panels on the back of buses, prompts urging us to “keep antibiotics working” are almost as ubiquitous as the drug-resistant microbes themselves. Although medical experts have been warning about the indiscriminate use of antibiotics since the 1940s, their consumption continues to grow. This is not only a problem in countries like South Africa and India where antibiotics are widely available over the counter. In the UK, where doctors are supposed to act as gatekeepers and guardians of antibacterial therapies, it is estimated that nearly half of people aged 15–24 years have taken antibiotics not meant for them, and that one in four general practitioners’ prescriptions may be unnecessary. These prescribing practices and patients’ apparent complacency have grave consequences: antibiotic resistance accounts for about 70 000 deaths per year worldwide and is projected to be 10 million in 2050. As Superbugs, an exhibition at the Science Museum in London declares, we are engaged in “the fight for our lives”. Antibiotics are essential for everything from hip replacements to organ transplants to treatments for common communicable diseases. If penicillin and other antibiotics had existed in 1918, it is unlikely that in excess of 50 million people would have perished from the “Spanish” influenza pandemic and the opportunistic lung infections that followed in its wake. But today such a tsunami of deaths is no longer unthinkable and antibiotic resistance has joined influenza on WHO’s watch list of pandemic risks.
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Reflecting on his scientific career toward the end of his life, the French-educated medical researcher René Dubos presented his flowering as an ecological thinker as a story of linear progression-the inevitable product of the intellectual... more
Reflecting on his scientific career toward the end of his life, the French-educated medical researcher René Dubos presented his flowering as an ecological thinker as a story of linear progression-the inevitable product of the intellectual seeds planted in his youth. But how much store should we set by Dubos's account of his ecological journey? Resisting retrospective biographical readings, this paper seeks to relate the development of Dubos's ecological ideas to his experimental practices and his career as a laboratory researcher. In particular, I focus on Dubos's studies of tuberculosis at the Rockefeller Institute in the period 1944-1956-studies which began with an inquiry into the tubercle bacillus and the physiochemical determinants of virulence, but which soon encompassed a wider investigation of the influence of environmental forces and host-parasite interactions on susceptibility and resistance to infection in animal models. At the same time, through a close readi...
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In 2014 the World Health Organization (WHO) was widely criticised for failing to anticipate that an outbreak of Ebola in a remote forested region of south-eastern Guinea would trigger a public health emergency of international concern... more
In 2014 the World Health Organization (WHO) was widely criticised for failing to anticipate that an outbreak of Ebola in a remote forested region of south-eastern Guinea would trigger a public health emergency of international concern (pheic). In explaining the WHO's failure, critics have pointed to structural restraints on the United Nations organisation and a leadership 'vacuum' in Geneva, among other factors. This paper takes a different approach. Drawing on internal WHO documents and interviews with key actors in the epidemic response, I argue that the WHO's failure is better understood as a consequence of Ebola's shifting medical identity and of triage systems for managing emerging infectious disease (EID) risks. Focusing on the discursive and non-discursive practices that produced Ebola as a 'problem' for global health security, I argue that by 2014 Ebola was no longer regarded as a paradigmatic EID and potential biothreat so much as a neglected tro...
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From his sick bed in Manchester town hall Lloyd George could just make out the tops of the plane trees lining Albert Square and, below them, the statue of John Bright dripping with constant rain. It had been raining for five long days... more
From his sick bed in Manchester town hall Lloyd George could just make out the tops of the plane trees lining Albert Square and, below them, the statue of John Bright dripping with constant rain. It had been raining for five long days now. The small group of well-wishers standing vigil outside the Prime Minister’s bedroom had little doubt that the weather was the cause of his illness.
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On 24 June 1918 the young war poet Wilfred Owen crawled into his Army-issue bell tent in a windswept field near Scarborough and began composing a letter to his mother. Then a 20-year-old lieutenant in the Second Manchesters, Owen had just... more
On 24 June 1918 the young war poet Wilfred Owen crawled into his Army-issue bell tent in a windswept field near Scarborough and began composing a letter to his mother. Then a 20-year-old lieutenant in the Second Manchesters, Owen had just been deemed fit for duty after a lengthy convalescence in Scotland following an attack of neurasthenia, a nervous condition brought on by the stresses and strain of the war. But as Owen waited in North Yorkshire for the orders that would return him to France and the Front his thoughts were seemingly on another disease entirely.
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Social historians have argued that the reason the 1918–19 ‘Spanish’ influenza left so few traces in public memory is that it was ‘overshadowed’ by the First World War, hence its historiographical characterisation as the ‘forgotten’... more
Social historians have argued that the reason the 1918–19 ‘Spanish’ influenza left so few traces in public memory is that it was ‘overshadowed’ by the First World War, hence its historiographical characterisation as the ‘forgotten’ pandemic. This paper argues that such an approach tends to overlook the crucial role played by wartime propaganda. Instead, I put emotion words, emotives and metaphors at the heart of my analysis in an attempt to understand the interplay between propaganda and biopolitical discourses that aimed to regulate civilian responses to the pandemic. Drawing on the letters of Wilfred Owen, the diaries of the cultural historian Caroline Playne and the reporting in the Northcliffe press, I argue that the stoicism exhibited by Owen and amplified in the columns ofThe Timesand theDaily Mailis best viewed as a performance, an emotional style that reflected the politicisation of ‘dread’ in war as an emotion with the potential to undermine civilian morale. This was especi...
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A few weeks after the terrorist attacks on the World Trade Centre and the Pentagon a series of letters containing an innocuous looking beige-coloured powder arrived at the offices of United States Congressman Tom Daschle. Containing... more
A few weeks after the terrorist attacks on the World Trade Centre and the Pentagon a series of letters containing an innocuous looking beige-coloured powder arrived at the offices of United States Congressman Tom Daschle. Containing spores of Bacillus anthracis that ...