How we beat tougher foes than COVID-19
The Spanish Flu, World War Two, The Depression, SARS and AIDS all challenged Australia in incredible ways, and yet we prevailed. Here’s what history can teach us for our current fight.
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From the Spanish Flu and the Depression to two world wars and the HIV and SARS epidemics, if there is one constant we can say about history, it’s that most of the time, we learn our lessons the hard way.
Here are some of the most difficult but valuable lessons we learnt from those tough times.
WHAT WE LEARNT: The value of ‘making do’
WHEN WE LEARNT IT: The Depression and the world wars
Mending clothes. Growing veggies. Keeping chickens. ‘Making do’ was a necessity for most people in Australia during the wars and the Depression, said Associate Professor Richard White, from the University of Sydney history department.
“There was a lot of bartering and sharing of produce, and in the Depression, a bit of communal gardening, where free land would be used to grow food that people couldn’t otherwise afford to buy.
“A lot of that went on during the war too. Where there were shortages, people found other ways to fill those shortages and altruistic ways of sharing those things.”
WHAT WE LEARNT: Mass gatherings are a killer
WHEN WE LEARNT IT: Spanish Flu epidemic
In late September 1918, hundreds of sailors in the US port city of Philadelphia had come down with the Spanish Flu, but authorities allowed a Liberty Loan Parade to go ahead on September 28. Within days, the city’s infection rate doubled, and shockingly, 12,000 people died within six weeks.
Fortunately for Australia, warnings reached our shores in time.
“By late 1918 we were having reports coming from the United States and from New Zealand of how their health systems were coping or not coping and what measures did or didn’t seem to be working,” said Dr Peter Hobbins, Adjunct Fellow in History at the University of Sydney. “By October 1918 when ships carrying cases of pneumonic influenza arrived … we were very aware of how dangerous it was, and we had a very rigid maritime quarantine system (in place).”
WHAT WE LEARNT: Not everybody is a saint in tough times
WHEN WE LEARNT IT: The Depression and World War Two
“Human nature stretches from generosity and altruism to fairly self centred and fairly nasty actions as well,” said
Assoc Prof White. “You see that in both the Depression and the Second World War. Although you hear about the Aussie spirit in both times, there was also a lot about profiteering and a big black market. There were people trying to scam the system. Some people saw a way of making money and exploiting the situation.”
WHAT WE LEARNT: Bipartisanship makes a difference
WHEN WE LEARNT IT: Second World War, HIV epidemic
It’s amazing what can be achieved in politics when parties call time out on point scoring. Although Australia never formed a coalition government during the Second World War, as Winston Churchill did in Britain, there was a high degree of bipartisanship, said Assoc Prof White. “There was some fraying at the edges, but a fair degree of the two parties being in synch.”
Adam Carr, a founding member of the Victorian AIDS Council (and history PhD), said political consensus around the politically dicey matters that surrounded HIV (such as needle exchange programs) was achieved, “although in practice it was sometimes difficult”. While the Hawke Labor government was strong in its response to the threat of AIDS, he said, “the Liberal opposition was fairly backwards and forwards, depending on who was the leader and who was the shadow minister.”
WHAT WE LEARNT: An independent expert can make a difference
WHEN WE LEARNT IT: HIV epidemic
One of the most striking features of the coronavirus crisis in Australia to date has been the open questioning of government strategy, with widely-divergent opinions on measures such as closing schools, and how tight our lockdowns should be. The criticism reached a zenith just a couple of weeks ago when thousands of doctors signed a petition calling on the federal government to implement a national lockdown – contrary to the advice of the government’s Chief Medical Officer, Dr Brendan Murphy. Those calls for ever-tighter measures have lost their edge somewhat as Australia seems to have avoided the sort of public health catastrophe we’ve seen in other countries. But you can bet that the criticism of government strategy will rev up again soon, as people question the need for continued control measures; those debates may be even more impassioned as business leaders add their voices to the mix, demanding a loosening of restrictions for the sake of the economy.
Adam Carr said Dr Murphy occupies a very different role to Professor David Penington during the AIDS epidemic.
“Penington’s position was different because he wasn’t from the government; he was an independent expert who was put in charge of the AIDS task force,” Dr Carr said.
“He was a professor of medicine, he wasn’t a public servant. He played a very positive role and no one seems to have emerged yet in Australia to occupy that role [with coronavirus]. It’s still the politicians who are doing most of the talking, and people’s willingness to believe what politicians tell them is not great.
“They don’t seem to have thought it was appropriate this time to appoint an independent medical body to offer leadership on this pandemic; they’re relying on the government’s health officers.
“Brendan Murphy is not in the same position Penington was in, and that’s maybe to his disadvantage. A public servant can’t come out and say ‘No, the PM is wrong’ whereas Penington could and did do that. Penington did say ‘Whatever Minister X said isn’t correct, this is what the truth is’. So far in Australia there is no one in a position to do that.”
WHAT WE LEARNT: Health services personnel need the greatest protection
WHEN WE LEARNT IT: SARS outbreak in 2003
The threat of Severe Acute Respiratory Syndrome (SARS) gripped the world in 2003, but it was a minnow compared to the monster that is coronavirus. According to the World Health Organisation just over 8000 people became infected across the globe, and 774 died, including many health services staff. In a report on the outbreak, WHO noted: “The people at greatest risk for SARS were health workers who either became infected by close face-to-face contact with patients or by procedures that brought them into contact with respiratory secretions”. Among the health experts to die was the Italian doctor and microbiologist who first identified the virus, Carlo Urbani. “Weaknesses in health systems can permit emerging infections to amplify and spread, and can compromise patient care. The strengthening of health systems thus deserves high priority,” WHO noted in its report.
WHAT WE LEARNT: Secrecy is a killer
WHEN WE LEARNT IT: SARS outbreak in 2003
The first cases of SARS were reported in China’s Guangdong province in November 2002, but China did not inform the World Health Organisation until February 2003 – a delay that resulted in thousands of needless infections. In its report on that outbreak, WHO said prompt and open reporting of any disease with the potential to spread internationally was the “first and most compelling lesson” of SARS. “Attempts to conceal cases of an infectious disease, for fear of social and economic consequences … carries a very high price,” they noted. Unfortunately this lesson was not fully learnt by Chinese officials dealing with COVID-19, who reprimanded the doctor who first aired his concerns about coronavirus over social media. But Beijing did at least get a little bit quicker at alerting global health authorities. With the first reported cases happening around November 17, China alerted the WHO on December 31, six and a half weeks later.
WHAT WE LEARNT: People don’t always tell the full truth about their behaviour
WHEN WE LEARNT IT: SARS and HIV outbreaks
Contact tracing is an essential part of controlling the spread of viruses, but people don’t always tell the full truth about where they have been or their risk factors, warned Professor Mary-Louise McLaws from the University of NSW.
“We learnt this during SARS in 2003 and with HIV in the early days. People often didn’t want to divulge their risk factors to those that were asking them,” she said.
During SARS, “it took a while sometimes for the real exposure to be found. There has to be a very sympathetic and non-judgemental method of asking people where their contacts were, and asking them away from their family, and asking them on a very very confidential basis, so that we can identify that larger group with local acquisition.”
WHAT WE LEARNT: Fear and fatigue will both have an impact
WHEN WE LEARNT IT: HIV epidemic
Anybody who remembers the AIDS epidemic Down Under will recall the Grim Reaper ads, the chilling 1987 TV commercial which prompted so much hysteria it was eventually pulled from the airwaves.
Fear of infection is a powerful motivating force – as it is now with coronavirus – but Adam Carr said behaviour change in the time of AIDS was also made possible because of positive information campaigns to people about how they could protect themselves.
When HIV activists first started looking at ways to educate people about the virus, he said, “we had far too much medical jargon and we thought we had to teach people virology, which turned out not to be true”.
“People wanted a simple basic message, which was use a condom every time, that’s what it boiled down to, and we were able to make that message stick.”
The public health messages with coronavirus are both more simple and more complicated, he said, but compliance fatigue will become a factor, as it was with safe sex.
“Fear is obviously driving a lot of people to do the necessary thing to avoid infection, which in this case is to go home and stay there,” he said. “This will need to be reinforced. It will weaken over time, as it becomes more inconvenient. People are going to have to make a balance between ‘Is it more dangerous for me to go to the supermarket when I’ve run out of milk to feed my children, or is it better to sit at home with no milk?’ People are going to have to make those judgments.”
WHAT WE LEARNT: It’s not over until it’s over
WHEN WE LEARNT IT: Spanish Flu epidemic
Health authorities in Victoria made a crucial mistake in their response to the 1919 Spanish Flu pandemic, said Melbourne University PhD student Mary Sheehan.
After an initial batch of cases in January, numbers dwindled in March, leading the state government to shut down 15 emergency hospitals and stop the mandatory reporting of new infections.
But the virus was not done. A second and bigger wave of infections hit in April, overwhelming the health system and forcing the authorities to reactive the hospitals. A third wave came a few months later.
WHAT WE LEARNT: Good things can come from bad times
WHEN WE LEARNT IT: Every time
It bears repeating that this is not the first time in history when a group of people thought life as they knew it was about to end. During World War Two, the threat of annihilation at the hands of Germany and Japan was a nightly reality.
But so was a wartime spirit, characterised by community co-operation, altruism, self-sacrifice and resilience.
“In the Depression and the Second World War that idea of resilience was very strong,” said Assoc Prof White. “Alongside that there were people whose mental health really suffered. Presumably we will see that range of responses happening again: a lot of people will find resilience they didn’t know they had, whereas other people might find it more traumatic.”
Research on those eras finds a somewhat unexpected but recurring theme of positivity, he said.
“Often people looking back say it was quite a happy time in that families did come together, they did find things to do together,” Assoc Prof White said.
“A lot of them are looking at the past with rose coloured glasses and so on, but I think with both the Depression and the war, it was possible to find joy and enjoyment and love and positive emotion as well.
“It wasn’t always all bleak.”
Originally published as How we beat tougher foes than COVID-19
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