How Have We Responded to Previous Pandemics?

27 May 2020. Updated 16 June 2020.

As we tot up the unintended consequences of lockdowns across the world, it’s worth bearing in mind that the quarantining of entire countries for extended periods of time is a new and untried strategy for managing a pandemic. Historically, there are very few examples of lockdowns being used before. The earliest historical example I can find is Florence in 1631, when an outbreak of the plague killed 12% of the population. More recently, Mexico in 2009, during the first days of an H1N1 influenza outbreak, isolated those suspected of being infected, closed schools, banned public gatherings and cancelled a regional soccer tournament. But those measures weren’t replicated in other countries and Mexico abandoned them after 18 days, partly due to the mounting social and economic costs.

We’re often told by lockdown enthusiasts that those US cities that introduced extreme social distancing measures during the Spanish flu pandemic experienced fewer deaths than those that didn’t. But those measures stopped well short of a full lockdown. For instance, in St Louis, which is often held up as a model of how to manage the current pandemic, churches and schools were closed, business hours were restricted and people were ordered to wear mask in public, but the city never issued a stay-at-home order and only cancelled business activity entirely for about forty-eight hours.

Also worth noting that lockdowns weren’t even suggested during America’s deadliest bouts of seasonal flu since 1919. In 1967-68, flu killed about 100,000 Americans and in 1957-58 it killed about 116,000. As of yesterday, the COVID-19 death toll in the US was just over 100,000. As a side note, it now looks almost certain that the outbreak in Germany, which Angela Merkel described as the worst crisis to afflict the country since the Second World War, will kill fewer people than the seasonal influenza outbreak in 2018 – and no thanks to the lockdown Chancellor Merkel ordered. Der Spiegel has published the daily mortality figures for Germany, which show infections beginning to fall before the more extreme measures were introduced. And there’s been no sustained uptick in infections in Germany since the the lockdown was lifted, something that’s also true of every other country – and every US state – that’s eased extreme social distancing measures.

So why the rush to lock down citizens across the world in response to coronavirus? It’s all the more surprising when you bear in mind that the World Health Organisation (WHO) specifically recommended against quarantining as a strategy for managing the outbreak of a flu-like pandemic in a report it published in 2019. This was drawn to my attention by a reader with a background in epidemiology and public health who says she’s been horrified by the unquestioning acceptance of the Covid response measures by her colleagues whom she expected to be more capable of critical thought. The WHO report even stopped short of recommending the quarantining of exposed individuals. No doubt some people will point out that COVID-19 isn’t a flu-like illness, so more drastic measures are called for. But the WHO report says that quarantining wouldn’t have done any good as a way to mitigate the impact of Spanish flu, a much more deadly virus than SARS-CoV-2.

What changed the WHO’s mind and prompted it to praise the response of the Chinese authorities in Hubei province, which included the virtual incarceration of 60 million people? It was this, more than anything else, that persuaded governments across the world to lockdown their citizens.