JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 118, NO 06, JUNE 2020
Editorial Untouchability — Other Face of Pandemic “Outbreaks have sparked riots and propelled public-health innovations , Prof. (Dr.) Jyotirmoy Pal prefigured revolutions and redrawn maps” MD, FRCP, FRCP, FICP, FACP, — Elizabeth Kolbert
WHO Fellow, Hony. Editor, JIMA
Pandemics have always had a great influence in shaping human history and politics. From Justinian Plague in sixth century to Influenzae pandemic in twentieth century, pandemics have triggered fall of empires , created social restructuring, changed the demography – leading to huge socio-economic and cultural impact. How Pandemics Changed History : Justinian Plague (541 AD – 750 AD) — It started in Sixth Century in Egypt and spread to Constantinople. The plague killed 25-100 million people and weakened the Empire Justinian substantially. This destroyed the dream to reunite Roman Empire leading to the beginning of the Dark Age of Europe. Black Death (1347-1351) — Bubonic Plague spread throughout Europe and killed more than 75 million people. At end of the pandemic, survivors’ standard of living increased, workers had more work, and social mobility increased as resource was more compared to population. Walter Scheidel had narrated in his book “The Great Leveler”- how black death led to improved wages for labourers. People’s faith on Catholic Church was lost, as the Church failed to save people when the pandemic spread like wildfire. Religious dominance on the society was put under question. Jews were blamed for spreading Disease and were burnt alive in many parts of Country. Frank M Snowden in his book- “Epidemics and Society: From the Black Death to the Present” described how a pandemic can change outlook of a society. Small Pox (15th -17th Century) — The Europeans invaded America in 15th Century. They introduced diseases to this continent against which natives had no immunity, one of these was Smallpox. During this period Small Pox killed approximately 90% of the population of America. In 1520, the Aztec Empire was destroyed by smallpox as it was incapacitated to resist Spanish invasion. The Pandemic helped Europeans to colonize in the newly vacated area thereby altering the history of America. Cholera (1817-23) — The Cholera pandemic started in Jessore (of Bengal Province), gradually spreading to the entire country. The British Soldiers then carried it to England and further to America. Initially, the pandemic was believed to be a Curse of God, which was thought to be spread by foul air ‘Miasma’. However, John Snow analysed hospital records and found a popular city well to be the cause of outbreak. Thus, the concept of Sanitation and Public health System was born. Spanish Flu (1918) — 500 million people were infected and 50 million died by the Spanish Flu. One of the major impacts of Pandemic was on the First World War. Germans and Austrians were so badly affected that they lost all their aggressiveness. German General Erich Ludendorff had written in “My War Memories” that the Flu was one of the main reasons for Germany’s Defeat. As the countries devastated in the War had failed to develop a structured protocol, the impact proved to be costly. However, understanding of the Pandemic helped to formulate better Public Health Measures. Use of Masks, Quarantine and Social Distancing were a few key measures adopted during this pandemic. The practices followed presently are basically a product of the experience of Spanish Flu Pandemic. All pandemics start as biological phenomenon, but keep footprint on Economical, social and political field. Equation of power may be shifted, economy may be remodelled, significant changes in the way we touch, behave and breath. Response to Pandemic : Presently, the world is under the siege of Novel Coronavirus, which has declared a War against Humanity. The World Health Organisation has adopted age old measures like masks, lockdown and social distancing, due to lack of effective antiviral drug or vaccine. Social distancing means keeping space between yourself and other people. It is a non-pharmaceutical measure to prevent spread of infection to others. Concept of social 09
