The coronavirus pandemic has caused unpreceded disruptions in American society—everything from health care to the economy to everyday routines. But pandemics have happened before, and epidemiologists say they will happen again. KNAU’s Melissa Sevigny speaks with infectious disease expert Dr. Paul Keim about what we’ve learned from past pandemics and how we can prepare for the next one, in our final segment of a three-month-long series on the science of COVID-19.
Melissa Sevigny: Talk to me about how the current coronavirus pandemic compares to some of those pandemics in the past.
Paul Keim: With COVID-19 one of the reasons it’s had such a global impact is because the entire world’s population was naïve to this virus. None of us had seen it before, none of us had immunity. In the case of smallpox, the same thing was true for Native Americans when Europeans showed up. The Aztec empire went from 11 million people to 1 million people in basically a decade, and that was due to infectious disease….Every pandemic is different, and our way out of every pandemic historically has been different as well. We got out of smallpox with a vaccine, that’s what really eliminated smallpox. In the case of plague, it was really only social distancing, quarantines, and ultimately we had antibiotics which today will stop a pandemic. With HIV, it was a drug. That was the answer to the disease, not a vaccine. The 1918 influenza… wiped out somewhere between 50 and 100 million people worldwide in a very short period of time…. and we don’t know why it went away. It’s possible it went away because everybody who survived it was immune…. Herd immunity due to infections, if that’s the way we get out of COVID-19, we’re going to have a massive toll on our population. That is absolutely not the way we want to go.
Do you have a sense of what’s most promising for the coronavirus pandemic?
Vaccines are definitely our best hope here at this time. We have seen public health and behavior modification drive the disease incidence to very, very low rates in some countries, but we don’t seem to have the will to do that in the United States. In the United States we’d have to get high compliance from our population, as well as have public health policies in place that would help control the disease, and frankly at this point in time that does not look hopeful. And so I think it’s really vaccines that are our hope, and with 140 different vaccine efforts under way, we’re going to start to see how good those different vaccines are in the next year. If we can deploy those widely, then we should be able to control, and maybe even eliminate, this disease.
What do you think we’ve learned from this experience that will help us prevent or prepare for a future pandemic?
I think everybody is now aware of how important public health is… We know that public health infrastructure—having epidemiologists, having contract tracing, having the ability to track disease across time and space, monitoring—is super important. That’s lesson number one, we can’t ignore prevention of disease by ignoring public health. We’ve got to put the investment into that so we’re ready for the next pandemic. And we will see pandemics again.
So Paul, you and I started having these conversations about the science of COVID-19 three months ago, I’m curious what did you expect from the pandemic back then and did those expectations come true?
I didn’t think it’d be this bad. We saw New York, and New York was really bad back in April…. I thought Arizona would miss that, I thought that we’re more distributed, even our biggest city, Phoenix, people are spread all over the place. So I didn’t expect us to be hitting this level in Arizona…. You know, the one thing we have control over is our own behavior. Arizonans have to be more compliant with social distancing, hygiene and masks. We have to personally responsible…. I’m not sure what’s going to happen in the future, but we’ve got a ways to go before we’re out of this.
Paul Keim, thanks for speaking with me.
It’s been my pleasure, Melissa.