Is COVID-19 Our Dress Rehearsal for the Next Pandemic?
William Schmalz, FAIA, CSI,
Author, "The Architects Guide to Writing"; Principal at Perkins and Will
“What sort of nasty bug, with what unforeseen origins and what inexorable impacts, will emerge next?”—David Quammen, Spillover
The COVID-19 pandemic is without a doubt the most serious health event to affect the United States in at least a hundred years. As of today (May 10, 2020), more than 80,000 Americans have died and more than a million have been infected by the virus. The economy has been shattered, and the human toll in deaths, illness, unemployment, and failed businesses has been enormous. We still don’t know how this will end. But now that we are living through the worst pandemic in most Americans’ lifetimes, what have we learned? And will we be prepared for the next one?
Before we consider those questions, let’s talk about earthquakes. Here in Los Angeles County, we occasionally experience destructive, lethal earthquakes. The most recent was the 1994 Northridge earthquake (M6.7) [1], which killed 57 people. Before that were the 1987 Whittier Narrows earthquake (M5.9, eight deaths), the 1971 San Fernando (a.k.a. Sylmar) earthquake (M6.5, around 60 deaths), the 1952 Kern County (just north of Los Angeles County) earthquake (M7.3, 14 deaths), and the 1933 Long Beach earthquake (M6.4, 120 deaths) [2]. As we can see, Los Angeles experiences a major earthquake around every 20 years. It’s been an ominous 26 years since Northridge, but we frequently get gentle reminders that the ground below us is not stable. So we Angelenos should, one would think, be prepared for an event that would potentially leave us without water, food, power, and paper products for days, even weeks. Yet, at the first hint that the pandemic might be serious, people here began hoarding, stripping store shelves bare [3].
So the point of this earthquake digression? That it takes a lot for us humans to learn important, life-saving lessons, and to remember those lessons once things have returned to normal. Most Angelenos should be prepared for a major earthquake, but most of us (including me) are probably not nearly as prepared as we should be. Is this what will happen after COVID-19? Considering that more than 300 times as many people have already died from COVID-19 than from all the above earthquakes combined, I would hope not. But I’m not optimistic.
Unlike a major quake, which violently affects a relatively small geographic area, this particular pandemic has affected the entire country, but for many of us not violently. Many Americans may think that COVID-19 is a freak occurrence, a once-in-a-lifetime event, as bad as a modern pandemic can get. After all, it’s been more than a hundred years since the 1918 Spanish flu pandemic, and centuries since the last plague [4]. So another COVID-19?like pandemic every hundred years may not be so bad. Perhaps, but . . .
How likely is it that another pandemic at least as deadly as COVID-19 will hit the U.S. within most of our lifetimes? This requires some complicated math, so hold on a moment while I do some figuring . . . almost there . . . Aha! Got it: exactly 100%. It is a certainty that something at least as bad as COVID-19 will happen within many of our lifetimes. Some of you may not believe me (and why should you; after all, I’m an architect, not an epidemiologist), but what about believing Dr. Tom Frieden, former CDC director, who says that it’s “inevitable that there will be future outbreaks. It’s not inevitable that we will continue to be so unprepared” [5]. A continuously growing world population that gets continuously denser and better connected is a perfect target for another pandemic.
But will we, as Dr. Frieden suggests, be prepared for it? Is COVID-19 our "dress rehearsal" for the next, possibly more serious pandemic? As a nation, we should have been better prepared for this event, and taken earlier measures to contain the disease [6]. Many Americans have learned that an early, relatively short shutdown will stop an infectious disease before it can spread, and that this is preferable to what we have now: a lingering, lethal disease that shows little sign of being stopped, and that will affect all our lives for many more months and continue to kill people. But have we really learned from this dress rehearsal?
We already had, if not a dress rehearsal, at least a sneak preview of what a pandemic might look like. The 2003 outbreak—it never became a pandemic—of severe acute respiratory syndrome (SARS) should have given the U.S. a hint of how bad a modern-day infectious disease can be. It started in China and quickly spread (thanks to modern air travel) to Hong Kong, Canada, Singapore, and Taiwan. A total of 8,098 people became ill, and 774 of them (9.5%) died. Like COVID-19, SARS was caused by a coronavirus, but what kept it from being worse and growing to a pandemic was that infected people didn’t themselves become infectious until they were already showing symptoms. With most coronaviruses, including COVID-19 and influenza, people become infectious days before they show symptoms, making the likelihood of spreading (and the difficulty of controlling) much greater. As science writer David Quammen says in his 2012 book Spillover, “When the Next Big One comes, we can guess, it will likely conform to the . . . pattern [of] high infectivity preceding notable symptoms. That will help it move through cities and airports like an angel of death.”
Every reasonable person knows—and they know this because they listen to and trust scientists and healthcare experts, not politicians—that containing COVID-19 is everyone’s responsibility, and that it’s also within everyone’s capability. Simple things—physical distancing, avoiding crowds, washing hands, wearing face masks in public, not touching anyone but family members, and working from home where possible—will go a long way toward keeping a virus from spreading. Some of these things are easier than others, and some will affect whatever used to be “normal” more than others, but all are doable. But will we forget over time?
I really hope we’ve learned something, that this dress rehearsal will help us meet the challenges of the next, possibly much more serious pandemic. In fact, I believe it’s our duty to have learned this lesson. We owe it to the people the coronavirus has killed or put through a torturous illness; to the healthcare providers who have risked their own health to help others; to the police officers, firefighters, postal workers, bus drivers, and other civic employees who are providing us valuable services; and to the people working the grocery stores, takeout restaurants, and other establishments that allow us to maintain some form of normality. Let’s not make their efforts and their sacrifices be for nothing. I’d like to think we’re learning from our experience and can make COVID-19 a dress rehearsal for the next one. But then I think of our historically short collective memory and fear the worst. Please, prove me wrong.
On a lighter note . . .
From every experience, no matter how bad, something good emerges. For instance, when I walk along the sidewalk and pass other mask wearers, I look in their eyes—because of course that’s all of them I can see—and I recognize that yes, we get it. We know that wearing face masks is important, not so much for ourselves, but for everyone else. It’s a matter of social consideration for others. I guess we’re developing a “mask-wearing community.” We’re not like those other mask-less jerks (yes, people who can’t be bothered to cover their faces when approaching someone outdoors are jerks). But something else has come out of this experience: brilliant, creative humor. People who unfortunately have a lot of free time are spending it making ingenious and funny videos. I’m sure you have all received videos from friends, but I’d like to share a couple of my favorites, videos I keep turning to because they make me laugh. Enjoy (and if the second one offends you, lighten up a bit; times are tough, and it is funny):
https://www.facebook.com/100000709599424/posts/2188077927892506/?d=n
Follow the author on Twitter @bill_schmwil.
Footnotes:
[1] I have a special connection to the Northridge earthquake. I was living in Chicago at the time and recognized it as a significant event, but not something that affected me. Slightly more than four years later, I was living in Los Angeles as part of the team designing the replacement for a hospital damaged in the earthquake. Who says life is predictable?
[2] This ignores major earthquakes that occurred in lightly populated areas surrounding Los Angeles County. For example, as recently as July 2019, an M7.1 earthquake happened near the town of Ridgecrest. Despite the strength of the quake, it resulted in only one person’s death.
[3] By March 12, the shelves were empty in of my nearby Trader Joe’s, which, I might mention, is on Sunset Boulevard, which happens to follow a known fault line.
[4] Three European bubonic plague outbreaks are well known: the Justinian Plague (541?542 AD), the Black Death (1347?1351 AD), and the Great Plague of London (1665?1666). But another, more recent plague outbreak isn’t as well known, probably because it affected mostly China and Hong Kong. When it crossed the Pacific, it affected San Francisco’s Chinatown in the early 1900s. It reinforced anti-Asian prejudice and led to the extension of the Chinese Exclusion Act. See this article for more about that law (and anti-Asian discrimination in general): https://www.dhirubhai.net/pulse/forget-jake-its-chinatown-architect-looks-immigration-william/. And by the way, bubonic plague is still with us, here in the USA: As recently as 2006 a case of plague was reported in Los Angeles.
[5] https://www.cnn.com/2020/05/06/health/cdc-coronavirus-truths-trnd/index.html
[6] For those of us wanting to blame someone for the way COVID-19 has affected the U.S., consider this: We can’t know how well the Bush or Obama administrations would have handled this crisis; that’s a “what if?” we can never be sure of. But we do know how this administration, after three years into its term, handled it: Not well at all.
And getting people off their duffs to plan for such contingencies prepares them for other possible perils, as well.