Information lacking RE where infections happen, says medical historian
Updated: May 6, 2020
Today we speak to a medical historian, Herwig Czech in Austria. He's an academic who doesn't shy away from controversy. He recently made headlines with his groundbreaking revelations about Hans Asperger, the pioneer of autism research after whom Asperger's syndrome is named.
Herwig uncovers the dark historical context of Asperger's work: Asperger is widely remembered as having advocated for autistic children, but in fact he actively supported the Nazi's euthanasia policies - including the murder of disabled children.
We reached out to Herwig because, even though he doesn't specialize in epidemics, his academic background provides him with a uniquely informed perspective on how human beings have dealt with past pandemics. He starts by telling us how life is going for him under quarantine in Vienna:
HOW ARE YOU GETTING BY? I cannot complain. My academic work continues relatively undisturbed. I have more time to write and think now. All academic events I was supposed to attend have been cancelled. It's harder for the students, who until the fall can only attend classes via conference calls.
Sleep is a bit of a challenge right now, but apart from that, the current situation - fewer external distractions - helps me better meet my writing deadlines. I have no small kids to look after, so all my time can be devoted to my academic work.
Everyone who has ever written a thesis or a book knows how to deal with self-imposed isolation. But this time, the difference is that I haven’t chosen the timing. For weeks, I didn’t know how long the lock-down would last. Uncertainty can be stressful. Now that it looks like the confinement is going to end at the beginning of May in Austria, the situation is much easier to bear.
In Austria, it's forbidden to enter public spaces. But there are major exceptions to the rule: you can go out to perform essential work, to buy the necessities of daily life, to care for others. Also, you can go out alone or with members of your household as long as you keep at least a one-meter distance from other people. There's no limit on how far you can venture. Theoretically you could walk through the whole of Austria if you wanted!
I go out every day. I have never been stopped by police. But I have heard of cases where the police have been over-eager to enforce the restrictions: asking people in parks where they were going, and how far away they were from their home… Some police are striking an authoritarian pose that has no justification. This while, until very recently, there were geriatric wards without any masks in Austria!
Another fact that strikes me: migrant families were told by the government – in their native languages – that they could not go out except to buy food or medicine. They were not informed that they could also go for a walk with their kids. For weeks, their liberties continued to be more restricted than those of other Austrians.
WHAT'S YOUR TAKE ON THE CURRENT SITUATION, FROM YOUR PERSPECTIVE AS A MEDICAL HISTORIAN?
The world has been taken by surprise by Covid-19.
During a relatively short window – roughly between the end of the Second World War and the beginning of the new millennium – we had the illusion that we had conquered infectious diseases. But from a historical perspective, pandemics have always been part of human history. Systematic quarantines go back as far as the 14th century, when they were widely used to tackle the Plague.
I have always found it fascinating that the 1918 Spanish Flu had been nearly forgotten from world history - up until recently. The history of epidemics on a whole has slightly fallen out of fashion among scholars, even though it continues to be a classic topic of the history of medicine. Of course, the current situation gives this field of research a whole new relevance.
In the U.S. state of Louisiana, up until the abolition of slavery, society was divided into those who were immune to yellow fever - because they had already been infected - and those who were not immune. A slave who was not immune had a much lower market value. This example comes to mind when considering the implications of “immuno-privilege” today.
In the 19th century, a major concern was how to limit the spread of epidemics without impacting global trade, and how to protect colonial metropolises from cholera, typhus, and yellow fever.
Up to the 1950s and 1960s, malaria persisted even in some parts of Italy, the Balkans, and the Netherlands.
So, the world has had its share of infectious diseases and epidemics. But what's happening right now is every public health expert’s worst nightmare in 100 years.
One of the things that strikes me right now: there is a huge lack of information about where people are actually getting infected. Is it in nursing homes, in shops, at home? This data would not be difficult to obtain, and it should be made public in order to inform the discussion about the next steps.
Also, people still wonder whether or not to wear masks. Wearing a mask, any mask is always better than wearing no mask at all! The introduction of surgical masks in operating rooms dates back to 1896. The fact that masks have been a staple of operating rooms for more than 100 years speaks for itself. All the same, for too long the main public message was that death lurks on door handles, and masks are only slowly becoming a priority.
* Interview by "How Are You Getting By?" reporter Tinka Kemptner.