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For Albert Camus, plague was both a fact of life and a powerful metaphor for the human condition. Camus engaged most explicitly and extensively with the subject of plague in his 1947 novel, The Plague (La peste), which chronicles an outbreak of what is presumably cholera in the French-Algerian city of Oran. I often thought of this novel-and what it might teach us-during the recent COVID-19 pandemic. In this article, I discuss seven important insights from The Plague about epidemics, public health and morality., (© The Author(s) 2024. Published by Oxford University Press on behalf of Faculty of Public Health.)

Every pandemic is embedded in specific spatial and temporal context. However, spatial patterns have almost always only been considered in the context of one individual pandemic. Until now, there has been limited consideration of spatial similarities or differences between pandemics. In this study, Bayesian spatial models for disease mapping were used to estimate excess mortality for the pandemics of 1890, 1918 and 2020. A robust linear regression was used to assess the association between ecological determinants and excess mortality. Spatial variations of excess mortality across Switzerland were observed in each pandemic, but the spatial patterns differ between the pandemics. Different determinants contribute to excess mortality, and these factors vary between COVID-19 and the previous pandemics. Spatial excess mortality from COVID-19 is most likely due to cultural and SEP differences, whereas in historical pandemics, mobility, pre-existing tuberculosis or remote mountain living likely contributed to spatial excess mortality., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Recognition of misinformation as a public health threat and interest in infodemics, defined as an inundation of information accompanying an epidemic or acute health event, have increased worldwide. However, scientists have no consensus on how to best define and identify misinformation and other essential characteristics of infodemics. We conducted a narrative review of secondary historical sources to examine previous infodemics in relation to four infectious diseases associated with pandemics (ie, smallpox, cholera, 1918 influenza, and HIV) and challenge the assumption that misinformation is a new phenomenon associated with increased use of social media or with the COVID-19 pandemic. On the contrary, we found that the spread of health misinformation has always been a public health challenge that has necessitated innovative solutions from medical and public health communities. We suggest expanding beyond the narrow scope of addressing misinformation to manage information ecosystems, defined as how people consume, produce, interact with, and behave around information, which include factors such as trust, stigma, and scientific literacy. Although misinformation can spread on a global scale, this holistic approach advocates for community-level interventions that improve relationships and trust between medical or public health entities and local populations., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This article assesses how and why the National Health Service (NHS) has remained at the forefront of British politics and society for 75 years amid significant economic pressures, organizational strain, shifting ideological trends, ongoing reforms, and an unprecedented public health emergency. The postwar "years of consensus" evolved into alleged decline and ostensible neglect during the 1980s, while New Labour sought to rejuvenate this core public service after 1997, featuring investment and often controversial reforms that challenged the party's social democratic values. Amid the New Labour era, NHS powers filtered down to devolved administrations, while from 2008 retrenchment and austerity ensued, fueled by global recession. Austerity eventually subsided, yet from early 2020 the NHS swiftly faced the extreme conditions of the globalized Covid-19 pandemic. The service continues to face challenges regarding its longer-term viability, and this article analyzes this scenario, within the context of the NHS's 75-year historical legacy, its contemporary status, comparative international trends, and likely future evolution., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Using the examples of plague, smallpox, and HIV/AIDS, the present essay argues for the benefits of incorporating the evolutionary histories of pathogens, beyond visible epidemic spikes within human populations, into our understanding of what pandemics actually are as epidemiological phenomena. The pandemic arc - which takes the pathogen as the defining "actor" in a pandemic, from emergence to local proliferation to globalization - offers a framework capable of bringing together disparate aspects not only of the manifestations of disease but also of human involvement in the pandemic process. Pathogens may differ, but there are common patterns in disease emergence and proliferation that distinguish those diseases that become pandemic, dispersed through human communities regionally or globally. The same methods of genomic analysis that allow tracking the evolutionary development of a modern pathogen such as SARS-CoV-2 also allow us to trace pandemics into the past. Reconstruction of these pandemic arcs brings new elements of these stories into view, recovering the experiences of regions and populations hitherto overlooked by Eurocentric narratives. This expanded global history of infectious diseases, in turn, lays a groundwork for reconceiving what ambitions a truly global health might aim for., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Narrative structures, though invisible to the naked eye, guide our understanding of pandemics. Like curves and graphs, we can plot them, identify their patterns and organizing principles. These structures act upon our understanding of social and biological events just as much as the rhythms of viral replication and mutation. They order not only themselves but also social and health outcomes. This essay uses narrative precision to expand beyond Charles Rosenberg's influential dramaturgic model and develops new pandemic forms, scaled from the level of an individual line break to the multi-part series: Arc, a form of sequence. Cycle, a form of repetition. Sequel, a form of elongation. Caesura, a form of break. It investigates the potentialities and limitations of these forms, how they intersect, collide, and contradict, and how analysis of these interactions contributes to a deeper understanding of pandemics, their effects, and the diverse perspectives defining their structures. In doing so, it prototypes how literary methods offer conceptual frameworks for pandemic historiography and how a transdisciplinary, medical humanities analysis produces novel understandings at the intersection of health, culture, and society., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This paper deals with the ways in which the intellectual and political history of AIDS can assist in the chronological conceptualization of a pandemic such as COVID-19 as it is unfolding. It problematizes the idea of pandemic "beginnings" and "ends" to show that such definitions are shaped by the disciplinary location and thematic foci of relevant scholars. Central to this analysis is the notion that ethical and political contexts affect research on a pandemic in different ways at national and global levels at various points in its trajectory. The article develops this argument in relation to two main themes: firstly, with reference to the history of AIDS research in South Africa; secondly, with the philosophical concept of bioagency to understand the ways in which viruses and humans co-shape the course of epidemics over time. I first make the case for the development of historically informed, long-term ethnographic studies of COVID-19. Using bioagency as a point of departure to consider viruses as social actors, the essay then critiques the notion of bioinformationalism as catalyzing the widening accessibility of biomedical research. Instead, I discuss the biotechnology and pharmaceutical industries as protagonists in the operation of biocapital. I argue that the history of AIDS in South Africa can provide methodological and theoretical insights into how to interpret an unfolding epidemic, outlining an ambitious transdisciplinary research agenda for thinking about the temporality of a pandemic spanning the different, interconnected, scales of life., (© The Author(s) 2024. Published by Oxford University Press.)

This article focuses on Brazil and Peru, the Latin American epicenter of the coronavirus pandemic during 2020 and 2021. The pandemic magnified the legacy of years of neoliberal policies, corruption and racism in these countries, the limitations of their poverty-reduction programs, the fragility of their democratic systems, and the insufficient political regard for public health and basic sanitation. I rely on the concepts of negligence and necropolitics. The first refers to the abdication of authorities in providing sufficient basic services to its citizens. The second - coined by Achille Mbembe before the pandemic - is used to explain the banalization by governments of preventable deaths of discriminated social groups. On a global level, the problematic access to medical equipment and vaccines was a failure because of the hoarding of vaccines by rich nations and the blaming of developing countries for their high mortality. The result was that national and international governmental reactions to COVID-19 worsened health asymmetries within countries and between the Global North and South., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

The primary claim of this essay is that historical fluency is required for effective work in crafting legal and policy interventions as a part of public health emergency preparedness and response (PHEPR). At a broad level, public health law is explicitly recognized as a key systems-level component of PHEPR practice.1 This essay therefore focuses on the extent to which historical fluency is necessary or at least useful to all aspects of PHEPR that draw on or deploy legal and policy mechanisms (e.g., design, planning, implementation, dissemination, monitoring and evaluation, etc.). The essay collectively refers to these legal and policy mechanisms as epidemic law and policy response (ELAPR). Part I explains the concept of historical fluency. Part II explores the foundations of public health law both as a way of highlighting key structural features of ELAPR and in supporting the claim that historical fluency is critical for ELAPR. Part III applies the previous arguments to a specific case study to highlight the promise and power of historical fluency - the outbreak of bubonic plague in San Francisco in 1900. Tracking this essay's pragmatic focus, part IV offers several recommendations for how specifically historical fluency in public health law and ethics can be operationalized in PHEPR practice and policy. Part V summarizes and concludes., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This essay builds on the exciting trove of disaster social science research surfacing since the earliest days of the COVID-19 pandemic. It tracks the ways that both practitioners of medicine and public health, and their social science analogues, have approached the pandemic, explicitly considering the ways they reached for new concepts to explain the temporal phenomena presented by COVID-19 and its global course. The essay highlights a series of interviews conducted in the first two years of the pandemic as part of the COVIDCalls podcast. COVID is the moment for a scholarly convergence that was missed after September 11, and again after Hurricane Katrina, and should not be missed again. Accordingly, this essay explores themes where medicine/health studies and disaster studies seem to offer great help to one another in making sense of our COVID times: the origins of disaster, disasters in combination, and the end of a disaster., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Over the last several decades, a growing group of environmental and medical historians have argued that engagement with the materiality of disease is critical to eroding the false boundaries between environment and health, and especially to the historical study of major epidemics and pandemics. This article evaluates the ways in which environmental and medical historians have engaged materiality when thinking through questions of infectious disease. It argues that far from eschewing cultural constructions of disease and analysis of medical systems, these works demonstrate that engagement with materiality in the study of disease articulates the stakes of medical regimes and practices of healing, and renders legible the multiple scales at which epidemics occur. Addressing key controversies in the use of sources, it provides examples of works that incorporate material objects, biological ideas and actors, and non-humans without falling prey to the extremes of "biological determinism" or "constructivism." It argues that commonalities in the methods employed by these works - utilization of scientific frameworks and data, multispecies analysis, attention to scale, and spatial thinking - reveal unseen and untold aspects of past pandemics. It concludes with a brief example of how these frameworks come together in practice through a case study on the history of enteric fever in Dublin, Ireland., (© The Author(s) 2024. Published by Oxford University Press.)

The coronavirus disease 2019 (COVID-19) pandemic has been called the deadliest disease event in history. In this study, we compared the cause-specific mortality rate of the Spanish flu (1918-1920) with that of COVID-19 (2020-2022) in the Netherlands. During the periods of exposure, about 50 000 people died of COVID-19 and 32 000 people of the Spanish flu. In absolute numbers, COVID-19 seems to be deadlier than Spanish flu. However, the crude mortality rates for COVID-19 and Spanish flu were 287 and 486 per 100 000 inhabitants, respectively. Comparing age-standardized mortality rates, there would have been 28 COVID-19- and 194 Spanish flu-related deaths in 1918-1920, or 214 Spanish flu- and 98 COVID-19-related deaths in 2020-2022 per 100 000 inhabitants per year. Thus, taking the population differences into account, the Spanish flu would have been deadlier than COVID-19., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This paper examines the timing of one-time fluctuations in births subsequent to the 1918 influenza pandemic in Madras (now Chennai), India. After seasonally decomposing key demographic aggregates, we identified abrupt one-time fluctuations in excess births, deaths, and infant deaths. We found a contemporaneous spike in excess deaths and infant deaths and a 40-week lag between the spike in deaths and a subsequent deficit in births. The results suggest that India experienced the same kind of short-term postpandemic "baby bust" that was observed in the United States and other countries. Identifying the mechanisms underlying this widespread phenomenon remains an open question and an important topic for future research., (© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

In 1919-20, the European countries that were neutral in the First World War saw a small baby bust followed by a small baby boom. The sparse literature on this topic attributes the 1919 bust to individuals postponing conceptions during the peak of the 1918-20 influenza pandemic and the 1920 boom to recuperation of those conceptions. Using data from six large neutral countries of Europe, we present novel evidence contradicting that narrative. In fact, the subnational populations and maternal birth cohorts whose fertility was initially hit hardest by the pandemic were still experiencing below-average fertility in 1920. Demographic evidence, economic evidence, and a review of post-pandemic fertility trends outside Europe suggest that the 1920 baby boom in neutral Europe was caused by the end of the First World War, not by the end of the pandemic.

I read the article by Dr Pitlik on COVID-19 with great interest.1 The number of publications related to the current pandemic as well as how readily available they are is yet another difference between COVID-19 and previous pandemic diseases.

Venetian quarantine 400 years ago was an important public health measure. Since 1900 this has been refined to include "challenge" or deliberate infection with pathogens be they viruses, bacteria, or parasites. Our focus is virology and ranges from the early experiments in Cuba with Yellow Fever Virus to the most widespread pathogen of our current times, COVID-19. The latter has so far caused over four million deaths worldwide and 190 million cases of the disease. Quarantine and challenge were also used to investigate the Spanish Influenza of 1918 which caused over 100 million deaths. We consider here the merits of the approach, that is the speeding up of knowledge in a practical sense leading to the more rapid licensing of vaccines and antimicrobials. At the core of quarantine and challenge initiatives is the design of the unit to allow safe confinement of the pathogen and protection of the staff. Most important though is the safety of volunteers. We can see now, as in 1900, that members of our society are prepared and willing to engage in these experiments for the public good. Our ethnology study, where the investigator observed the experiment from within the quarantine, gave us the first indication of changing attitudes amongst volunteers whilst in quarantine. These quarantine experiments, referred to as challenge studies, human infection studies, or "controlled human infection models" involve thousands of clinical samples taken over two to three weeks and can provide a wealth of immunological and molecular data on the infection itself and could allow the discovery of new targets for vaccines and therapeutics. The Yellow Fever studies from 121 years ago gave the impetus for development of a successful vaccine still used today whilst also uncovering the nature of the Yellow Fever agent, namely that it was a virus. We outline how carefully these experiments are approached and the necessity to have high quality units with self-contained air-flow along with extensive personal protective equipment for nursing and medical staff. Most important is the employment of highly trained scientific, medical and nursing staff. We face a future of emerging pathogens driven by the increasing global population, deforestation, climate change, antibiotic resistance and increased global travel. These emerging pathogens may be pathogens we currently are not aware of or have not caused outbreaks historically but could also be mutated forms of known pathogens including viruses such as influenza (H7N9, H5N1 etc.) and coronaviruses. This calls for challenge studies to be part of future pandemic preparedness as an additional tool to assist with the rapid development of broad-spectrum antimicrobials, immunomodulators and new vaccines., (© 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Abstract: Throughout history, society has dealt with several devastating pandemics. Our objective is to analyze society's coping mechanisms to deal with pandemic-related stress in history congruent with the values of the time. For that purpose, we have carefully selected some of the most significant pandemics based on their impact and the available psychosocial literature. After a brief introduction, society's coping tools are reviewed and analyzed for the Antonine Plague, the second bubonic plague, the third cholera pandemic, the Spanish flu, the HIV pandemic, and the COVID-19 pandemic. Despite occurring at different times in history, parallels can be established in the study of society's psychological reactions among different pandemics. Magical thinking, political skepticism, fake accusations, and discrimination of minorities are recurrent reactions in society among different pandemics in history., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Yersinia pestis is the causative agent of at least three major plague pandemics (Justinianic, Medieval and Modern). Previous studies on ancient Y. pestis genomes revealed that several genomic alterations had occurred approximately 5000-3000 years ago and contributed to the remarkable virulence of this pathogen. How a subset of strains evolved to cause the Modern pandemic is less well-understood. Here, we examined the virulence-associated prophage (Ypf Φ ), which had been postulated to be exclusively present in the genomes of strains associated with the Modern pandemic. The analysis of two new Y. pestis genomes from medieval/early modern Denmark confirmed that the phage is absent from the genome of strains dating to this time period. An extended comparative genome analysis of over 300 strains spanning more than 5000 years showed that the prophage is found in the genomes of modern strains only and suggests an integration into the genome during recent Y. pestis evolution. The phage-encoded Zot protein showed structural homology to a virulence factor of Vibrio cholerae . Similar to modern Y. pestis , we observed phages with a common origin to Ypf Φ in individual strains of other bacterial species. Our findings present an updated view on the prevalence of Ypf Φ , which might contribute to our understanding of the host spectrum, geographical spread and virulence of Y. pestis responsible for the Modern pandemic.

Caused by Yersinia pestis , plague ravaged the world through three known pandemics: the First or the Justinianic (6th-8th century); the Second (beginning with the Black Death during c.1338-1353 and lasting until the 19th century); and the Third (which became global in 1894). It is debatable whether Y. pestis persisted in European wildlife reservoirs or was repeatedly introduced from outside Europe (as covered by European Union and the British Isles). Here, we analyze environmental data (soil characteristics and climate) from active Chinese plague reservoirs to assess whether such environmental conditions in Europe had ever supported "natural plague reservoirs". We have used new statistical methods which are validated through predicting the presence of modern plague reservoirs in the western United States. We find no support for persistent natural plague reservoirs in either historical or modern Europe. Two factors make Europe unfavorable for long-term plague reservoirs: 1) Soil texture and biochemistry and 2) low rodent diversity. By comparing rodent communities in Europe with those in China and the United States, we conclude that a lack of suitable host species might be the main reason for the absence of plague reservoirs in Europe today. These findings support the hypothesis that long-term plague reservoirs did not exist in Europe and therefore question the importance of wildlife rodent species as the primary plague hosts in Europe.

Human populations have been shaped by catastrophes that may have left long-lasting signatures in their genomes. One notable example is the second plague pandemic that entered Europe in ca. 1,347 CE and repeatedly returned for over 300 years, with typical village and town mortality estimated at 10%-40%. 1 It is assumed that this high mortality affected the gene pools of these populations. First, local population crashes reduced genetic diversity. Second, a change in frequency is expected for sequence variants that may have affected survival or susceptibility to the etiologic agent (Yersinia pestis). 2 Third, mass mortality might alter the local gene pools through its impact on subsequent migration patterns. We explored these factors using the Norwegian city of Trondheim as a model, by sequencing 54 genomes spanning three time periods: (1) prior to the plague striking Trondheim in 1,349 CE, (2) the 17 th -19 th century, and (3) the present. We find that the pandemic period shaped the gene pool by reducing long distance immigration, in particular from the British Isles, and inducing a bottleneck that reduced genetic diversity. Although we also observe an excess of large F ST values at multiple loci in the genome, these are shaped by reference biases introduced by mapping our relatively low genome coverage degraded DNA to the reference genome. This implies that attempts to detect selection using ancient DNA (aDNA) datasets that vary by read length and depth of sequencing coverage may be particularly challenging until methods have been developed to account for the impact of differential reference bias on test statistics., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

In standard historical accounts, the hyperlethal 1918 flu pandemic was inevitable once a novel influenza virus appeared. However, in the years following the pandemic, it was obvious to distinguished flu experts from around the world that social and environmental conditions interacted with infectious agents and could enhance the virulence of flu germs. On the basis of the timing and geographic pattern of the pandemic, they hypothesized that an "essential cause" of the pandemic's extraordinary lethality was the extreme, prolonged, and industrial-scale overcrowding of US soldiers in World War I, particularly on troopships. This literature synthesis considers research from history, public health, military medicine, veterinary science, molecular genetics, virology, immunology, and epidemiology. Arguments against the hypothesis do not provide disconfirming evidence. Overall, the findings are consistent with an immunologically similar virus varying in virulence in response to war-related conditions. The enhancement-of-virulence hypothesis deserves to be included in the history of the pandemic and the war. These lost lessons of 1918 point to possibilities for blocking the transformation of innocuous infections into deadly disasters and are relevant beyond influenza for diseases like COVID-19. ( Am J Public Health . 2022;112(10):1454-1464. https://doi.org/10.2105/AJPH.2022.306976).

The origin of the medieval Black Death pandemic (AD 1346-1353) has been a topic of continuous investigation because of the pandemic's extensive demographic impact and long-lasting consequences 1,2 . Until now, the most debated archaeological evidence potentially associated with the pandemic's initiation derives from cemeteries located near Lake Issyk-Kul of modern-day Kyrgyzstan 1,3-9 . These sites are thought to have housed victims of a fourteenth-century epidemic as tombstone inscriptions directly dated to 1338-1339 state 'pestilence' as the cause of death for the buried individuals 9 . Here we report ancient DNA data from seven individuals exhumed from two of these cemeteries, Kara-Djigach and Burana. Our synthesis of archaeological, historical and ancient genomic data shows a clear involvement of the plague bacterium Yersinia pestis in this epidemic event. Two reconstructed ancient Y. pestis genomes represent a single strain and are identified as the most recent common ancestor of a major diversification commonly associated with the pandemic's emergence, here dated to the first half of the fourteenth century. Comparisons with present-day diversity from Y. pestis reservoirs in the extended Tian Shan region support a local emergence of the recovered ancient strain. Through multiple lines of evidence, our data support an early fourteenth-century source of the second plague pandemic in central Eurasia., (© 2022. The Author(s).)

The plague pandemic ("The Black Death") that struck Eurasia in the middle of XIV century, "settled" this lethal disease in Europe for a long time. The new outbreaks of this disease, with breaks of several years, occurred in single cities, regions and states, covering sometimes entire continent over the next centuries. However, impression that "The Black Death" made upon minds of European scribes, staggering European society by its inevitability, for a long time determined particular angle of view under which it is accepted to consider the history of plague in Europe in the epoch of Middle Ages and early New Age. The image of The Great Plague of XIV century overshadowed all subsequent outbreaks of this lethal disease, so its subsequent occurrences are traditionally given less attention. The article, being based on on analysis of numerous chronicle evidences, for the first time in Russian historiography analyzes the history of plague in Rus during first decades of XV century and restores chronology of its occurrence and development and determines areas affected by the plague in the first place, estimating caused damage.

For several decades, the 1918-20 global influenza outbreak has been called "the forgotten pandemic." Although recent scholarly and public interest in the pandemic has complicated the narrative of forgetting, the label has stuck. Highlighting historical evidence of influenza's long-term impact upon survivors, family, and community in Canada, the flu stories presented here, diverse in form and content, verify that a key question in pandemic influenza history is not whether the pandemic was forgotten or remembered, but by whom, and in what ways, it has been suppressed - or foregrounded. By moving beyond the classic epidemic plot line, with beginning, middle, and end, historians can find new methodologies and evidence with which to more fully understand the influenza pandemic's unfolding intersection with colonialism, war, social inequality, and labour struggles in the 20 th century.

The Black Death (1347-1352 CE) is the most renowned pandemic in human history, believed by many to have killed half of Europe's population. However, despite advances in ancient DNA research that conclusively identified the pandemic's causative agent (bacterium Yersinia pestis), our knowledge of the Black Death remains limited, based primarily on qualitative remarks in medieval written sources available for some areas of Western Europe. Here, we remedy this situation by applying a pioneering new approach, 'big data palaeoecology', which, starting from palynological data, evaluates the scale of the Black Death's mortality on a regional scale across Europe. We collected pollen data on landscape change from 261 radiocarbon-dated coring sites (lakes and wetlands) located across 19 modern-day European countries. We used two independent methods of analysis to evaluate whether the changes we see in the landscape at the time of the Black Death agree with the hypothesis that a large portion of the population, upwards of half, died within a few years in the 21 historical regions we studied. While we can confirm that the Black Death had a devastating impact in some regions, we found that it had negligible or no impact in others. These inter-regional differences in the Black Death's mortality across Europe demonstrate the significance of cultural, ecological, economic, societal and climatic factors that mediated the dissemination and impact of the disease. The complex interplay of these factors, along with the historical ecology of plague, should be a focus of future research on historical pandemics., (© 2022. The Author(s).)

The ongoing COVID-19 pandemic has a major precedent almost exactly a century ago: the world-famous H1N1 influenza virus pandemic, sometimes known to the general public as the Spanish flu. From a history of medicine perspective, it is possible to underline many potential common traits between the two. In this article, hygiene and prophylaxis strategies are analyzed in a review of the most popular Italian general medical journals at the time of Spanish flu, Il Policlinico being the most representative of them. The analysis included 40 original journal articles as well as important references to the most influential coeval national manuals and international journals. The main issues in the context of public hygiene are prophylaxis with quinine and quinine derivatives, vaccinations, face masks, disinfection, and social distancing. We draw a comparison between these and the most recent international World Health Organization and Italian national guidelines on the topic. Sadly, little has changed since those times in terms of most of the prevention techniques, even with technical improvements, showing how shortsighted doctors and physicians can be when dealing with medical history. ( Am J Public Health . 2021;111(10):1815-1823. https://doi.org/10.2105/AJPH.2021.306412).

The 1918 Influenza pandemic had long-term impacts on the cohort exposed in utero which experienced earlier adult mortality, and more diabetes, ischemic heart disease, and depression after age 50. It is possible that the Coronavirus Disease 2019 (COVID-19) pandemic will also have long-term impacts on the cohort that was in utero during the pandemic, from exposure to maternal infection and/or the stress of the pandemic environment. We discuss how COVID-19 disease during pregnancy may affect fetal and postnatal development with adverse impacts on health and aging. Severe maternal infections are associated with an exaggerated inflammatory response, thromboembolic events, and placental vascular malperfusion. We also discuss how in utero exposure to the stress of the pandemic, without maternal infection, may impact health and aging. Several recently initiated birth cohort studies are tracking neonatal health following in utero severe acute respiratory syndrome virus 2 (SARS-CoV-2) exposure. We suggest these cohort studies develop plans for longer-term observations of physical, behavioral, and cognitive functions that are markers for accelerated aging, as well as methods to disentangle the effects of maternal infection from stresses of the pandemic environment. In utero exposure to COVID-19 disease could cause developmental difficulties and accelerated aging in the century ahead. This brief review summarizes elements of the developmental origins of health, disease, and ageing and discusses how the COVID-19 pandemic might exacerbate such effects. We conclude with a call for research on the long-term consequences of in utero exposure to maternal infection with COVID-19 and stresses of the pandemic environment.

Pathogens and associated outbreaks of infectious disease exert selective pressure on human populations, and any changes in allele frequencies that result may be especially evident for genes involved in immunity. In this regard, the 1346-1353 Yersinia pestis-caused Black Death pandemic, with continued plague outbreaks spanning several hundred years, is one of the most devastating recorded in human history. To investigate the potential impact of Y. pestis on human immunity genes, we extracted DNA from 36 plague victims buried in a mass grave in Ellwangen, Germany in the 16th century. We targeted 488 immune-related genes, including HLA, using a novel in-solution hybridization capture approach. In comparison with 50 modern native inhabitants of Ellwangen, we find differences in allele frequencies for variants of the innate immunity proteins Ficolin-2 and NLRP14 at sites involved in determining specificity. We also observed that HLA-DRB1*13 is more than twice as frequent in the modern population, whereas HLA-B alleles encoding an isoleucine at position 80 (I-80+), HLA C*06:02 and HLA-DPB1 alleles encoding histidine at position 9 are half as frequent in the modern population. Simulations show that natural selection has likely driven these allele frequency changes. Thus, our data suggest that allele frequencies of HLA genes involved in innate and adaptive immunity responsible for extracellular and intracellular responses to pathogenic bacteria, such as Y. pestis, could have been affected by the historical epidemics that occurred in Europe., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.)

The second plague pandemic started in Europe with the Black Death in 1346 and lasted until the 19th century. Based on ancient DNA studies, there is a scientific disagreement over whether the bacterium, Yersinia pestis , came into Europe once (Hypothesis 1) or repeatedly over the following four centuries (Hypothesis 2). Here, we synthesize the most updated phylogeny together with historical, archeological, evolutionary, and ecological information. On the basis of this holistic view, we conclude that Hypothesis 2 is the most plausible. We also suggest that Y. pestis lineages might have developed attenuated virulence during transmission, which can explain the convergent evolutionary signals, including pla decay, that appeared at the end of the pandemics., Competing Interests: The authors declare no competing interest., (Copyright © 2021 the Author(s). Published by PNAS.)

SARS-CoV-2 is the etiological agent of the current pandemic worldwide and its associated disease COVID-19. In this review, we have analyzed SARS-CoV-2 characteristics and those ones of other well-known RNA viruses viz. HIV, HCV and Influenza viruses, collecting their historical data, clinical manifestations and pathogenetic mechanisms. The aim of the work is obtaining useful insights and lessons for a better understanding of SARS-CoV-2. These pathogens present a distinct mode of transmission, as SARS-CoV-2 and Influenza viruses are airborne, whereas HIV and HCV are bloodborne. However, these viruses exhibit some potential similar clinical manifestations and pathogenetic mechanisms and their understanding may contribute to establishing preventive measures and new therapies against SARS-CoV-2.

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has emphasized the vulnerability of human populations to novel viral pressures, despite the vast array of epidemiological and biomedical tools now available. Notably, modern human genomes contain evolutionary information tracing back tens of thousands of years, which may help identify the viruses that have impacted our ancestors-pointing to which viruses have future pandemic potential. Here, we apply evolutionary analyses to human genomic datasets to recover selection events involving tens of human genes that interact with coronaviruses, including SARS-CoV-2, that likely started more than 20,000 years ago. These adaptive events were limited to the population ancestral to East Asian populations. Multiple lines of functional evidence support an ancient viral selective pressure, and East Asia is the geographical origin of several modern coronavirus epidemics. An arms race with an ancient coronavirus, or with a different virus that happened to use similar interactions as coronaviruses with human hosts, may thus have taken place in ancestral East Asian populations. By learning more about our ancient viral foes, our study highlights the promise of evolutionary information to better predict the pandemics of the future. Importantly, adaptation to ancient viral epidemics in specific human populations does not necessarily imply any difference in genetic susceptibility between different human populations, and the current evidence points toward an overwhelming impact of socioeconomic factors in the case of coronavirus disease 2019 (COVID-19)., Competing Interests: Declaration of interests The Krogan Laboratory has received research support from Vir Biotechnology and F. Hoffmann-La Roche. N.J.K. has consulting agreements with the Icahn School of Medicine at Mount Sinai, New York, Maze Therapeutics, and Interline Therapeutics; is a shareholder of Tenaya Therapeutics; and has received stocks from Maze Therapeutics and Interline Therapeutics. The other authors declare no competing interests., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

In 1348, a pandemic known as Black Death devastated humanity and changed social, economic and geopolitical world order, as is the current case with SARS-CoV-2 coronavirus. The doctor of the Nasrid Kingdom of Granada, Ibn-Jatima from Almeria, wrote "Treatise on the Plague", in which it may be found epidemiological and clinical similarities between both plagues. In the context of Greco-Arab medicine, he discovered respiratory and contact contagion of Pestis and attributed its physiopathology to a lack of pulmonary cooling of the innate heat, generated in the heart and carried by the blood humor. The process described was equivalent to the oxygen transport system. Furthermore, it was supposed to generate toxic residues, such as free radicals, leading to an irreversible multiple organ failure (MOF), considered a mortality factor as in Covid-19. Due to its similitude, it would be the first antecedent of the MOF physiopathological concept, a finding that enriches the scientific and historical heritage of our clinical specialty., (Copyright © 2021. Published by Elsevier España, S.L.U.)

Background: The worldwide tragedy of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic vividly demonstrates just how inadequate mitigation and control of the spread of infectious diseases can be when faced with a new microorganism with unknown pathogenic effects. Responses by governments in charge of public health, and all other involved organizations, have proved largely wanting. Data infrastructure and the information and communication systems needed to deal with the pandemic have likewise not been up to the task. Nevertheless, after a year of the worldwide outbreak, hope arises from this being the first major pandemic event in history where genomic and related biosciences - relying on biomedical informatics - have been essential in decoding the viral sequence data and producing the mRNA and other biotechnologies that unexpectedly rapidly have led to investigation, design, development, and testing of useful vaccines. Medical informatics may also help support public health actions and clinical interventions - but scalability and impact will depend on overcoming ingrained human shortcomings to deal with complex socio-economic, political, and technological disruptions together with the many ethical challenges presented by pandemics., Objectives: The principal goal is to review the history of biomedical information and healthcare practices related to past pandemics in order to illustrate just how exceptional and dependent on biomedical informatics are the recent scientific insights into human immune responses to viral infection, which are enabling rapid antiviral vaccine development and clinical management of severe cases - despite the many societal challenges ahead., Methods: This paper briefly reviews some of the key historical antecedents leading up to modern insights into epidemic and pandemic processes with their biomedical and healthcare information intended to guide practitioners, agencies, and the lay public in today's ongoing pandemic events., Conclusions: Poor scientific understanding and excessively slow learning about infectious disease processes and mitigating behaviors have stymied effective treatment until the present time. Advances in insights about immune systems, genomes, proteomes, and all the other -omes, became a reality thanks to the key sequencing technologies and biomedical informatics that enabled the Human Genome Project, and only now, 20 years later, are having an impact in ameliorating devastating zoonotic infectious pandemics, including the present SARS-CoV-2 event through unprecedently rapid vaccine development. In the future these advances will hopefully also enable more targeted prevention and treatment of disease. However, past and present shortcomings of most of the COVID-19 pandemic responses illustrate just how difficult it is to persuade enough people - and especially political leaders - to adopt societally beneficial risk-avoidance behaviors and policies, even as these become better understood., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

The encephalitis lethargica (EL) epidemic swept the world from 1916 to 1926 and is estimated to have afflicted between 80,000 to one million people. EL is an unusual neurological illness that causes profound sleep disorders, devastating neurological sequalae and, in many cases, death. Though uncommon, EL is still occasionally diagnosed today when a patient presents with an acute or subacute encephalitic illness, where all other known causes of encephalitis have been excluded and criteria for EL are met. However, it is impossible to know whether recent cases of EL-like syndromes result from the same disease that caused the epidemic. After more than 100 years of research into potential pathogen triggers and the role of autoimmune processes, the aetiology of EL remains unknown. The epidemic approximately coincided with the 1918 H1N1 influenza pandemic but the evidence of a causal link is inconclusive. This article reviews the literature on the causes of EL with a focus on autoimmune mechanisms. In light of the current pandemic, we also consider the parallels between the EL epidemic and neurological manifestations of COVID-19. Understanding how pathogens and autoimmune processes can affect the brain may well help us understand the conundrum of EL and, more importantly, will guide the treatment of patients with suspected COVID-19-related neurological disease, as well as prepare us for any future epidemic of a neurological illness., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Both the 1918 influenza pandemic and the 2019‒2021 COVID-19 pandemic are among the most disastrous infectious disease emergences of modern times. In addition to similarities in their clinical, pathological, and epidemiological features, the two pandemics, separated by more than a century, were each met with essentially the same, or very similar, public health responses, and elicited research efforts to control them with vaccines, therapeutics, and other medical approaches. Both pandemics had lasting, if at times invisible, psychosocial effects related to loss and hardship. In considering these two deadly pandemics, we ask: what lessons have we learned over the span of a century, and how are we applying those lessons to the challenges of COVID-19?

The major epidemic and pandemic diseases that have bothered humans since the Neolithic Age and Bronze Age are surveyed. Many of these pandemics are zoonotic infections, and the mathematical modeling of such infections is illustrated. Plague, cholera, syphilis, influenza, SARS, MERS, COVID-19, and new potential epidemic and pandemic infections and their consequences are described and the background for the spread of acute and chronic infections and the transition to endemic infections is discussed. The way we can prevent and fight pandemics is illustrated from the old and new well-known pandemics. Surprisingly, the political reactions through different periods have not changed much during the centuries., (© 2020 The Authors. APMIS published by John Wiley & Sons Ltd on behalf of Scandinavian Societies for Medical Microbiology and Pathology.)

The rise of the covid-19 pandemic has led to renewed interest in the 1918-1919 influenza in search of aspects that might help us understand the current situation, but also as an opportunity to re-evaluate the serious twentieth-century health crisis in light of what we are experiencing now. In this context and with that goal, this historical reflection shows the parallels that exist and the need for a realization that our model of society is undergoing a crisis and requires profound transformation.

This text uses theoretical contributions from the history of science to discuss aspects of the stages of pandemics understood as social phenomena and how covid-19 moved into the interior of the Amazon region. The arrival of this disease in the vast forest territory made differentiated access to public health more evident, with services and professionals concentrated in the larger cities in the north of Brazil. The rise in coronavirus rates within the forest consequently highlights the history of social inequalities in the region and problems accessing citizenship in Brazilian society.

Questions persist as to the origin of the COVID-19 pandemic. Evidence is building that its origin as a zoonotic spillover occurred prior to the officially accepted timing of early December, 2019. Here we provide novel methods to date the origin of COVID-19 cases. We show that six countries had exceptionally early cases, unlikely to represent part of their main case series. The model suggests a likely timing of the first case of COVID-19 in China as November 17 (95% CI October 4). Origination dates are discussed for the first five countries outside China and each continent. Results infer that SARS-CoV-2 emerged in China in early October to mid-November, and by January, had spread globally. This suggests an earlier and more rapid timeline of spread. Our study provides new approaches for estimating dates of the arrival of infectious diseases based on small samples that can be applied to many epidemiological situations., Competing Interests: The authors have declared that no competing interests exist.

Although every emerging infectious disease occurs in a unique context, the behaviour of previous pandemics offers an insight into the medium- and long-term outcomes of the current threat. Where an informative historical analogue exists, epidemiologists and policymakers should consider how the insights of the past can inform current forecasts and responses.

The 2019 novel coronavirus disease pandemic poses a serious threat. While its short-term effects are evident, its long-term consequences are a matter of analysis. In this work, the existence of long-lasting negative effects derived from exposure in utero to a great pandemic -1918 influenza pandemic- is analysed for the Argentine case. Outcomes of interest include educational achievement and unemployment status in adulthood -50 years after the pandemic. Based on a regression analysis, temporal differences in the spread of the pandemic and between close birth cohorts are exploited. The results indicate a significant reduction in educational achievement for people exposed in utero to the pandemic. In the region with the highest incidence of cases (Noroeste), this reduction is 0.5 years of education. There are no significant changes in the chances of being unemployed. In the context of climate change, these results constitute a call of attention for the implementation of child protection policies from gestation., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Decades ago, in his foundational essay on the early days of the AIDS crisis, medical historian Charles Rosenberg wrote, "epidemics start at a moment in time, proceed on a stage limited in space and duration, following a plot line of increasing revelatory tension, move to a crisis of individual and collective character, then drift toward closure." In the course of epidemics, societies grappled with sudden and unexpected mortality and also returned to fundamental questions about core social values. "Epidemics," Rosenberg wrote, "have always provided occasion for retrospective moral judgment" (Rosenberg 1989, pp. 2, 9). Following Rosenberg's observations, this essay places COVID-19 in the context of epidemic history to examine common issues faced during health crises-moral, political, social, and individual. Each disease crisis unfolds in its own time and place. Yet, despite specific contexts, we can see patterns and recurring concerns in the history of pandemics: (1) pandemics and disease crises in the past, along with public health responses to them, have had implications for civil liberties and government authority; (2) disease crises have acted as a sort of stress test on society, revealing, amplifying or widening existing social fissures and health disparities; (3) pandemics have forced people to cope with uncertain knowledge about the origin and nature of disease, the best sources of therapies, and what the future will hold after the crisis. While historians are not prognosticators, understanding past experience offers new perspectives for the present. The essay concludes by identifying aspects of history relevant to the road ahead.