Litchfield Lecture: “A Funny Thing Happened on the Way to the Pandemic: How Medical History Helped Flatten the Curve"

“A Funny Thing Happened on the Way to the Pandemic:  How Medical History Helped Flatten the Curve" 

Between 2006 and 2010, together with Martin Cetron, the director of the C.D.C.’s Division of Global Migration and Quarantine, I worked to help develop the concept now known as “flattening the curve”: using social distancing to decrease the peak burden on health-care systems and to buy time for scientists and doctors to respond. (Those now-familiar drawings of flattened curves, seen at White House briefings and elsewhere, were taken from one of Marty’s PowerPoint slides.) With the assistance of medical historians, epidemiologists, infectious-disease experts, and statisticians, we gathered more than twenty thousand documents from hundreds of archives across the country, focussing on how forty-three American cities responded to the 1918 flu pandemic. We looked, in particular, at how those cities employed isolation and quarantine, the banning of public gatherings, the closing of schools, and, in some cases, the shutting down of roads and railways. We found that those cities which used more than one intervention simultaneously, and which acted early and persisted for sustained periods, experienced significantly lower rates of death than those which didn’t. The fates of twenty-three “double-humped” cities were equally telling: having released the brakes too soon, they suffered a second spike in cases and in deaths, sometimes worse than the first. Many had to institute another round of social distancing—a thorny political task.

Because social distancing is a quiet form of civic action, and because its success results in fewer infections, it’s easy to underestimate its effects—and yet they have been formidable. A 2020 study published in Nature estimated that the social-distancing measures employed in the United States, China, South Korea, Italy, Iran, and France have prevented around five hundred and thirty million coronavirus infections—sixty million of them in the United States. (Currently, with distancing, the U.S. has reported around four and a half million confirmed cases; the real number is probably higher.) Another study, conducted at Columbia University, found that, if parts of this country had started distancing on March 1st—roughly two weeks before most Americans began to stay home—fifty-four thousand fewer people would have died. It’s difficult to say with certainty how many deaths flattening the curve has prevented, but it is likely in the millions. The global social-distancing effort has been “one of humanity’s greatest collective achievements,” Solomon Hsiang, the leader of the Nature study, said, in announcing the findings. “I don’t think any human endeavor has ever saved so many lives in such a short period of time.”

In this lecture, I will discuss the inner history of “flattening the curve” and how medical history informs the present.

To book your place please complete the registration form here.

Please contact Charlotte Thompson-Grant, PA to Professor Trish Greenhalgh, if you have any questions: charlotte.thompson-grant@phc.ox.ac.uk