From the Great Influenza to COVID-19: Epidemics of Scale through a Historical Lens

Abstract

COVID-19 has galvanized changes in the economy of patient-doctor relationships and technological interfaces across the healthcare system. A rapid adoption of technologies that were previously slow to take hold opened more diverse and accessible spaces for care. At the same time, some persistent barriers in pivoting to scientific-medical advances in managing the pandemic revealed stark inequities in both access to care and exposure to risk. Political and organizational responses to the crisis often excluded the perspectives of vulnerable groups bearing more burdens than others. Some patients and healthcare providers suffered in isolation, however these experiences have escaped public attention due to the fragmented Canadian health information infrastructure.

The social meanings of and collective responses to the pandemic nationally are rooted in historical developments. Comparative analyses of epidemic crises along with their consequences have the potential to inform our critical evaluations of problem-solving approaches and policymaking when what we do not know about the issue exceeds what we know. This article demonstrates that historical analysis serves an important role in examining the complex interaction of social and biological forces that constitute epidemic disease. By linking the past and present of epidemic crises we can better understand how social and scientific-medical responses to epidemics shift following the epidemic experience. To be forewarned is to be forearmed acquires a definite meaning as historical contexts set a background for assessing new situations. The COVID-19 pandemic has not emerged out of thin air, so tracing its origin and development is simultaneously a scientific and an historical undertaking.