FESTIVAL DELLA SCIENZA MEDICA
LESSONS FROM MEDICINE
Although it was not, nor will be a “Big One”, the Covid-19 pandemic could – if new clusters of infection continue to reappear, and if we fail to adopt a more rational approach – cause economic and social damage comparable to the worst epidemics in history, like the Black Death of the 14th century, and the so-called Spanish Flu of 1918-19.
Since the 1970s, infectious disease experts had been expecting a new devastating worldwide influenza pandemic or a deadly, highly transmissible infection from among the dozens of very infectious “emerging” viruses that since 1981–82 – when AIDS/HIV first appeared – have passed from wild animals to man in different parts of the world. What has emerged is this strange beast, which first evolved in bats and perhaps in a few intermediary hosts to then infect our species where it has been able to circulate very effectively and practically unnoticed in some 80% of those infected – provided they are in good health and enjoy some genetic protection – create some clinical discomfort in a further 15%, and threaten the lives of the remaining 5%, namely the elderly, very elderly and/or people with co-morbidities.
The Covid-19 pandemic raises several considerations regarding both the history of our healthcare systems and our social psychology. First, the vulnerability of complex societies to only relatively lethal infections – as Covid-19 in fact is – may well be due to imbalances in our healthcare system. In other words, a system geared increasingly to the management of chronic degenerative diseases should not find it itself unprepared for, or at worst, be a vehicle aiding the spread of a virus like SARS-CoV-2.
The vulnerability of complex societies to infectious diseases also depends on social perceptions. Today mortality rates, so far, much lower than the norm for various other influenza pandemics – not to mention Spanish Flu – have struck inordinate terror in a society no longer familiar with the (relative) mortality and contagion rates of diseases spread by physical contact.
Other questions concern how different political and institutional policies responded, and the extent to which they have been negatively impacted by the pandemic. The constant referrals to the Chinese or South Korean models, and the irritated reactions before the Swedish approach all show our inability to keep a sense of reality in our assessment of global scenarios.
The question can rightly be asked whether the dialogue between the political and scientific world did in fact lead to better management of the emergency. The trust placed in mathematical models can hardly be considered to have improved the efficacy of public-health policies; it only fuelled panic and hypnotized the population.
Problems also emerged regarding consensus within the medical community over carefully investigated virology theories, evidence-based clinical practice and the validation of experimental clinical treatments.
Once a decision is taken to manage a pandemic using paternalistic, technocratic and terror tactics, backtracking proves difficult. Indeed, this is perhaps the most severe risk factor Western societies now face: not Covid-19 as such but rather a much more contagious paranoia that justifies economic paralysis, social segregation and illiberal policies that strike at the heart of the West, with devastating consequences for the achievements our societies have made.
The sixth edition of Festival della Scienza Medica will take a close look not so much at our successes but rather explore the critical issues raised by the Covid-19 pandemic, drawing useful lessons to improve the way in which medical science and society work together.
Scientific Director, Festival della Scienza Medica