Some stories are appealing, such as that the Roaring 20s was a celebratory reaction to the 1918 influenza pandemic, when it’s not clear that it was even related to the pandemic, especially since those “roaring” parties represented the activities of the white upper class, not everyone.1 And people seem to conveniently forget 1929 in imaginary nostalgia about the 1920s. The decade of the 1920s was a time before antibiotics when people often died of infections,2 there were subsequent deadly waves of flu throughout the 1920s,3 and smallpox was still a thing.4
The relationship between politics, governance, the political economy, and health is well known to public health — it’s called The Social Determinants of Health (SDOH).5
And that’s why I was a bit troubled by a post on social media where someone stated that a famine in Tanzania in 1918 was caused by survivors of the 1918 influenza pandemic getting “long flu” and being unable to do enough planting because of fatigue. This claim was included in a TIME article about Long Covid and Long Flu published in December 2020.6 It’s a provocative and enticing narrative, but famines are rarely caused by one thing and are almost always political — caused by military action, or a dictator’s decisions.7 It’s likely the 1918 flu pandemic did contribute to the “famine of corms” - how could it not when the flu associated with the 1918 pandemic was known for striking people in “the prime of life” with a peak mortality of age 28, speculated as caused by prior exposure in early life to the pandemic of 1889.8 But the truth is rarely simple. Regardless of why the H1N1 flu killed so many youths, of course it no doubt killed outright many of the productive farmers left in Tanzania, before you even consider long-term flu sequelae like fatigue. But before considering the effects of the pandemic in the region, it must be acknowledged that Tanzania was rocked with warfare and colonial rule for decades prior, massively killing and driving out the inhabitants for years.9 Famines in Tanzania spanned from 1917 to 1920, and it is well understood that “This famine came after both German and British military requisitions had drained the arid region of men, cattle and food.”10 It would not be surprising if the colonialist militaries were the carriers of flu to the region as well of course. Disease spread is rampant in war, including in modern times, such as has been reported in Gaza.11 The bottom line is, like practically all famines in history, there is a political cause.
It’s important not to erase or downplay the role of political decisions, such as colonial rule in Africa, just because it makes satisfying clickbait to highlight an issue in simple stories. No matter how compelling it feels, it’s counterproductive in the end. This enticingly neat story - claiming long flu caused a famine in Africa - it actually flattens the issue of Long Covid today in the West as well, since the effects of the pandemic and its sequelae - that’s also a political decision. It was a political decision that two administrations running things in the U.S. have failed to do a proper vaccination campaign.12 It was a political decision to drop funding of mitigations and supports, such as discontinuing Medicaid extensions13 and ending the insurance coverage of rapid home tests.14 It’s a political decision to fail to robustly fund long covid treatment research.15 It was a political decision, guided by business industry interests, for people with the power of leadership to eschew guidelines that could prevent the spread of infections.16 It was political decisions that have led to so many people becoming infected and so post-infection effects abound.
A political choice. Not inevitable.
So I think that focusing on ah-ha! stories that feel good to use to shout out “Look, post-infection sequelae are real!” is actually a red herring and the wrong place to invest energy if you want social change and solutions on Long Covid. It’s a placebo, and an inaccurate one too. People know when something is wrong. Many people understand very well that post-covid complications are to blame, even if they don’t say so publicly, as evidenced by a report that the former GOP Senator James Inhofe who retired because of Long Covid said that other colleagues have it too, but that they just don’t admit it.17 Like cats, the elected officials hide their illnesses out of a survival impulse18 - the fear of being preyed upon as weak in a society that, even if it’s often hidden under the surface, on some level morally embraces the pseudoscience of eugenics.19 At the least, people in charge know very well the ongoing pandemic is a politically inconvenient problem that they want to spin as fixed more than they want to fix it.20 Because, as has been said for decades, the PR firms promote crisis management that focuses on managing perception over solving problems.21 And so those people with power and money have agendas that incentivize them trying to keep everybody distracted and focused on trying to fight the denial, spend energy trying to convince everybody that there’s a problem, shouting into the “Hypernormalisation” social media void,22 instead of just moving forward confident in the right to pressure for solutions from the people who have the power to solve problems - elected representatives.23 The longer they can keep people stuck in pluralistic ignorance, believing wrongly that nobody agrees,24 the longer people are delayed in better organizing to this action.
The solutions are POLITICAL. Because government is about governance, and ultimately controls what happens or doesn’t in every area of society. We can’t wait to convince everybody.25 And the answer isn’t to blame some inevitable "natural" force, and so give cover to panicked elites doing the wrong things for the wrong reasons26 when the real causes are not inevitable and can be changed. We know who sets the rules - elected politicians. Let’s not be distracted by decoys and paper tigers.
"The ultimate, hidden truth of the world is that it is something that we make, and could just as easily make differently."
- David Graeber, The Utopia of Rules, 2015
References:
Smithsonian Magazine: What Caused the Roaring Twenties? Not the End of a Pandemic (Probably) by Lila Thulin - May 3, 2021 F. Scott Fitzgerald once described the 1920s as “the most expensive orgy in history.” Between quotes like that and canonical works like The Great Gatsby, the author has an outsized role in how the Roaring Twenties are viewed today. “I blame Fitzgerald for a lot of [misconceptions]” about the decade, says Lynn Dumenil, a historian who revisited the decade in her book The Modern Temper: American Culture and Society in the 1920s. In her class at Occidental College, Dumenil would show the feverish, champagne-fueled party scene in Baz Luhrman’s movie adaptation of Gatsby, as good an example as any of the “unnuanced” pop-culture vision of the decade as a flapper bacchanal*. “There’s this notion of the ’20s as a wild period where everyone is just grabbing everything they can get,” adds Nancy Bristow, history chair at the University of Puget Sound. This idea is broad-brush hyperbole of a reality that held true for only a certain class of Americans—not everyone.
Biden’s “new normal” on COVID is neither normal nor new By MARTHA LINCOLN - LORENZO SERVITJE - June 26, 2022 As only readers in their eighties or nineties will remember, Americans used to die easily and frequently from bacterial and viral infections such as pneumonia, influenza, and tuberculosis. In the late 1930s and early 1940s — just shy of the "Antibiotic Era" — these high rates of mortality from infectious disease diminished drastically, mostly due to decades' worth of public health interventions, including improvements in sanitation and hygiene. These achievements were bolstered by the ability to treat bacterial infections with an expanding arsenal of antimicrobial drugs. In just seven years — from 1943 to 1949 — Americans saw the age-adjusted death rate from influenza and pneumonia get cut in half, dropping from 101.7 deaths per 100,000 to 45.1 per 100,000.
American Journal of Public Health and THE NATION'S HEALTH - The Influenza Epidemic of 1928-1929 with Comparative Data for 1918-1919 * - Selwyn D. Collins - February 1930 It will be seen that since January 1, 1920, there have occurred six more or less definite epidemics. The epidemic of 1928-1929 was the most important since that of 1920. The peaks of these six epidemics occur all the way from the early part of January to the early part of May, and the peak of the pandemic of 1918-1919 occurred much earlier in the fall than was the case in 1928-1929.
Statista: Number of smallpox cases recorded in the United States from 1900 to 1952 The number of smallpox cases in the United States fluctuated between 1900 and 1930, with as many as 110,000 reported cases in 1920, however the number of cases fell sharply in the 1930s, and there were no cases at all in the United States from 1950 onwards.
KFF - Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity - Samantha Artiga and Elizabeth Hinton - Published: May 10, 2018 Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care.
TIME - What Long Flu Sufferers of the 1918-1919 Pandemic Can Tell Us About Long COVID Today - By Laura Spinney December 31, 2020 7:00 AM EST “The incapacity caused by the flu and its after-effects seriously affected the country’s economy for some time,” wrote Phillips in 1990, in Black October, his comprehensive study of the 1918 epidemic in South Africa. In what is now Tanzania, to the north, post-viral syndrome has been blamed for triggering the worst famine in a century—the so-called “famine of corms”—after debilitating lethargy prevented flu survivors from planting when the rains came at the end of 1918. “Agriculture suffered particular disruption because, not only did the epidemic coincide with the planting season in some parts of the country, but in others it came at the time for harvesting and sheep-shearing.”
PBS NEWS - How political and military conflict caused the return of famine Mar 3, 2018 ALEX DE WAAL: “Overwhelmingly the cause of famine is political and military action. We can have economic and climatic causes as secondary factors. But famine, starvation, is basically a political decision made usually in the context of war or a dictatorial government.”
Gagnon A, Miller MS, Hallman SA, Bourbeau R, Herring DA, Earn DJ, Madrenas J. Age-specific mortality during the 1918 influenza pandemic: unravelling the mystery of high young adult mortality. PLoS One. 2013 Aug 5;8(8):e69586. doi: 10.1371/journal.pone.0069586. PMID: 23940526; PMCID: PMC3734171. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889–90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death.
Jan–Bart Gewald (2008) Colonial Warfare: Hehe and World War I, the Wars Besides Maji Maji in South-Western Tanzania, African Historical Review, 40:2, 1-27, DOI: 10.1080/17532520902793254 In the years between 1860 and 1925 the inhabitants of what is currently the Iringa district in southwestern Tanzania experienced more than a fair share of warfare and armed violence, as well as political, economical, and cultural changes.11 In the first twenty years of colonial rule wide-ranging wars were fought in which the original inhabitants of the Iringa highlands were either killed or driven off the land and forced into servitude with settlers.
Mtunya: Famine in Central Tanzania, 1917–20 - Published online by Cambridge University Press: 22 January 2009 Gregory Maddox Affiliation: Texas Southern University In the Dodoma Region of central Tanzania the people called Wagogo name a famine that struck between 1917 and 1920 the Mtunya—‘The Scramble’. This famine came after both German and British miliary requisitions had drained the arid region of men, cattle and food. The famine, which killed 30,000 of the region's 150,000 people, is more than just a good example of what John Iliffe has called ‘conjunctural poverty’. The Mtunya and the response to it by both the people of the region and the new colonial government also shaped the form of the interaction between local economy and society and the political economy of colonial Tanganyika. The Gogo, in their own interpretation of the famine, stress the ways in which this famine made them dependent on the colonial economy. For them, this famine represented a terrible loss of autonomy, a loss of the ability to control the reproduction of their own society.
CIDRAP - Worrying disease trends in Gaza, avian flu expansion, more dengue in Florida - News brief - November 8, 2023 - Lisa Schnirring Worrying trends are already emerging regarding the rapid spread of infectious diseases in Gaza, owing to intensifying hostilities, intense overcrowding, and disruptions in healthcare, water, and sanitation, the World Health Organization (WHO) said today. Since mid October, 33,551 cases of diarrhea have been reported, more than half in young children, a steep rise compared to the 2,000 monthly cases typically reported in Gaza in the age-group over the past 2 years. Nearly 9,000 cases of scabies and lice have been reported, about 12,600 cases of rash, and nearly 55,000 upper respiratory infections, the group said. Other problems include disruptions in vaccination and disease surveillance and struggles to maintain infection prevention and control practices in healthcare facilities. The WHO repeated calls to ramp up humanitarian aid and for all parties in the conflict to abide by humanitarian law.
People's CDC - Statement on FDA’s proposal for once a year COVID vaccination Published January 25, 2023 Public Comment by Rob Wallace, PhD, submitted to the FDA’s Vaccines and Related Biological Products Advisory Committee regarding the future vaccination regimens addressing COVID-19. Secondly, the rationale here behind simplifying the vaccine schedule is all wrong. It isn’t the present scheduling that keeps booster coverage at a little over 16% of eligible Americans. It’s the insistence in declaring a still rapidly evolving pandemic over and ending all those programs that would have helped vaccination programs succeed. The success of federal pharmaceutical campaigns depends on the NPI campaigns going door-to-door that two administrations running dropped.
MedPage Today - I'm Sorry, Your Patient No Longer Has Medicaid Coverage — Too many kids are still suffering the consequences of the Medicaid "unwinding" by Valerie Smith, MD, MPH December 29, 2023 Nationally, over 3.2 million children have lost coverage to date and, here in Texas where I practice, more than 835,000 children are no longer insured through Medicaid. What is most alarming is that 71% of the disenrollments are for procedural reasons, such as paperwork that hasn't been returned, computer program errors, or not receiving mailed notifications because a family moved during the pandemic. Many, if not most, of these children are likely still eligible for Medicaid and should be enrolled.
KFF - The End of the COVID-19 Public Health Emergency: Details on Health Coverage and Access Cynthia Cox, Jennifer Kates, Juliette Cubanski, and Jennifer Tolbert Published: Feb 03, 2023 After May 11, 2023, people with traditional Medicare will no longer receive free, at-home tests. Those with private insurance and Medicare Advantage (private Medicare plans) no longer will be guaranteed free at-home tests, but some insurers may continue to voluntarily cover them.
The Sick Times - Q&A: Eric Topol on Long Covid clinical trials, RECOVER funding, what he’s looking forward to in 2024 Posted by Betsy Ladyzhets – January 2, 2024 Eric Topol: “So, I think there are some smart ways to get at this. But unfortunately, we haven’t seen any major pharma prepared to get into it at this point. We are going to try to get drugs out of these major pharma companies, which we think have tremendous promise, and for which they have not initiated trials, for one reason or another. We would probably have to hold the IND [Investigational New Drug application] ourselves, because they don’t want to take the risk. We know there are some agents that have promising features to test, but unfortunately, our enthusiasm is not shared by the pharma companies who make these drugs.”
CDC made medical guidelines please Delta Airlines, and now lots of people work sick and contagious in every industry - Chloe Humbert · Jan 10, 2024 Delta Airlines sent a letter to the CDC on December 21, 2021 complaining that the 10 day isolation guidelines were interfering with their operations because of people being off sick too often. Instead of better infection control, stopping the spread among staff, or hiring more staff to cover the “new normal” of everyone getting covid on the job all the time, they instead asked the CDC to reduce the isolation time recommended. On December 27, 2021, the CDC complied with Delta Airlines request and reduced the guideline for isolation down to 5 days.
Business Insider : Former GOP Senator James Inhofe retired because of long COVID symptoms. Other colleagues have it but keep it secret, he said. by Isobel van Hagen Feb 26, 2023 He said “five or six” other political colleagues have long COVID, “but I’m the only one who admits it.” Inhofe left office before the end of his term last February, and Senator Markwayne Mullin took his place. The 88-year-old repeatedly voted against COVID protections for Americans during his time in office. In March 2020, Inhofe voted against the Families First Coronavirus Response Act, which broadly expanded benefits for those affected by the pandemic. In 2021, he also voted against the American Rescue Plan — which included a $1,400 stimulus check, improved vaccine distribution, and extended unemployment benefits. He did, however, vote in favor of the CARES Act — which offered a $1,200 stimulus check — and generally offered conflicting opinions on the pandemic during his time in office.
Texas A&M School of Veterinary Medicine & Biomedical Sciences - When is your cat hiding illness or injury? - September 14, 2017 We do our best to take care of our feline friends, but sometimes signs of pain and sickness go unnoticed. Dr. Stacy Eckman, clinical assistant professor at the Texas A&M College of Veterinary Medicine & Biomedical Sciences, described feline behavior that could mean a cat is hiding an illness, injury, or other underlying health issue. “Cats tend to hide their symptoms, which is probably due to survival instinct,” Eckman said. “Most signs of illness or injury are subtle, including sleeping more than normal; not getting up to greet you, if that is normal behavior; or laying and sleeping in the same position for long periods of time.” Other changes pet owners should be aware of include the cat withdrawing or being reluctant to be petted. Changes in litter box habits and vomiting can also indicate underlying issues.
Eugenics as an ideology Legal and political agendas have motivations to make semantic arguments that obscure eugenics and maybe that’s why we don’t have a separate word for eugenics as an ideological belief. CHLOE HUMBERT NOV 30, 2023 The proponents of this type of eugenics claim that they are leaving it up to “nature” or, alternately, specifically a divine power, depending on their religious or secular orientation. The point is to stop any intervention that would save people they think are “weak” or “undeserving” in some way as inappropriately countering the superior “nature” to do its thing. This includes resistance to all public health measures like masks, vaccines, food assistance, healthcare equity, or even disaster relief and universal education in public schools. Never mind that interventions are natural too, because humans do them, the same way birds build nests, but clearly people draw the line on “natural” wherever it’s convenient to their purpose.
The Wrong Impact Research - Chloe Humbert · Jun 25, 2023 “IMPACT RESEARCH” is some kind of PR firm that seems to be guiding Democratic party elected representatives on the pandemic issues to prioritize business and industry over human health. They basically suggest Democrats stick to messaging it’s no biggie, and nothing substantive….
Toxic Sludge is Good for You, documentary, 2002 “In today’s corporate culture major PR firms promote crisis management as a necessary business expense. Whenever something bad happens to a corporation, often its first move is not to deal with the actual problem, but to manage the negative perception caused by that problem.”
Hypernormalisation Documentary, 2016, by Adam Curtis ”The liberals were outraged at Trump. But they expressed their outrage in cyberspace so it had no effect. Because the algorithms made sure that they only spoke to people who already agreed with them. Instead ironically their waves of angry messages and tweets benefitted the large corporations who ran the social media platforms. one online analyst put it simply — angry people click. It meant that the radical fury that came like waves across the internet no longer had the power to change the world. Instead it became a fuel that fed the systems of power making them ever more powerful.”
Writing Letters to Elected Representatives, a guide Letters to politicians are some of the easiest and most effective actions many neglect. CHLOE HUMBERT JAN 24, 2023 They often keep tallies in spreadsheets and track issues. So it’s not just your lonely voice, each person who writes really makes a larger difference than you might expect from one person. Pressure on elected government officials with letter campaigns have shaped the laws that govern our lives and protect us from lies and harm, such as car seat belt laws and even the rule that peanut butter has to be made of peanuts and not full of additives!
Pluralistic ignorance From Wikipedia In social psychology, pluralistic ignorance refers to a situation in which the minority position on a given topic is wrongly perceived to be the majority position or where the majority position is wrongly perceived to be the minority position.
Don’t wait for everybody before speaking up. CHLOE HUMBERT AUG 8, 2023 We don’t need to wait for most people to agree with us, we just need those who do, to speak up and push forward.
Elite Panic. Big shots have different goals than the rest of us. Politicians should be representatives, businesses shouldn’t lead, even billionaires can’t seem to buy common sense, and tech won’t save us. By Chloe Humbert, JUL 13, 2023 The people in high places and big positions will never panic over the right things - they do elite panic. Left to their own devices, people in charge panic over the wrong things & try to fix things other than the actual crisis because they’re often more concerned with their own position within the status quo, and are more concerned about the upheaval of the status quo, than the damage that upheaval is causing.