Florence Nightingale (1820–1910) was an early and persistent advocate of the best means to prevent the spread of infectious diseases – frequent handwashing – calling for it in her 1860 Notes on Nursing and adding details on the use of disinfectants in later writing. She was a pioneer of evidence-based health care, from the lessons learned from the high mortality rates of the Crimean War (1854–56). NHS England, in giving the name “Nightingale Hospital” to seven temporary hospitals for Covid-19 patients, is recognizing Nightingale’s relevance to combatting infectious diseases.
At the end of March 2020, in an interview with the BBC, Ellen Johnson Sirleaf, the former president of Liberia, spoke about the 2014-16 Ebola outbreak in West Africa, which killed almost 5,000 Liberians. “Fear drove people to run, to hide, to hoard to protect their own,” she said, “when the only solution is, and remains[,] based in the community”. These wise words take on new resonance in the face of the coronavirus outbreak.
I’m writing this article from the country with more confirmed Covid-19 cases than any other – the US. At the time of finishing my first draft (Monday, 6 April 2020) there were 336,830 confirmed cases. Almost no one, however, believes that this number reflects the true number of Covid-19 cases. Due to the US’s limited testing capacity, we suspect there are cases that have escaped the attention of authorities.
Pandemic swine-flu, which emerged from Mexico in spring 2009, was a wild thing but a mild thing: H1N1 claimed fewer than 500 lives in the UK.1 Nonetheless, the severity of its third wave in winter 2010/11 alarmed intensive care specialists.
On 31 December 2019, the World Health Organization (WHO) was alerted to an unusual cluster of pneumonia patients in the city of Wuhan, China. Clinical signs and symptoms included fever and breathing difficulties; chest radiographs revealed invasive lesions of both lungs. Some of the early patients were vendors in Wuhan’s Huanan seafood wholesale market, where live wild animals were also being sold illegally, and where the new disease is suspected to have originated.