Doctor's Casebook: Dr Keith Souter - Lessons to learn from history

Meanwhile it is of course vital that we all continue to take the precautions as advised by the government and the NHS to wash hands, use masks and maintain social distancing.

It will be interesting to see if we can learn from the lessons of history in our attempts to control Covid-19. Research has just been published from McMaster University, looking at what we can learn from the waves of smallpox epidemics in London, by viewing weekly records of deaths in the capital between 1664 and 1930. Incredibly, those records date from the days when Samuel Pepys was writing his diary.

There are only two infectious diseases that have ever been eradicated globally. Smallpox, which affects humans, and rinderpest, which affects cattle and other ruminants. Smallpox had been a huge problem for many centuries, with a mortality rate of 40 per cent. Those who survived could be left blind or disfigured for life. The year 2020 marked the 40th anniversary of its official eradication.

These London records give a quite remarkable opportunity to see what patterns can be teased out from the data when the timeline of historical events is laid alongside them.

First, we see that variolation, a process of deliberately infecting individuals with the disease by giving them powdered skin lesions as snuff, had a large reduction. I have written previously about how this was introduced by Lady Mary Wortley-Montagu. Secondly, came Dr Edward Jenner’s discovery of vaccination, which was far safer and saw a huge reduction in the numbers of deaths.

Incredibly, the scientific establishment was sceptical about Jenner’s work, so he actually by-passed the Royal Society and published a pamphlet. This seemed to persuade people to have the vaccination.

From the analysis these measures look as if they made eventual eradication possible, but they did not do it alone. Public health measures and pubic response to them seem to have reduced the frequency of epidemics decade by decade.

So, it suggests that we must strive to learn the lessons from history, which means we need to continue to do our bit by obeying the mantra, wash hands, cover face and maintain space.