Past the Virus - The Evolution of Public Health

They established and deployed several types of measures that proved to be somewhat effective, and that were ironically later reactivated by other governments in subsequent epidemics, even though with less efficacy. 

Perhaps the greatest influence of a microbial agent over a governmental public health policy comes from the cholera pandemics in the 19^th century. Historians commonly agree on their major role in encouraging and enabling the British sanitary movement. Conceptualized in the 1830s and deployed until World War 1, this movement was largely carried out by Edwin Chadwick, a former barrister who drove the New Poor Law (1834). Thereafter, he carried out highly detailed studies of the health of the English people. His findings were published in a document known as the Sanitary Report (1842). It described the poor level of population health in England, and how it had been deteriorated by the industrial and urban transitions (in part through cholera outbreaks). Its psychological impact on the public was so great that it gave Chadwick sufficient political momentum to push for another set of legislative actions against filth across the country. These acts increased the power of the state to deal with microbes and diseases, even if germs had not been formerly identified and even if theories about diseases were mostly false. From that point on, many infrastructural aspects of English towns and cities changed, the country became cleaner and health indicators such as infant mortality and even life expectancy continuously improved for decades after. 

Covid-19: a turning point in public health policy

This brings us to the current period. Will the Covid-19 pandemic be remembered by historians as pivotal in the way governments manage public health? In the short term, the answer can easily be positive. States have already heightened their level of leadership over population health since the beginning of the crisis.

Most stimulus plans designed by governments or the European Union are actually environmental transition programs. They aim to mitigate pollution and to curb greenhouse gas emissions, threats that are absolutely existential though they have very little to do with Covid-19. The virus is an emerging pathogen that - putting aside the hypothesis that it could originate from a laboratory leak - is closely linked to the pressure exerted on species. It is not directly caused by CO₂, nor climate change. But the brutality and the intensity of the pandemic seem to have triggered a much broader awareness. In that respect, Covid-19 may be on the way to launching a novel sort of global sanitary movement that goes well beyond the sole purpose of combating the virus. 

Shortly after the onset of the pandemic, Western states claimed that they would prioritize health over the economy, invest in microbial science and technologies, mitigate greenhouse gas emissions, and activate reliable levers to move toward greener societies in general. If they succeed, the current pandemic will have been a starting point for a huge change in the approach to governmental public health in the broadest sense. If they fail to do so, then we’ll have a bigger problem than the pandemic itself. 

Copyright: Ernesto BENAVIDES / AFP